Manual Therapy May Help Trigeminal Neuralgia

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

Neck issues:

  • 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…




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This entry was posted in Manual Med, Neck, Trigeminal Neuralgia. Bookmark the permalink.

One Response to Manual Therapy May Help Trigeminal Neuralgia

  1. Deborah Poirier says:

    Hello. Just came across this site in search of some answers for myself. I am a massage therapist and have been working on a client with TN. She did have surgery last year and was pain free for some time. She recently is experiencing small attacks again. She receives massage almost every week and occasionally when she feels tightening in the trigeminal nerve area I perform Craniosacral therapy, specifically mouth work, tractioning the zygomas. She gets relief from this treatment but not enough for me to feel it’s a success. She is occasionally hesitant in receiving these treatments in fear of an attack during the treatment. I believe that further study into this type of treatment would be wise. If it has already been done then I would love to see the results of this study. I desperately want to help my client….it’s so hard to see her going through this again. If anyone has any experience with CST please pass it on to me. Thank you.

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