Trigeminal Neuralgia Relief: New Treatment Options and Practical Steps
Hi — I’m Dr. David Kulla from Synergy Wellness in New York City. In my video “Trigeminal Neuralgia – NEW Treatment Options,” I explain what trigeminal neuralgia is, discuss common causes, and share a non-drug treatment approach that can provide relief for many people. Below, I walk you through the condition in plain language, explain conventional and emerging techniques, and give clear, practical steps you can try or discuss with your clinician.
What is trigeminal neuralgia?
Trigeminal neuralgia is a neurological condition that produces sudden, sharp, electric-like pains in the face. It involves irritation of the trigeminal nerve, the major sensory nerve for the face. The nerve begins near the ear and splits into three branches: ophthalmic (around the eye and forehead), maxillary (across the cheek), and mandibular (along the jaw). The condition most often affects one side of the face and is more common after age 40.
Common causes and triggers
Several mechanisms can cause or trigger trigeminal neuralgia symptoms:
- Vascular compression: A blood vessel presses on the trigeminal nerve root (vascular compression), producing repeated irritation.
- Jaw and dental factors: Bruxism (teeth grinding), TMJ dysfunction, or jaw misalignment can create muscle tension, spasm, and inflammation that irritate the nerve.
- Trauma: Concussive injuries to the head, neck, or upper back can damage nerve pathways in the brainstem or spinal cord. Symptoms may appear immediately or months to years later.
- Dental procedures: Some people notice the condition after fillings, root canals, or other dental work — sometimes because the nerve pain mimics tooth pain.
How trigeminal neuralgia typically presents
The pain often feels like a quick, stabbing “needle” prick or electric shock. It may come on spontaneously or be triggered by light touch, chewing, shaving, or talking. Because the pain can feel intense, many people initially think it’s a tooth problem and seek dental care — sometimes even having teeth removed unnecessarily.
Diagnosis and tests
If you suspect trigeminal neuralgia, a medical evaluation is essential. Your clinician may recommend:
- Neurological exam to check sensory changes and reflexes.
- An MRI is needed to look for vascular compression or other structural causes.
- Referral to a neurologist or neurosurgeon when imaging suggests nerve compression, or a chiropractor equipped with cold laser therapy.
Conventional medical treatments
First-line medical therapy usually involves anticonvulsant medications that reduce nerve firing. Carbamazepine (brand name Tegretol) is commonly used and can be very effective for many patients. However, medications have side effects and should be reviewed with your prescriber. If you don’t see benefit within a short trial (a few weeks to a couple of months), you and your doctor should reassess.
Cold laser therapy as a non-drug option
At Synergy Wellness, we’ve had success using cold (low-level) laser therapy to reduce inflammation around the trigeminal nerve and provide relief from trigeminal neuralgia. The goal is to calm the irritated nerve root and surrounding tissues. Cold laser can be beneficial when symptoms are recent or when patients want to avoid systemic medication side effects.
Practical laser application points
If you have access to a clinical or home cold laser device, the following treatment points cover the trigeminal nerve branches and the nerve root area. (Always follow device instructions and consult a clinician when in doubt.)
- Top or in front of the ear — where the trigeminal nerve wraps above the ear.
- In front of the ear and down along the mandible (jawline).
- On the cheekbone and slightly inward toward the sinus if symptoms involve that region.
- Up at the temple if the ophthalmic branch (around the eye) is painful.
- Behind the ear, pointing upward under the skull toward the brainstem to address the nerve root region.
Some home lasers allow higher-frequency settings (for example, 1,000 Hz). Daily treatments over several days can produce rapid improvement in some people — in our cases, we’ve seen substantial relief within a few sessions when treatments are applied to the correct areas.
Important caution about dental extractions
Because trigeminal neuralgia can mimic tooth pain, people sometimes undergo unnecessary tooth extractions. If your dentist says a tooth is healthy, consider trusting that opinion and seeking a neurological evaluation before removing teeth for pain that seems atypical. If needed, get a second dental opinion — but be aware that trigeminal neuralgia can look like dental pain.
When to see a specialist
See a neurologist or neurosurgeon if:
- Your pain is severe, recurrent, or getting worse.
- Imaging suggests vascular compression or another structural cause.
- Medications, chiropractic, and low-level laser therapy are ineffective or intolerable.
Surgical options (microvascular decompression, percutaneous procedures, or radiosurgery) exist for refractory cases and are discussed with patients when conservative measures fail.
Research & further reading
- National Institute of Neurological Disorders and Stroke (NINDS) — Trigeminal Neuralgia: https://www.ninds.nih.gov/health-information/disorders/trigeminal-neuralgia
- Accessible review: Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G. Trigeminal neuralgia. Lancet Neurol. 2017 — a clinical review (search “Maarbjerg trigeminal neuralgia Lancet Neurol 2017” on PubMed).
- On low-level laser therapy and neuropathic pain: search PubMed for “low-level laser therapy trigeminal neuralgia” to find clinical case reports and small trials describing LLLT use for facial nerve pain.
Conclusion
If you’re reading this because you or someone you care about is dealing with sharp, shock-like facial pain, know that trigeminal neuralgia is treatable. For many people, conservative measures — including careful evaluation, medication trials, and non-drug approaches such as cold laser therapy — can provide meaningful trigeminal neuralgia relief. If you have neck stiffness, headaches, or a history of trauma along with facial pain, mention these to your clinician because they can be important clues. If you have questions about the specific laser approach I use at Synergy Wellness, or to schedule an evaluation, you can contact our office: 212-533-4900 for a consultation.
FAQ
What exactly does trigeminal neuralgia feel like?
It usually feels like a sudden, sharp, electric shock or stabbing pain on one side of the face. Attacks can last for seconds to minutes and may be triggered by touching the face, chewing, speaking, or even a breeze.
Can trigeminal neuralgia be cured?
Some causes, like a blood vessel compressing the nerve, can be addressed surgically (microvascular decompression) and may provide long-term relief. Other patients find effective symptom control with medications or non-drug treatments, including cold laser therapy.
Is cold laser therapy safe, and are there side effects?
Cold (low-level) laser therapy is noninvasive and generally well tolerated, with minimal reported side effects when used properly. Always follow device guidelines and seek clinician guidance for treatment over the skull or near the eyes.
How quickly can I expect trigeminal neuralgia relief with laser therapy?
Response varies. Some patients experience measurable improvement within a few days of daily treatments; others need more sessions. If you don’t improve after a short trial, re-evaluate with your clinician about alternative therapies.