Neuralgia how long

There may also be a constant throbbing, aching or burning sensation between attacks. You may have episodes of pain lasting regularly for days, weeks or months at a time. It is possible for the pain to then disappear completely and not recur for several months or years a period known as "remission". However, in severe cases, attacks may occur hundreds of times a day, and there may be no periods of remission. Living with trigeminal neuralgia can be extremely difficult, and your quality of life can be significantly affected.

You may feel like avoiding activities such as washing, shaving or eating to avoid triggering pain, and the fear of pain may mean you avoid social activities.

However, it's important to try to live a normal life, and be aware that becoming undernourished or dehydrated can make the pain far worse.

The emotional strain of living with repeated episodes of pain can lead to psychological problems, such as depression. During periods of extreme pain, some people may even consider suicide. Even when pain-free, you may live in fear of the pain returning. Although the exact cause is not known, trigeminal neuralgia is often thought to be caused by compression of the trigeminal nerve or an underlying condition affecting this nerve.

The trigeminal nerve also called the fifth cranial nerve is the largest nerve inside the skull. You have two trigeminal nerves, one in each side of your face.

Small branches from different parts of the face join into three major nerve branches. These are:. These branches enter the skull through three different routes and then join together in what is called the Gasserian ganglion, before connecting to the brainstem in the part of the skull called the posterior fossa. Trigeminal neuralgia can involve one or more branches of the trigeminal nerve.

The maxillary and mandibular branches are affected most often, and the ophthalmic branch is the least commonly affected. In most cases, this pressure seems to be caused by an artery or vein compressing the trigeminal nerve, although it's not known why this happens.

It's also not clear exactly why this pressure can cause painful attacks, as not everyone with a compressed trigeminal nerve will experience pain. It may be that, in some people, the pressure on the nerve wears away its protective outer layer called the myelin sheath, which may cause uncontrollable pain signals to travel along the nerve.

However, this does not fully explain why periods of remission periods without symptoms can occur and why pain relief is immediate after a successful operation to move the blood vessels away from the nerve.

As the pain caused by trigeminal neuralgia is often felt in the jaw, teeth or gums, it is common for people to visit their dentist initially, rather than their GP. If you visit your dentist, they will ask you questions about your symptoms and investigate your facial pain using a dental X-ray and other means to look for other more common causes, such as a dental infection or cracked tooth.

If the dentist cannot find a cause, it is important not to undergo unnecessary treatment such as a root canal filling or an extraction, even though you may be convinced that it is a tooth problem. If your dentist can't find anything wrong, do not try to persuade them to remove a particular tooth, as this will not solve the problem. Often, the diagnosis of trigeminal neuralgia is made by a dentist, but if you have already seen your dentist and they have not been able to find an obvious cause of your pain, visit your GP.

There is no specific test for trigeminal neuralgia, so a diagnosis is largely based on your symptoms and your description of the pain.

If you have experienced facial pain, your GP will ask you questions about your symptoms, such as how often they occur, how long the pain attacks last and which areas of your face are affected.

The more details about your pain you can provide, the better. Your GP will consider other possible causes of your pain and may also examine your head and jaw to identify which parts are painful. An important part of the process of diagnosing trigeminal neuralgia involves ruling out other conditions that can also cause facial pain. By asking about your symptoms and carrying out an examination, your GP may be able to rule out other conditions, such as:.

Your medical, personal and family history will also need to be taken into consideration when determining possible causes of your pain. For example, trigeminal neuralgia is less likely if you are under 40 years old, and multiple sclerosis MS may be more likely if you have a family history of the condition or if you have some other form of this condition.

However, trigeminal neuralgia is very unlikely to be the first symptom of MS. If your GP is not sure about your diagnosis, or if you have unusual symptoms, they may refer you for a magnetic resonance imaging MRI scan of your head.

An MRI scan uses strong magnetic fields and radio waves to create detailed images of the inside of your head. It can help identify potential causes of your facial pain, such as sinusitis inflammation of the lining of the sinuses , tumours on one of the facial nerves, or nerve damage caused by MS.

An MRI can also sometimes detect whether a blood vessel in your head is compressing one of the trigeminal nerves, which is one of the main causes of trigeminal neuralgia. However, highly sophisticated MRI scans may be needed to show this accurately, although this may not necessarily be helpful, because not everyone with a compressed trigeminal nerve has trigeminal neuralgia.

