Trigeminal neuralgia is a chronic pain condition causing sudden, severe, electric shock-like pain in the face, affecting approximately 150,000 Americans annually. While often called "the suicide disease" due to its intensity, effective relief is available. Upper cervical chiropractic care addresses a frequently overlooked contributor, misalignment of the atlas (C1) and axis (C2) vertebrae that can irritate the trigeminocervical complex where the trigeminal nerve converges with upper cervical nerves.
Research published in the Journal of Integrative Medicine (2023) found that four out of five trigeminal neuralgia patients experienced reduced pain following upper cervical adjustments, with two achieving complete cessation of symptoms.
You're Not Alone in This Battle
If you've landed on this page, chances are you already know a pain that most people can't imagine. A bolt of lightning across your cheek when you smile at your grandchild. An electric shock through your jaw when you take a sip of morning coffee. Agony that stops you mid-sentence because the simple act of speaking triggered another attack.
According to the Cleveland Clinic, about 150,000 people in the United States receive a trigeminal neuralgia diagnosis every year. The condition predominantly affects adults over 50, and women develop it at nearly twice the rate of men. But statistics don't capture what it's really like to live with this condition, the fear that steals moments, the isolation that creeps in, the desperation when medication stops working.
You deserve to know there's hope. And you deserve to understand every option available to you, including approaches that address the source of your pain rather than simply masking symptoms.
This content is for informational purposes only and does not constitute medical advice. The information provided should not be used for diagnosing or treating health problems or diseases. Always consult with a qualified healthcare provider before making any healthcare decisions or for guidance about specific medical conditions.
What Living With Trigeminal Neuralgia Actually Feels Like
The Pain That Defies Description
People who haven't experienced trigeminal neuralgia often can't comprehend its severity. This isn't an ordinary headache or toothache.
The trigeminal nerve is the largest cranial nerve, responsible for sensation throughout your face, your forehead, cheeks, jaw, gums, lips, and the area around your eyes. When this nerve malfunctions, it sends overwhelming pain signals to your brain in response to the lightest touch or sometimes nothing at all.
Patients describe the pain as:
- Electric shocks shooting across the face
- Stabbing sensations like a knife in the cheek
- Burning lightning bolts from ear to mouth
- Attacks so severe they stop you in your tracks
What makes trigeminal neuralgia particularly cruel is what triggers it. Activities that should bring comfort or joy become sources of dread.
Everyday Triggers That Become Landmines
The International Association for the Study of Pain notes that trigeminal neuralgia attacks can be triggered by:
- Brushing your teeth
- Washing your face
- Shaving
- Applying makeup
- A gentle breeze on your cheek
- Eating or chewing
- Drinking (especially cold beverages)
- Smiling, laughing, or talking
- Touching your face
- Kissing a loved one
Each attack typically lasts from a few seconds to two minutes. But attacks can strike dozens or even hundreds of times per day. And between the attacks, many people experience a constant, dull aching, what physicians call "concomitant continuous pain", that serves as a reminder that the next shock could come at any moment.
The Hidden Toll: Beyond Physical Pain
Research from the Cleveland Clinic Journal of Medicine (2023) emphasizes that trigeminal neuralgia's psychological impact cannot be underestimated. The condition has been called "the suicide disease" not because it's life-threatening in itself, but because the relentless, unpredictable pain can lead to:
- Depression and anxiety
- Social withdrawal and isolation
- Fear of eating, leading to weight loss
- Avoidance of speaking, damaging relationships
- Sleep disruption from nighttime attacks
- Loss of employment due to disability
- Strain on marriages and family relationships
If you recognize yourself in any of this, please know: you are not weak for struggling. This is a recognized medical condition with devastating quality-of-life impacts. And seeking help, in all its forms, is an act of courage.
Understanding Your Condition: The Neurology Behind the Pain
The Trigeminal Nerve: Your Face's Information Highway
To understand why trigeminal neuralgia happens and what can help, it's useful to know a bit about the nerve involved.
