A case demonstrating that work on the neck can be helpful in Trigeminal Neuralgia (TN).
J Can Chiropr Assoc. 2010 Sep;54(3):177-86.
Trigeminal neuralgia and chiropractic care: a case report.
Rodine RJ, Aker P. free article here
- 68 year old lady with 7 1/2 years TN following surgery for a brain tumor
- Intolerance to meds – something so common in TN, I saw a case yesterday
- pain 10/10
- right parietal and temporal regions , cheek, mandible, and mouth. – all over
- trigger zone to light touch in cheek
- C0-1, C1-2 ,C2-3 and C5-6 issues in neck – upper cervical joint motion restriction and tenderness.
- “Palpation of the upper cervical paraspinal tissues referred pain to the lateral head and face” – I had seen cervical pain referring to face as well as scalene issues as well doing such referral
- Right rotation and extension restricted and cervical axial compression tender
- Foraminal narrowing at C5-6 bilaterally on Xray
- diagnosed with upper cervical dsyfunction, TMJ, and OA mid-lower cervical spine
- cervical lateral flexion exercises ? stretches
- ultrasound- 3 minutes pulsed, 1.9 watts/cm over the upper cervical joints on the right
- mobilization – “rotary and lateral flexion impulses”
- Manual Traction
- Massage – long and cross-fibre
- TMJ soft tissue and mobilization – a little vague there
- Tries TENS but tended to aggravate (not a surprise – pinched joints everytime tightened muslces)
- 50% improvement with first Rx but had multiple treatments with ups and downs, over a period of a year, that I find difficult to follow. – but did get pain to 2/10
- “During flare-ups, treatment frequency increased as necessary, up to six treatments provided over a three week period, to control the pain”
- Their contention was that the Trigeminal Nucleus is just unstream of the upper cervical levels and they cross-talk their pains – something that is seen in cervicogenic headaches.
Comment – working the neck will help TN but looks like a lot of work…