It’s a terribly sad thing to say, but this one is about a condition that’s been called the suicide disease: a grim reflection of the pain and hopelessness a person can feel when they suffer from Trigeminal Neuralgia, which may render even a light breeze or the simple act of cleaning one’s teeth unbearably painful. Trigeminal neuralgia is a rare but devastating pain disorder that affects the trigeminal nerve (cranial nerve V), the major nerve that supplies sensation to the face. Though estimates of its prevalence sit at just 0.16 to 0.3 per cent of the population, its impact on those who live with it can be profound. Women are three times more likely to develop the condition than men, and the risk increases significantly after the age of 50. [1]
The condition is marked by sudden, severe, electric shock-like pain in the face. These episodes can be triggered by seemingly harmless activities like applying makeup, shaving or the slightest air movements. Attacks may last only seconds or minutes, but their intensity can be overwhelming. In some cases, the pain occurs on both sides of the face, further complicating diagnosis and treatment.
At present, the exact cause of trigeminal neuralgia is not fully understood and remains a case for further research. One leading hypothesis is compression of the nerve by nearby blood vessels as they exit the brainstem. [2] Risk factors include prior head or facial trauma, high blood pressure, multiple sclerosis, stroke, genetic factors, and age over 37.[3]
As the exact cause or causes haven’t been nailed down firmly in research, it stands to reason that management is not as targeted as it could be. Mainstream management usually involves anticonvulsant medications or, in more resistant cases, surgical procedures to decompress the nerve. While these interventions can be effective, they often carry significant side effects or risks. For some patients, these approaches fail to provide lasting relief.
This reality has spurred interest in complementary or conservative approaches, including chiropractic care. While we don’t have larger studies specific to the condition, we do have a growing tranche of case reports indicating cases of Trigeminal Neuralgia resolving or improving significantly under chiropractic care. [4, 5] Why would this be? We can only speculate, but point to the mere fact that chiropractic care is nervous system care. And Trigeminal Neuralgia is a nervous system problem in its simplest form.
One case in the Asia Pacific Chiropractic Journal pointed to chiropractic management and upper cervical chiropractic care, which may point to the brain stem hypothesis of Trigeminal Neuralgia. [6] Another study in the Journal of Contemporary Chiropractic indicated craniocervical posture may have contributed to the individual case in the study. [7] With such massive nerve supply through the cervical spine, this traditional research tie-in may indeed be one research rabbit hole worth diving down.
A new case from clinical practice
Turning to a new case recently published in the Asia Pacific Chiropractic Journal, we now look at another case from clinical practice, one where other modalities had failed to bring relief – that of a 72-year-old woman who sought chiropractic care after living with trigeminal neuralgia for four years.
Her pain began as what felt like a toothache, eventually escalating into bouts of excruciating facial pain that returned every six months despite medical intervention. She had been prescribed pain medications but found herself still suffering, with her daily activities severely curtailed. Even the simple act of brushing her teeth or touching her face triggered unbearable discomfort.
In addition to the neuralgia, she reported chronic stiffness in her left shoulder, a history of frozen shoulder, and ongoing neck pain and headaches. Sleep was restricted to just five hours per night. At presentation, she was heavily reliant on painkillers and concerned about the side effects of long-term pharmaceutical use.
Her chiropractic examination revealed antalgic posture with a right head tilt and lowered right shoulder, reduced cervical range of motion, and muscle weakness across several areas. Blood pressure was high (185/93), and balance testing showed asymmetry. Her Bournemouth Questionnaire score—a measure of disability related to neck and back pain—was 43 out of 70, indicating significant impairment.
Thermography scans confirmed consistent signs of nervous system dysfunction. Importantly, palpation of the face was painful, ruling out some types of neurological testing.
The Upper Cervical Chiropractic Approach
Her care plan used the Knee Chest Upper Cervical Specific technique. This protocol included:
- A pre-rest period to allow body temperature to stabilize for accurate thermography scans.
- Thermographic scans to assess from T1 to the occiput.
- An upper cervical adjustment if indicated.
- Rest and recovery in a darkened room, often in a supine “zero-gravity” position.
- A post-care thermography scan to monitor changes.