The trigeminal nerve (also called cranial nerve V or CN V) begins at the brainstem and divides into three main branches:
1. Ophthalmic branch (V1): Serves the forehead, upper eyelid, and front of the scalp
2. Maxillary branch (V2): Serves the cheek, upper lip, upper teeth, gums, and nasal cavity
3. Mandibular branch (V3): Serves the lower jaw, lower lip, lower teeth, and part of the tongue
The maxillary (V2) and mandibular (V3) branches are most commonly affected, which is why pain typically involves the cheek, jaw, teeth, gums, and lips.
What Goes Wrong: The Conventional Explanation
According to the National Institute of Neurological Disorders and Stroke, the most widely accepted cause of classical trigeminal neuralgia is vascular compression, a blood vessel (usually an artery) pressing against the trigeminal nerve near where it exits the brainstem.
This chronic pressure can damage the nerve's protective myelin sheath, causing the nerve to "misfire" and send pain signals in response to minimal or no stimulation. The nerve essentially becomes hyperexcitable, interpreting any input as severe pain.
Key Statistic
The lifetime prevalence of trigeminal neuralgia is estimated at 0.3% of the population, with onset typically occurring after age 50. However, younger adults can develop the condition, particularly those with multiple sclerosis.
Source: Cleveland Clinic Journal of Medicine, 2023
The Missing Piece: The Trigeminocervical Connection
Here's something your neurologist may not have fully explained, and it's critical to understanding why upper cervical care can help trigeminal neuralgia when other treatments fall short.
Deep within your upper cervical spinal cord and brainstem lies a region called the trigeminocervical nucleus (also known as the trigeminal nucleus caudalis or trigeminocervical complex). According to research published in Current Pain and Headache Reports, this is a convergence zone where:
- Sensory fibers from the trigeminal nerve (face and head)
- Sensory fibers from the upper cervical nerves (C1, C2, C3)
...meet, integrate, and relay pain signals to the brain.
This anatomical reality means that irritation or dysfunction in the upper cervical spine can directly influence trigeminal nerve activity. Think of it as crossed wires: when the upper neck is problematic, the brain can interpret those signals as face and head pain.
The trigeminal nucleus caudalis extends from the brainstem down to the level of C2-C3 in the spinal cord. This overlap creates a functional connection between neck problems and facial pain that explains why:
- Whiplash injuries sometimes precede trigeminal neuralgia onset
- Neck trauma and poor posture correlate with facial pain conditions
- Upper cervical corrections can reduce or eliminate trigeminal neuralgia symptoms
A case series published in the Journal of Integrative Medicine (2023) examining five patients with chronic, severe trigeminal neuralgia found that Atlas Orthogonal upper cervical adjustments resulted in reduced pain in four of five patients, including two who experienced complete cessation of their trigeminal neuralgia.
Day-to-Day Management: Living While Seeking Relief
Managing trigeminal neuralgia requires a combination of medical treatment, lifestyle adjustments, and proactive self-care. While you work toward long-term relief, these strategies can help you navigate daily life.
Identifying and Avoiding Your Personal Triggers
While common triggers exist, each person with trigeminal neuralgia has their own pattern. Keeping a pain diary can help you identify yours:
Track:
- Time of day attacks occur
- What you were doing immediately before
- Food or drink consumed
- Weather conditions (wind, temperature changes)
- Stress levels
- Sleep quality the night before
- Any neck pain, stiffness, or tension
After two to four weeks, patterns often emerge that allow you to minimize exposure to your most potent triggers.
Practical Adaptations That Help
Eating and Drinking:
- Use a straw positioned away from trigger zones
- Choose soft, room-temperature foods during flare periods
- Eat smaller, more frequent meals to reduce prolonged chewing
- Avoid extremely hot, cold, or spicy foods
Personal Hygiene:
- Use an extra-soft toothbrush
- Rinse with lukewarm water rather than cold
- Use an electric razor rather than a blade
- Apply skincare products gently with fingertips rather than rubbing
Protection from Elements:
- Wear a scarf over your face in cold or windy weather
- Use a wide-brimmed hat to shield your face from sun and wind
- Avoid sitting near air conditioning vents or fans
Communication:
- On difficult days, use texting or written notes to reduce speaking
- Alert family and coworkers about your condition so they understand
- Plan important conversations for times when pain is typically lower
The Importance of Stress Management
Stress doesn't cause trigeminal neuralgia, but it can lower your pain threshold and increase attack frequency. Research suggests that stress management techniques can be valuable adjuncts to treatment:
- Deep breathing exercises (avoiding cold air)
- Progressive muscle relaxation
- Meditation and mindfulness practices
- Gentle yoga (focusing on poses that don't strain the neck)
- Adequate sleep
- Counseling or therapy for pain-related depression and anxiety
The Gap in Conventional Care
Notice something missing from the conventional approach? None of these treatments address the trigeminocervical connection, the relationship between upper cervical spine health and trigeminal nerve function.
