Pain & trigeminal neuralgia - When lightning strikes the face
Trigeminal neuralgia is one of the most painful diseases in humans - as sufferers report time and again. Like an electric shock, a knife thrust or a sudden flash of lightning that runs through the face for seemingly no reason. Hardly comprehensible to outsiders, often existentially stressful for those affected.
The attacks of pain come on suddenly, last seconds to minutes, are sharp, stabbing, shooting - usually on one side of the cheek, upper jaw, lower jaw or forehead. Even the smallest triggers such as wind, chewing, brushing your teeth or even speaking can provoke the attacks.
What remains is not only pain, but often also fear: of the next attack, of losing control, of social withdrawal.
What happens with trigeminal neuralgia?
The cause is usually an irritation or compression of the trigeminal nerve, the fifth cranial nerve. In many cases, a blood vessel presses on the nerve at a sensitive point on the brain stem - sometimes inflammation, MS, scars or idiopathic processes are also the cause.
The result: the nerve "fires" without adequate stimulation. This results in so-called paroxysmal pain symptoms - i.e. sudden onset of pain without an external injury.
Therapy: When every touch is too much
For us therapists, trigeminal neuralgia poses a particular challenge: classic manual techniques or mobilizations are usually not only ineffective in the acute phase , but potentially harmful.
And yet we can achieve a lot - if we focus on the vegetative system, include the peripheral tension patterns and, above all, enable regulation.
What helps?
Vagus-friendly breathing and positioning techniques to calm the system
Fascia and muscle tension work in the shoulder, neck and jaw area - but always pain-free and carefully dosed
Mindful jaw and tongue mobilization, indirectly via movement or perception
Treatment of vegetative involvement: Heart rate, breathing pattern, visceral tensions
Psychosomatic support: anxiety, pain memory, traumatized body zones
Attitude: safety is more important than appeal
Trigeminal neuralgia forces us to be therapeutically humble: we cannot "treat away" what is triggered neurovascularly. But we can create safety, defuse pain contexts and guide the system towards calm.
Conclusion:
Trigeminal neuralgia is a disease of the nerve - but also a disease of trust in one's own body. Therapy here does not primarily mean treatment, but support, grounding and stabilization. The face may be the site of the pain - but regulation begins deeper down.
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