Facial pain treatment

Older man speaking to doctor about facial pain.

​Neurosurgeons at The Christ Hospital Health Network offer the latest treatments for facial pain, including trigeminal neuralgia types 1 and 2 (TN1 and TN2). We will work with you to develop the treatment plan that best suits your condition and needs.

Advanced treatment for facial pain from trigeminal neuralgia 

Trigeminal neuralgia (TN) is a progressive disorder that can sometimes cause excruciating, worsening pain. Over time, it can even become resistant to medicines. People with TN may choose complementary therapies like acupuncture and biofeedback.

Medicines to treat facial pain 

Anticonvulsant medicines that block nerve function usually are effective for TN1 but are less effective for TN2. Certain antidepressants, such as amitriptyline or nortriptyline, can treat the pain as well. 

Medicines may stop relieving pain or cause significant side effects such as memory loss, excess tiredness, bone marrow disorders and allergies. If this happens, your doctor may recommend a surgical treatment. 

Surgery to treat facial pain

The neurosurgical procedure you may have for trigeminal neuralgia depends on the type of pain and your overall health. Some surgeries for TN are outpatient procedures, while others may require a hospital stay. You may have some facial numbness after the procedure and sometimes TN returns. 

Risks of TN surgery include:

  • Balance problems

  • Hearing loss 

  • Infection 

  • Numbness in face

  • Stroke (rare)

  • Weakness in facial muscles

Surgical procedures include:

  • Balloon compression—a catheter (small hollow tube) guides a tiny balloon to the area for treatment. The balloon inflates and keeps pain signals from getting through to the brain. The effects of this outpatient procedure last about two years.

  • Glycerol injection—an intravenous procedure that uses a naturally occurring carbohydrate to disable the trigeminal nerve fibers temporarily. The effects of this outpatient procedure last one to two years but may be repeated as needed.

  • Microvascular decompression (MVD)—this is the most invasive of all surgeries for TN, but it offers the lowest probability that pain will return. During this inpatient procedure, a small cushion is placed between the trigeminal nerve and the blood vessel touching it and stops the pain message to the brain. It usually does not produce numbness like other procedures. Pain relief is often immediate, however recovery may take several weeks.

  • Radiofrequency thermal lesioning (also known as RF ablation)—a catheter (small hollow tube) guides a small needle to the trigeminal nerve. An electric current passed though the needle heats the nerve fibers. Effects last about three to four years, with about half of patients experiencing a recurrence of TN symptoms.

  • Rhizotomy—a type of nerve block that purposely damages nerve fibers to block pain. Rhizotomy always causes some loss of facial feeling and numbness. 

  • Stereotactic radiosurgery—a radiation beam is used to treat the area where the trigeminal nerve exits the brain. Although results are often very good, patients may not experience symptom relief for several weeks. About half of patients have symptoms return in about three years.

Complementary therapies to treat facial pain

Some people choose to manage trigeminal neuralgia with nonsurgical treatments, which are often combined with medicines. The success of these therapies may vary, depending on your condition. 

They include:

  • Acupuncture—uses small needles placed on specific points of the face to reduce pain.

  • Biofeedback—a mind-body technique that gives patients the skills and control to lessen their pain. 

Learn about facial pain care at The Christ Hospital Health Network.