What is Trigeminal Neuropathy?

Trigeminal neuropathy is a condition involving damage to the trigeminal nerve, which provides sensation to the face. Unlike trigeminal neuralgia, which causes sudden sharp pains,
trigeminal neuropathy tends to produce more constant, dull, or burning pain, often accompanied by numbness, tingling, or altered sensation in the face. It may follow trauma, surgery, infections, or neurological conditions.
This condition can significantly affect quality of life, especially when facial sensation and daily functions such as eating, speaking, or grooming are impacted.

Common Symptoms

  • Persistent dull, burning, or aching facial pain
  • Numbness or tingling (paresthesia) in the face
  • Sensitivity or reduced sensation in affected areas
  • Pain may worsen with touch or movement
  • May affect one or multiple branches of the trigeminal nerve

Possible Causes

  • Post-surgical or dental trauma: Nerve injury following procedures
  • Post Nerve ablation: for Trigeminal Neuralgia
  • Facial trauma: Direct injury to the face or skull
  • Infections: Such as shingles (herpes zoster) involving the trigeminal nerve
  • Neurological conditions: Including multiple sclerosis or tumours
  • Autoimmune conditions: That affect nerve tissue

When to Seek Help:

If you experience persistent facial pain, numbness, or tingling, especially following surgery or trauma, it’s important to seek medical evaluation. Early intervention can improve outcomes and comfort.

Management of Trigeminal Neuropathy

Treatment aims to relieve pain, restore function, and manage sensory changes. It often involves a combination of medications, nerve therapies, and supportive care.

Medications

  • Neuropathic pain medications: such as amitriptyline, nortriptyline, gabapentin, or carbamazepine
  • Topical treatments: including lidocaine patches or capsaicin cream
  • Antidepressants or anticonvulsants: to modulate nerve signals

Medications

  • Neuropathic pain medications: such as amitriptyline, nortriptyline, gabapentin, or carbamazepine
  • Topical treatments: including lidocaine patches or capsaicin cream
  • Antidepressants or anticonvulsants: to modulate nerve signals

Physical and Occupational Therapy

  • Techniques to improve facial mobility, function, and reduce hypersensitivity
  • Strategies for adapting daily activities affected by altered sensation

Nerve Blocks and Injections:

  • Local anaesthetic and steroid injections can help reduce inflammation and pain.
  • Trigeminal nerve blocks may be offered for diagnostic or therapeutic relief.
  • Botox is a novel therapy, which can help in certain cases.

Nerve Blocks and Injections:

  • Local anaesthetic and steroid injections can help reduce inflammation and pain.
  • Trigeminal nerve blocks may be offered for diagnostic or therapeutic relief.
  • Botox is a novel therapy, which can help in certain cases.

Psychological Support:

  • Chronic facial pain can affect mood and coping.
  • Cognitive Behavioural Therapy (CBT) and counselling can offer emotional support.

Advanced Interventions (if diagnostic nerve block is positive)

  • Radiofrequency ablation (RFA) for well localised, one sided facet joint pain
  •  Radiofrequency ablation (RFA) for one sided Sacro-iliac Joint pain
  • Pulsed RF of nerve root for sciatica in a single nerve

Possible Causes:

  • Muscle or ligament strain from lifting, bending, or poor posture
  • Degenerative disc disease (most common)
  • Facet joint dysfunction
  • Sacroiliac joint pain
  • Spinal Stenosis
  • Nerve impingement (sciatica)
  • Fibromyalgia (90% fibromyalgia sufferers report spinal pain, as their main complaint)
  • In rare cases, infection, fracture, or tumour

How Can We Help?

At PainClinicNI, we offer a comprehensive, evidence-based approach to low back pain. Our services include:
  • Detailed assessment and diagnosis
  • Medication optimisation
  • Trigeminal nerve blocks
  • Botox injections
  • Stellate ganglion block
  • Coordination with neurologists and surgeons as needed
“Our goal is to relieve your pain, restore function, and support your recovery journey.”