How Upper Cervical Care Relates to
Trigeminal neuralgia (TN -- tic douloureux) is a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the nerve are distributed - lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw. The disorder most often affects one side of the face, but some patients experience pain at different times on both sides. TN is considered to be one of the most painful afflictions known to medical science.
Researchers have determined that TN pain originates from damage not only to the Trigeminal nerve in the face but also from damage to the central Trigeminal system in the upper spinal cord and the ponto-medullary levels in the brainstem.1-5 Therefore, trauma to the head and neck (concussive trauma to the head, neck, or upper back) that results in injury to nerve pathways in the spinal cord and brain stem has been shown in medical literature to be a possible cause of TN.5-15 Following the trauma, facial pain can be triggered immediately or can take months or years to develop.
The purpose of upper cervical chiropractic care is to reverse the trauma-induced upper neck injury; thereby reducing irritation to the nerves in the brain stem and spinal cord that can trigger TN. While many TN sufferers recall specific traumas such as head injuries, auto accidents or falls, some do not. An evaluation is necessary in each individual's case to assess whether an upper cervical injury is present and whether benefit from upper cervical care can be achieved.
Research Articles and Publications
- Gao S, Wang Y, Wang Z. Assessment of trigeminal somatosensory evoked potentials in burning mouth syndrome. Chin J Dent Res 2000 May; 3(1): 40-6.
- Ren K, Dubner R. Central nervous system plasticity and persistent pain. J Orofac Pain 1999 Summer; 13(3): 155-63; discussion 164-71.
- Sessle BJ. Neural mechanisms and pathways in craniofacial pain. Can J Neurol Sci 1999 Nov; 26 Suppl 3:S7-11.
- Jaaskelainen SK, Forssell H, Tenovuo O. Electrophysiological testing of the trigeminofacial system: aid in the diagnosis of atypical facial pain. Pain 1999 Mar; 80(1-2): 191-200.
- Knibestol M, Hildingsson C, Toolanen G. Trigeminal sensory impairment after soft-tissue injury of the cervical spine. A quantitative evaluation of cutaneous thresholds for vibration and temperature. Acta Neurol Scand 1990 Oct; 82(4): 271-6.
- Fuchs P. On the treatment of posttraumatic neuritis and neuralgia in the jaw region. Fortschr Kiefer Gesichtschir 1967; 12: 41-5.
- Paillas JE, Pellet W, Rakotobe A. Post-traumatic facial algia. Rev Otoneuroophtalmol 1970 Jan-Feb; 42(1): 5-13.
- Szabo G, Hoffman J. Posttraumatic trigeminal neuralgia. Fogorv Sz 1973 Sep; 66(9): 268-71.
- Gregg JM. Post-traumatic trigeminal neuralgia: response to physiologic, surgical and pharmacologic therapies.
- Moritz M, Niederdellmann H, Dammer R. Involvement of the Trigeminal nerve in fractures of the face. Rev Stomatol Chir maxillofac 1995; 96(1): 46-9.
- Canavan D, Graff-Radford SB, Gratt BM. Traumatic dysesthesia of the Trigeminal nerve. J Orofac Pain 1994 Fall; 8(4): 391-6.
- Nappi G, Facchinetti F, Bono G. Plasma opioid levels in post-traumatic chronic headache and Trigeminal neuralgia: maintained response to acupuncture. Headache 1982 Nov; 22(6): 276-9.
- Woda A, Pionchon P. A unified concept of idiopathic orofacial pain: pathophysiologic features. J Orofac Pain 2000 Summer; 14(3): 196-212.
- McGlone R, Morton RJ, Sloan JP. Trigeminal pain due to whiplash injury. Injury 1988 Sep; 19(5): 366.
- Rozenfel'd LG, Timofeev AA, Borisenko ON. Thermographic diagnosis of diseases of the maxillofacial area. Stommatologiia 1989 Jan-Feb; 68(1): 54-8.