Coping Strategies for Facial Neuralgia Pain

This page contains some practical tips for dealing with facial neuralgia pain, culled from the experiences of many facial neuralgia Suffers.

None of the hints are dangerous, as long as they are used with a grain of common sense. Many may seem self-evident, but it can occasionally take a long time to hit upon even the most obvious-seeming solutions.

One thing applies to even the most stupid-sounding tips here: someone out there is using them. One person commented that: "Although some of these techniques may not make sense, they appear to fit the definition of "sensory overload." Basically, a confused nerve (or nervous system) gives up and calms down."

FACIAL MASKS

Facial neuralgia pain is often triggered by the cold or especially by cold drafts. A neoprene ski mask is used by some to protect against the cold. When the use of a mask is impossible because the pressure triggers a TN attack, a scarf wrapped several times around the head can have a similar effect. Also, a coat with an oversized hood can help.

HOT BATHS

For many people, taking a VERY hot bath during a bad facial neuralgia attack can make it feel less bad. In general this means very hot, almost enough to scald the skin. Running in the hot sun can have the same effect, except that then the pain may worsen, possibly because of the rise in blood pressure. A sauna can also have the same effect.

ICE PACKS AND/OR WARM POULTICES

Paradoxically, although facial neuralgia pain can be triggered by the cold, the use of ice packs can help control the pain. The apparent reason is that it numbs the nerve. The trick is to combine pressure with ice cold. Strangely enough, others find it more helpful to use use warm poultices. And still others switch between hot and cold packs. This is something that each person must test for himself. One person commented that he finds relief by applying an ice-pack (possibly alternating with a warm compress) to a remote region, such as the knee(!). He explained that he started using this technique for severe headaches where he could not tolerate the touch, weight and pressure of an ice pack on his head.

For ice treatments, the following "Ice Protocol" may be found useful:

Ice is an effective tool in reducing inflammation, pain and/or spasm, and is important in your daily pain management routine. You will be frequently reminded to use ice, in combination with other pain control measures prescribed.

There several varieties of ice packs:

Commercial ice pack purchased through local pharmacy or physical therapy center.

Flaxseed packs - hold cold well and will not deteriorate.

Frozen vegetable packages: peas or corn. Refreeze after each use (and it wouldn't hurt to mark the package so you would remember not to eat them due to freezing and thawing numerous times)

Homemade: using ziplock bags (quart or gallon size) Mix 1 part alcohol to 3 parts water and place in freezer. Refreeze after each use.

It is not recommended that you use ice cubes or crushed ice. Not only are they uncomfortable to lay or lean on; but they melt quickly and make a mess.

Follow these instructions:

Place in a pillowcase, to absorb and contain moisture. Do not use a terrycloth towel. Towels absorb too much of the cold and make the ice application less effective.

Expose the area for ice application. Place ice pack (in pillowcase) on bare skin of the affected area. Leave ice pack in place for no more than 30 minutes with each use. Only the first 3 minutes are uncomfortable (if at all) after this time you will be numb.

Apply ice pack every 2 hours as needed for control of pain and discomfort, and/or swelling or spasm.

PRESSURE

Paradoxically, even though even a light touch can sometimes trigger facial neuralgia pain, pressure applied steadily over a large area may relieve it. The pain-relief mechanism is probably similar to that of ice packs. "One thing I have found to help-- I press my palm against my face and clench my teeth for 10 to 15 seconds and let go fast. If it starts to hurt, I repeat the same procedure until I get relief." "Flash".

SIGN LANGUAGE

Some people, especially those with trigeminal neuralgia find that their facial pain is triggered by talking. Learning some basics of sign language would be helpful in these cases. It will not take long to learn a few basic signs and also teach them to the people close to you. The sign alphabet is also quite simple and and a handy way to communicate. On the downside, sign language requires so much motion of the body that it can be impossible to manage during a bad pain attack.

SCALP MASSAGER

Several people have reported that applying a scalp massager (or similar vibrating object) firmly to the side of the face affected by the pain can decrease the pain. This has been reported both for classical and atypical TN. Another possibility is to use it on the side opposite to the pain. This is another paradox similar to the ice and pressure treatments; even though a light touch can trigger the pain, a heavier touch can mask it.

SLEEP

Sleeping can be a major problem for some facial neuralgia patients, because even a slight touch of a pillow on a trigger point may launch off spasms of pain. Luckily, facial neuralgia pain is usually not triggered during sleep (though of course this varies); however, managing to fall asleep is still a problem. One possibility is to try to sleep in a sitting position, but most people will find this difficult or impossible. Another possibility has been suggested: "I fold up a pillow and place it under my chest to raise my shoulders and rest my forehead on the bed". Others report that pressing the affected cheek firmly on a pillow may actually help to prevent major pain attacks (the effect is most likely related to the one discussed above). But on the whole, there seems to be no perfect solution.

EATING HINTS

For many, eating triggers facial pain and can thus become next to impossible. This is an extremely difficult problem for many, resulting in major weight loss. No perfect solution exists, but liquefying the food with a food processor or juicer often helps somewhat.

Eating and Swallowing.

These suggestions have been written for those suffering from Huntington's Disease, but will partially apply to TN as well.

Eating and Swallowing

Jeff Searle, MS, Department of Hearing and Speech

Kansas University Medical Center

SETTING:

Quiet, relaxed atmosphere.

Avoid eating when tired, upset or stressed.

Good lighting so that all food items can be seen.

Avoid talking while eating/swallowing.

POSTURE:

Sit upright for all meals, snacks or drinks.

Swallow with the head tilted down so that the chin points to the chest (a pillow or rolled towel behind the head may be helpful for keeping the head in this position).

Stay seated upright for 20-30 minutes after a meal or snack.

Experiment to find the best way to minimize head movements. Resting the elbows on the table with the chin resting in the palm of the hands may work best.

MEAL DURATION:

Eat several (4-6) smaller meals throughout a day rather FREQUENCY than three large ones.

Eat slowly, pausing between bites and sips (for some people tapping the table with the spoon between bites helps them remember to go slower)

Try to keep meals 25 minutes long or less.

SIZE OF BITE/SIP:

Small bites (1/2 tsp. or less) are usually easier.

a small spoon may help you remember this

cut all solid foods into small pieces

Some people find drinking from a straw easier than sipping from a cup (if a straw is easier, consider using a flexible one-way straw; if a cup is easier, consider using a "nosey" cup that is double handled and made of durable plastic).

FOODS AND LIQUIDS:

Soft, blended or pureed foods are generally easier to swallow. Avoid dry, tough and stringy foods.

Thickened liquids (honey to milk-shake consistency) are generally easier to swallow. A commercial thickener can be purchased which allows you to thicken, any liquid to any consistency desired.

Avoid acidic and spicy foods. If aspirated, these types of food are more likely to cause a pneumonia.

Start a food diary to keep track of what you ate I what strategies you tried and how easy/difficult it was to swallow.

PRECAUTION: Learn to do the Heimlich maneuver.

The Non-Chew Cookbook by Randy Wilson.

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