She attended 36 visits over four to six months, beginning at twice weekly, then tapering as her progress stabilised. Re-examinations occurred every 12 visits, tracking both subjective changes (pain, sleep, ability to perform daily activities) and objective findings (posture, muscle strength, blood pressure, balance, and thermography).
Outcomes:
At her first re-examination (12 visits), she reported reduced facial pain, less neck stiffness, and improved shoulder mobility. Objectively, her posture was better, cervical range of motion increased, arm strength improved, balance equalized, and blood pressure normalized.
By the 24th visit, she noted further reductions in facial pain and a return to daily chores. Her chiropractor documented continued improvements in posture, muscle strength, and spinal balance.
At the final review (36 visits), her progress was remarkable. Facial pain had largely subsided, her Bournemouth Questionnaire score dropped from 43 to 2, and thermography scans showed sustained neurological improvement. Importantly, she was now able to sleep through the night, engage socially, and resume activities with her family.
Given the severity of her initial state—where even combing her hair or brushing her teeth was unbearable—this turnaround represented a dramatic improvement in quality of life.
Why does this matter?
For patients with trigeminal neuralgia, life can be a cycle of fear and avoidance. Triggers are unpredictable, treatments often unsatisfying, and the emotional toll immense.
In this context, the improvements seen with chiropractic care in this case are not trivial. While it represents a single patient and should not be generalised without further study, it highlights the possibility that conservative care focusing on nervous system function, posture, and subluxation may provide meaningful relief for those left behind by mainstream approaches.
Of course, there are limitations. Case reports, while powerful for hypothesis generation, cannot prove causation. Some of the clinical measures used, such as muscle testing, are open to subjective interpretation. This patient also missed some appointments, affecting care consistency. More comprehensive neurological testing could have deepened the picture, but was limited due to her pain levels.
Nevertheless, this case aligns with other reports where chiropractic care, particularly targeting the upper cervical spine, has helped patients with facial pain syndromes. For a condition where even the most advanced medical interventions do not guarantee remission, the idea that chiropractic may offer hope deserves serious exploration.
Trigeminal neuralgia is a condition that disrupts lives at the most basic level. Current medical approaches remain invasive, pharmaceutical, and often incomplete. While research on chiropractic care for trigeminal neuralgia is still sparse, individual cases like this one demonstrate tangible improvements in pain, function, and quality of life.
For practitioners and patients alike, the message is clear: more research is needed. If chiropractic care can provide relief without long-term dependence on medication or risky surgical interventions, then it could represent a valuable, conservative option for people with this debilitating condition.
For the woman in this case, chiropractic was not just another treatment attempt. It was the first intervention to offer lasting change and restore her ability to live fully again. That is a story worth paying attention to.
Reference
- Katusic, S., Beard, C. M., Bergstralh, E., & Kurland, L. T. (1990). Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945–1984. Annals of Neurology, 27(1), 89–95.
- Maarbjerg, S., Gozalov, A., Olesen, J., & Bendtsen, L. (2017). Trigeminal neuralgia – a prospective systematic study of clinical characteristics in 158 patients. Headache, 54(10), 1574–1582.
- Love, S., & Coakham, H. B. (2001). Trigeminal neuralgia: Pathology and pathogenesis. Brain, 124(12), 2347–2360.
- Meyers M, Jordahl J, Johnson K, Riddle R. CHIROPRACTIC MANAGEMENT OF PATIENT WITH TRIGEMINAL NEURALGIA: A CASE REPORT. JCC. 2022;5(1):82-84.
- Meyers M, Vozar A, Jordahl J. CHIROPRACTIC MANAGEMENT OF PATIENT WITH ATYPICAL PRESENTATION OF TRIGEMINAL NEURALGIA: A BRIEF REPORT. JCC. 2022;5(1):243-245.
- Rai S, Postlethwaite R, McIvor C. Reduction in Trigeminal Neuralgia, and increase in muscle function and Quality of Life in 72-year-old female: A case report. Asia-Pac Chiropr J. 2025;6.1. www.apcj.net/papers-issue-6-1/#RaiTrigeminalNeuralgia
- Berry R, Oakley P, Harrison D. IS ONE CAUSE OF TRIGEMINAL NEURALGIA SUBLUXATION OF CRANIOCERVICAL POSTURE? JCC. 2020;3(1):28-35.