If your trigeminal neuralgia has a cervicogenic component (meaning it's influenced by neck dysfunction), medications and even surgery may provide incomplete or temporary relief because the underlying spinal irritation continues feeding abnormal signals into the trigeminocervical nucleus.
This is where upper cervical chiropractic care offers something different.
Upper Cervical Chiropractic: Addressing the Root Source
Why the Upper Neck Matters for Trigeminal Neuralgia
The atlas (C1) and axis (C2) vertebrae sit at the very top of your spine, directly beneath your brainstem and in the same region where the trigeminal nucleus caudalis resides. This area is sometimes called the "craniocervical junction"—the meeting point between skull and spine.
Several factors make this region uniquely vulnerable and influential:
Anatomical Significance:
- The atlas has no vertebral body and no disc—it moves differently than other vertebrae
- The C1-C2 junction accounts for approximately 50% of the neck's rotation
- The brainstem, which contains trigeminal nerve nuclei, sits mere millimeters away
- Blood vessels supplying the brain pass through this area
Neurological Density:
- More proprioceptors (position sensors) exist in suboccipital tissues than anywhere else in the body
- Upper cervical nerves directly connect to the trigeminocervical nucleus
- Misalignment can alter cerebrospinal fluid flow and brainstem function
When the atlas or axis shifts out of proper alignment, through trauma, repetitive strain, or degenerative changes, it can create mechanical irritation that sensitizes the trigeminocervical complex and lowers the threshold for trigeminal nerve firing.
The Blair Technique: Precision Without Force
At PRC Pierce Ringstad Chiropractic in Roseville, we use the Blair Upper Cervical Technique, a specialized method designed for the unique anatomy of the upper neck.
What makes Blair technique different:
1. Three-Dimensional Analysis: We use precise imaging to analyze the exact position and angle of your atlas and axis, recognizing that everyone's anatomy is slightly different.
2. No Twisting or Cracking: Unlike general chiropractic adjustments, Blair technique uses gentle, specific corrections without rotational manipulation.
3. Individualized Vectors: Your adjustment is calculated specifically for your anatomy, not a one-size-fits-all approach.
4. Minimal Force: The adjustment itself is quick and gentle, patients are often surprised by how light the touch is.
5. Holding is Healing: The goal isn't repeated adjustments but rather helping your spine hold its correction so healing can occur.
What the Research Shows
While large-scale randomized controlled trials specifically on upper cervical care for trigeminal neuralgia are still needed, existing evidence is encouraging:
Research Highlight
A 2023 case series published in the Journal of Integrative Medicine examined five patients with chronic, severe, daily trigeminal neuralgia who underwent Atlas Orthogonal upper cervical adjustments for eight weeks. Results:
- 4 of 5 patients reported reduced trigeminal neuralgia pain
- 2 patients experienced complete cessation of symptoms
- 3 patients were able to reduce their medication dosages
- All patients showed improvements in upper cervical alignment on imaging
Source: Journal of Integrative Medicine, 2023
A case report in the Journal of Chiropractic Medicine documented a 68-year-old woman with a 7.5-year history of trigeminal neuralgia who achieved significant improvement with upper cervical chiropractic care targeting the trigeminocervical nucleus connection.
