Psychosomatics of trigeminal neuralgia
Trigeminal neuralgia is sudden attacks of severe facial pain that feel like an electric shock. The pain lasts from seconds to a couple of minutes, usually on one side, and is set off by touch, wind, eating or brushing your teeth. Most often a blood vessel presses on the nerve. It can be treated, and a neurologist makes the diagnosis. The Ladder method adds questions about how you "save face", and it does not replace a doctor.
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When to see a doctor
If a dentist has ruled out your teeth, you need a GP or a neurologist. They ask about the attacks, examine your face and may order an MRI to see the vessel near the nerve and rule out other causes. A doctor chooses the treatment, with a neurosurgeon if needed.
In the Ladder method
In the Ladder method trigeminal neuralgia is not explained as "you imagined it". You are not to blame. It is a nerve condition, and a neurologist, check-ups and treatment come first. Questions to yourself belong next to them, not instead of them.
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In the method the face fits the image of "saving face": where you are afraid of losing respect, reputation or your place in people's eyes, and where you were hurt as if "slapped in the face". It is an image, not the cause, and it does not replace treatment.
On the ladder this shows up as the steps "I must not embarrass myself" and "I smile even though it hurts". You can work through them at your own pace alongside treatment.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
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How it shows up
Book a doctor’s appointment if you notice:
- Sudden facial pain like an electric shock
- An attack lasts seconds or up to 2 minutes
- Usually one side of the face
- Pain in the jaw, teeth, gums or cheek
- Attacks from touch, wind, eating or brushing teeth
- Periods of frequent attacks alternate with calm
What medicine knows
The trigeminal nerve carries sensation from the face. The NHS says the pain of neuralgia is sudden and very severe, like an electric shock or a stabbing, most often in the jaw, teeth, gums or cheek, less often near the eye and forehead. An attack lasts from a few seconds to 2 minutes, and between attacks there may be no pain at all.
Attacks are set off by a light touch, washing your face, make-up, talking, eating, brushing your teeth or a draught. There can be weeks or months with frequent attacks and periods of calm.
Most often the cause is a blood vessel pressing on the nerve where it enters the brain. MedlinePlus says neuralgia is more common in women and usually after 50. In younger people it can happen with multiple sclerosis, so the doctor checks for this too.
Neuralgia can be treated: there are medicines that reduce the attacks, and if they do not help, doctors discuss surgery. Ordinary painkillers hardly work for it, so do not just put up with it or pick tablets yourself.
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Frequently asked questions
Can trigeminal neuralgia be treated?
Yes. There are medicines that reduce the attacks, and if they do not help, surgery is discussed (NHS). Ordinary painkillers hardly work for it, so a neurologist chooses the treatment.
What does trigeminal neuralgia mean in psychosomatics?
There is no proven "meaning". In the Ladder method it becomes a reason to ask yourself where it matters to you to "save face" and where you were hurt. It is a question to yourself, not a diagnosis.
Why does my face hurt like an electric shock?
This kind of pain is typical of trigeminal neuralgia: most often a blood vessel presses on the nerve (NHS). But teeth and other conditions can cause similar pain, so see a dentist first, then a neurologist.
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Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.