There are a number of treatments available that can offer some relief from the pain caused by trigeminal neuralgia. Most people with trigeminal neuralgia will be prescribed medication to help control their pain, although surgery may be considered for the longer term in those cases where medication is ineffective or causes too many side effects. The painful attacks associated with trigeminal neuralgia can sometimes be triggered or made worse by a number of different things.

Therefore, in addition to your medical treatment, it may help to try to avoid these triggers, if possible. For example, if your pain is triggered by wind or even a draught in a room, it may help to avoid sitting near open windows or the source of air conditioning, and wearing a scarf wrapped around your face in windy weather.

A transparent dome-shaped umbrella can also protect your face from the weather. Hot, spicy or cold food or drink may also trigger your pain, so avoiding these can help. Using a straw to drink warm or cold drinks may also help prevent the liquid coming into contact with the painful areas of your mouth. It is important to eat nourishing meals, however, so if you are having difficulty chewing, consider eating mushy foods or liquidising your meals. Certain foods seem to trigger attacks in some people, so you may want to consider avoiding things such as caffeine, citrus fruits and bananas.

As normal painkillers such as paracetamol are not effective in treating trigeminal neuralgia, you will normally be prescribed an alternative medication, such as an anticonvulsant medication usually used to treat epilepsy to help control your pain. These medications were not originally designed to treat pain, but they can help relieve nerve pain by slowing down electrical impulses in the nerves and reducing their ability to transmit pain.

The trigeminal nerve supplies various areas of the face, including the cheeks and jaw. Trigeminal neuralgia is characterised by sudden jolts of shooting pain that usually affect one side of the face only.

Sometimes, a person experiences pain on both sides of the face, though at alternating times. The pain may be severe enough to cause spasms of the facial muscles tic. Trigeminal neuralgia turns everyday activities, such as toothbrushing or shaving, into agonising events. Even a gentle breeze blowing on the face can trigger pain.

Known causes include multiple sclerosis or tumours pressing against the nerve. Women over the age of 50 years are most commonly affected. Occipital neuralgia Irritation of the main nerve that runs from the back of the skull can cause occipital neuralgia. This type of headache or pain is dull, throbbing and localised to the back of the head.

The pain can sometimes include the forehead. It is suspected that tense muscles or ligaments may press against the nerve, causing irritation, inflammation and subsequent pain. Other causes may include viral infection, trauma to the neck or bad posture. Diagnosis of neuralgia There are no specific tests for neuralgia. Share on: Facebook Twitter.

Show references AskMayoExpert. Postherpetic neuralgia adult. Rochester, Minn. Bajwa ZH, et al. Postherpetic neuralgia. Accessed Oct. Forstenpointner J, et al. Up-date on clinical management of postherpetic neuralgia and mechanism-based treatment: New options in therapy. The Journal of Infectious Diseases. Mallick-Searle T, et al. Postherpetic neuralgia: Epidemiology, pathophysiology, and pain management pharmacology. Journal of Multidisciplinary Healthcare. The pain can be caused by a blood vessel pressing down on the nerve where it meets with the brainstem.

It can also be caused by multiple sclerosis , injury to the nerve, or other causes. Trigeminal neuralgia causes severe, recurrent pain in the face, usually on one side. Pain from the glossopharyngeal nerve, which is in the throat, is not very common. This type of neuralgia produces pain in the neck and throat.

The cause of some types of nerve pain is not completely understood. You may feel nerve pain from damage or injury to a nerve, pressure on a nerve, or changes in the way the nerves function. The cause may also be unknown. An infection can affect your nerves. For example, the cause of postherpetic neuralgia is shingles , an infection caused by the chickenpox virus. The likelihood of having this infection increases with age.

An infection in a specific part of the body may also affect a nearby nerve. For example, if you have an infection in a tooth, it may affect the nerve and cause pain. Multiple sclerosis MS is a disease caused by the deterioration of myelin, the covering of nerves. Trigeminal neuralgia may occur in someone with MS. Many people with diabetes have problems with their nerves, including neuralgia. The excess glucose in the bloodstream may damage nerves. This damage is most common in the hands, arms, feet, and legs.

These include:. The pain of neuralgia is usually severe and sometimes debilitating. If you have it, you should see your doctor as soon as possible. You should also see your doctor if you suspect you have shingles.