Additional case studies in chiropractic literature have documented:
- A 10-year-old boy with trigeminal and glossopharyngeal neuralgia who became pain-free within five days of his first adjustment
- Patients with medication-resistant trigeminal neuralgia who responded to upper cervical correction
- Long-term symptom remission following atlas alignment
Long-Term Outlook: There Is Hope
Remission Is Possible
One of the most important things to know about trigeminal neuralgia is that it often follows a remitting-relapsing pattern. Many people experience periods, sometimes lasting months or years, with minimal or no symptoms.
According to the National Institute of Neurological Disorders and Stroke, while trigeminal neuralgia is typically a chronic condition, it is not progressive in the sense that it doesn't damage the brain or shorten lifespan. With proper management, many people maintain good quality of life.
At PRC Pierce Ringstad Chiropractic, we believe in working collaboratively with your neurologists and other healthcare providers. Our goal isn't to replace your medical care but to address a dimension of your condition that often goes overlooked.
What Others Want to Know: Frequently Asked Questions
1. Can upper cervical chiropractic cure trigeminal neuralgia?
No treatment can "cure" trigeminal neuralgia in the sense of permanently eliminating the underlying vulnerability. What upper cervical care can do is address spinal irritation contributing to trigeminocervical sensitization, which for many patients results in significant reduction or cessation of symptoms.
Published case studies show that some patients achieve long-term remission with maintenance care, while others experience meaningful reduction in attack frequency and severity that improves their quality of life. If you've been suffering and haven't explored the upper cervical connection, scheduling an evaluation with a Blair specialist could reveal whether spinal misalignment is contributing to your pain.
2. Is upper cervical adjustment safe for someone with trigeminal neuralgia?
Yes. The Blair Upper Cervical Technique uses extremely gentle, specific corrections without the twisting, cracking, or forceful manipulation that concerns many trigeminal neuralgia patients. We understand that even light touch can trigger attacks, so we approach each patient with care and modify our technique as needed. The adjustment itself doesn't touch your face. Many patients report the correction is far gentler than they anticipated.
3. How quickly might I see results?
Response time varies significantly. Some patients notice improvement within days of their first correction. Others require several weeks of care as their nervous system recalibrates. A 2023 case study documented a pediatric patient who was pain-free within five days, while adult patients in case series have taken four to eight weeks to achieve maximum improvement. We typically recommend a trial of care for at least six to eight weeks before evaluating response.
4. Will I need to keep coming for adjustments forever?
The goal of upper cervical care is stability, helping your spine maintain proper alignment so that your nervous system can function optimally without constant intervention. During the initial corrective phase, visits are more frequent. As your spine stabilizes, visits decrease. Many long-term patients come in for periodic maintenance checks, often monthly or even quarterly. If your alignment is holding when you visit, no adjustment is given.
5. Can I continue my medications while under upper cervical care?
Absolutely. Never stop or reduce any prescribed medication without your physician's guidance. Many patients pursue upper cervical care while continuing their medication regimen. As symptoms improve, your prescribing doctor can evaluate whether medication reductions are appropriate. We'll coordinate with your medical team as needed.
6. What if upper cervical care doesn't help me?
Not every trigeminal neuralgia patient has a significant cervicogenic component. If thorough upper cervical evaluation reveals minimal misalignment, or if a proper trial of care doesn't produce improvement, we'll tell you honestly. Our examination process is designed to identify who is most likely to benefit before committing to a full treatment program. If you're not a good candidate, we'll help you explore other options.
Take the Next Step Toward Relief
Living with trigeminal neuralgia takes extraordinary strength. The fact that you're researching options, advocating for yourself, and refusing to give up speaks to your resilience.
At PRC Pierce Ringstad Chiropractic in Roseville, Dr. Celia Ringstad and Dr. Paul Pierce have over 30 years of combined experience helping patients with complex neurological conditions find relief through gentle, precise Blair Upper Cervical care. We understand the devastation trigeminal neuralgia causes, and we've seen firsthand how addressing the upper cervical spine can change lives.
What to Expect at Your First Visit:
1. Comprehensive consultation discussing your complete history
2. Neurological and orthopedic examination
3. Specialized upper cervical imaging analysis to assess atlas and axis alignment
4. Honest assessment of whether you're likely to benefit from care
5. Customized treatment recommendations if upper cervical dysfunction is found
We won't pressure you, and we won't promise miracles. What we will do is give you answers and, if you're a good candidate, a path forward that addresses a piece of the puzzle that may have been overlooked.
