Trigeminal Neuralgia: Why Is My Face in So Much Pain?

You go to take a sip of water, brush your teeth, or feel a light breeze against your cheek, and suddenly a bolt of pain shoots through your face so sharp it nearly stops you in your tracks. That sudden, electric shock–like sensation could be a sign of trigeminal neuralgia, a chronic nerve pain disorder that affects the trigeminal nerve, the main nerve responsible for sensation in your face. 

This condition, sometimes triggered by the most ordinary actions, affects between four and 13 out of every 100,000 people each year. If these symptoms sound familiar, read on to learn common triggers and the modern treatment options now available from the best trigeminal neuralgia surgeon in Los Angeles. 

Facial Nerve Pain: What Is Trigeminal Neuralgia?

Trigeminal neuralgia (TN) is a chronic facial pain disorder that affects the trigeminal nerve, which carries sensation from the face to the brain. When this nerve becomes irritated or damaged, it can misfire, sending intense pain signals even from the lightest touch. 

Most people experience the pain on just one side of the face, though the exact area depends on which branch of the nerve is involved. There are two main types of trigeminal neuralgia: 

• Classic trigeminal neuralgia: Causes sudden, electric shock–like bursts of stabbing facial pain
• Atypical trigeminal neuralgia: Produces a more constant, burning, or aching facial pain

Both forms of TN can be deeply distressing, turning routine actions like smiling, chewing, or washing your face into moments of severe pain.

What Causes Trigeminal Neuralgia?

The most common cause of trigeminal neuralgia pain is vascular compression, which happens when a nearby blood vessel presses against the trigeminal nerve root near the brainstem. Over time, this constant pressure can wear away the nerve’s protective covering, leading to misfired pain signals that feel sharp and electric. In some cases, trigeminal neuralgia develops as a result of underlying conditions such as multiple sclerosis, which damages the myelin sheath, or from tumors, facial trauma, or nerve injury that physically disrupts the nerve’s function. 

However, not every case has an obvious explanation; some people are diagnosed with idiopathic trigeminal neuralgia, meaning no structural cause can be found even with advanced imaging. Regardless of the trigger, the end result is the same: a hypersensitive nerve that reacts to normal sensations as if they were painful shocks.

Trigeminal Neuralgia Triggers 

When the trigeminal nerve is damaged or irritated, it overreacts to even the smallest touch or movement. The nerve’s pain threshold drops so low that simple, everyday actions, like brushing your teeth, chewing, talking, or even feeling a light breeze on your face, can trigger a burst of severe pain. These jolts often feel electric or stabbing, coming in waves that last seconds or minutes, but leave lingering fear of the next attack. 

How is Trigeminal Neuralgia Diagnosed?

Diagnosing trigeminal neuralgia starts with a detailed look at your symptoms and medical history. Neurologists pay close attention to the type of pain you describe, especially if it feels like sudden, electric shock–like bursts, and where it occurs on your face. Because several conditions can mimic trigeminal neuralgia, such as dental problems, temporomandibular joint (TMJ) disorder, sinus infections, migraines, or other neuralgias, these are carefully ruled out first. 

Imaging tests like an MRI can help diagnose TN by detecting if a blood vessel is compressing the nerve or if conditions like multiple sclerosis or a tumor are involved. In some cases, specialized nerve imaging is used to get an even closer look. 

Treatment Options and Pain Relief Strategies for Trigeminal Neuralgia

Treating trigeminal neuralgia often starts with medication like nerve pain medications or muscle relaxants that can help calm overactive nerve signals and reduce the frequency of attacks. 

When medication no longer provides enough relief, surgical or procedural options may be considered by the best neurosurgeon in Los Angeles: 

• Procedures such as microvascular decompression (MVD) relieve pressure from a blood vessel on the nerve, while less invasive treatments like radiosurgery, nerve blocks, or glycerol injections can help interrupt the nerve’s pain signals. 
• Alongside medical treatments, supportive strategies such as avoiding known triggers, making small lifestyle changes, managing stress, and seeking emotional support can all help make the condition more manageable. 

Living With Trigeminal Neuralgia

The unpredictability of TN flare-ups can take an emotional toll, creating anxiety or fear of simple activities like eating, speaking, or smiling. These daily limitations can lead to frustration, social withdrawal, or mood changes if pain remains uncontrolled. 

It’s important to recognize when it’s time to seek specialist care, particularly if medications stop working, side effects become too difficult to manage, or imaging reveals a structural cause like a blood vessel or tumor pressing on the nerve. A neurologist or neurosurgeon who specializes in trigeminal neuralgia can offer advanced treatment options and help restore comfort and confidence in daily life.

Finding the Best Trigeminal Neuralgia Surgeon in Los Angeles

When facial pain becomes unbearable and life feels interrupted by every movement or touch, you deserve care guided by precision, compassion, and expertise. At California Neurosurgical Specialists, we specialize in advanced, minimally invasive treatments for trigeminal neuralgia designed to relieve pain and restore quality of life. 

Under the leadership of Dr. Arnau Benet, a world-renowned cerebrovascular and skull base neurosurgeon, our team combines cutting-edge technology with meticulous surgical skill to achieve the safest and most effective outcomes. 

Ready to get lasting relief from facial nerve pain with the best trigeminal neuralgia surgeon in Los Angeles?