Call: (916) 773-0200
Visit our website
We serve patients throughout Roseville, Rocklin, Sacramento, Citrus Heights, Granite Bay, Folsom, and Lincoln.
You Deserve a Life Beyond Pain
Trigeminal neuralgia may have taken much from you, peaceful meals, easy conversations, spontaneous smiles, ordinary days without fear. But it doesn't have to define your future.
Effective help exists. Whether through medication, upper cervical care, lifestyle management, or, when necessary, surgical intervention, relief is possible for most people with this condition. The key is finding the right combination of approaches for your unique situation.
We believe everyone deserves to explore every legitimate option. If you've wondered whether there's something more you could be doing, whether some underlying factor has been missed, whether your neck could be contributing to your facial pain, now is the time to find out.
Your next pain-free day could be closer than you think.
Key Takeaways
Trigeminal neuralgia is a recognized medical condition causing severe facial pain that affects approximately 150,000 Americans annually, you are not alone, and your suffering is valid.
The trigeminocervical connection links upper cervical spine health to trigeminal nerve function, explaining why neck dysfunction can contribute to facial pain.
Upper cervical chiropractic care offers a gentle, non-invasive approach that addresses this connection, with published research showing encouraging results for some patients.
Multiple treatment options exist, from medications to surgery to conservative care, the best outcomes often come from combining approaches.
Remission is possible for many patients with proper management, and quality of life can improve significantly with the right support.
References
1. Cleveland Clinic. (2024). Trigeminal Neuralgia: What It Is, Causes, Symptoms & Treatment. Retrieved from https://my.clevelandclinic.org/health/diseases/15671-trigeminal-neuralgia-tn
2. Cleveland Clinic Journal of Medicine. (2023). Guidelines for the management of trigeminal neuralgia. 90(6), 355-364.
3. National Institute of Neurological Disorders and Stroke. (2024). Trigeminal Neuralgia Information Page. Retrieved from https://www.ninds.nih.gov/
4. Journal of Integrative Medicine. (2023). Atlas orthogonal chiropractic management of trigeminal neuralgia: A series of case reports.
5. PMC - National Library of Medicine. (2010). Chiropractic care and trigeminal neuralgia: a case report. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC2921783/
6. Bogduk N. (2005). Cervicogenic headache: anatomic basis and pathophysiologic mechanisms. Current Pain and Headache Reports, 5, 382-386.
7. Bartsch T, Goadsby PJ. (2003). The trigeminocervical complex and migraine: current concepts and synthesis. Current Pain and Headache Reports.
8. NCBI Bookshelf - StatPearls. (2024). Trigeminal Neuralgia. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554486/
9. Johns Hopkins Medicine. (2024). Trigeminal Neuralgia. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/trigeminal-neuralgia
10. Pergolizzi JV Jr, et al. (2024). An update on pharmacotherapy for trigeminal neuralgia. Expert Review of Neurotherapeutics, 24(8), 773-786.
11. UCSF Health. (2024). Trigeminal Neuralgia Treatment. Retrieved from https://www.ucsfhealth.org/conditions/trigeminal-neuralgia
12. Journal of Upper Cervical Chiropractic Research. (2016). Trigeminal Neuralgia Helped With Chiropractic - Case Study.
About the Authors
Dr. Celia Ringstad, DC, Blair Upper Cervical Specialist, has over 30 years of experience providing gentle, precise upper cervical corrections for patients with complex neurological conditions. Dr. Ringstad graduated from chiropractic college and has dedicated her practice to helping patients find relief through the Blair Technique.
Dr. Paul Pierce, DC, Blair Upper Cervical Specialist, brings extensive training in upper cervical biomechanics and neurological assessment to his patient care at PRC Pierce Ringstad Chiropractic.
Article Information:
- Published: January 2025
- Last Reviewed: January 2025
- Next Review: January 2026
- Category: Neurological Conditions / Upper Cervical Care
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