What are you assessing?

Ask whether the chiropractor is evaluating neck or shoulder problems, and how those findings relate to your treatment goals.

How will we measure progress?

Useful measures may include your ability to perform daily activities, neck movement, and changes in symptoms you report.

When would I need another referral?

Your providers should communicate when symptoms change, the diagnosis is uncertain, or pain remains difficult to manage.

How does this fit with my current treatment?

Make sure the chiropractor knows about your prescribed medication and any recommendations from your medical specialist.

Trigeminal Neuralgia in Older Adults: Symptoms, Care Options, and a Chiropractic Case Report

Tina Ramalingam

Sep 25

4 min read

Updated: Sep 30

Updated Sept 30, 2026

A sudden jolt of pain while brushing your teeth can be alarming. When sudden facial pain repeatedly occurs during ordinary activities such as eating, speaking, or washing your face, trigeminal neuralgia is one possible cause.

Chiropractor gently assessing an elderly patient’s upper neck as she experiences one-sided facial pain associated with trigeminal neuralgia.

This condition affects the nerve that carries sensation from the face and can make even light touch difficult to tolerate. Because several dental, neurological, and other conditions can cause facial pain, an accurate diagnosis matters before choosing treatment. Understanding the symptoms is the first step toward getting the right care.

What Does Trigeminal Neuralgia Feel Like?

Trigeminal neuralgia is a pain condition involving the trigeminal nerve, which carries sensation from the face. It commonly causes brief attacks of intense pain on one side of the face. Light touch and everyday activities can trigger an attack.

A clinician typically asks where the pain occurs, what it feels like, how long attacks last, and what triggers them. An MRI may help investigate possible causes, including pressure on the nerve or another underlying condition. Treatment usually begins with medication; a specialist may discuss procedures when medication does not control the pain or causes troublesome side effects.

For comprehensive data regarding the diagnosis, specialized imaging, and multidisciplinary management of facial nerve disorders, patients can consult the educational materials provided by the National Institute of Dental and Craniofacial Research (NIDCR).

Why Trigeminal Neuralgia Can Be Especially Disruptive for Older Adults

Trigeminal neuralgia occurs most often in people over 50. For an older adult, pain triggered by chewing, brushing teeth, or washing the face can make essential daily routines difficult. Some people may change what they eat or hesitate to touch their face because they fear setting off another attack. Interrupted sleep and the stress of unpredictable pain can add to the burden.

A care plan should take the person’s full health history into account, including other medical conditions and current medications. It should also address the activities that matter to them, such as eating comfortably, maintaining oral hygiene, sleeping, and spending time with family.

A published case report involving a 72-year-old woman offers a closer look at how trigeminal neuralgia can affect an older adult’s daily life. It also describes the changes she reported during a course of chiropractic care.

What a published case report describes

A case report published in the Asia-Pacific Chiropractic Journal followed a 72-year-old woman with a four-year history of right-sided facial pain. Her pain initially felt like a toothache. After a medical referral and MRI, she received a diagnosis of trigeminal neuralgia.

By the time she sought chiropractic care, touching her face, eating, and brushing her teeth had become difficult. She also reported neck pain, longstanding shoulder problems, headaches, and poor sleep. These concerns affected both her comfort and her ability to carry out daily activities.

The report describes 36 visits over approximately four to six months using an upper cervical chiropractic technique. At her 12th visit, the woman reported less facial pain, neck stiffness, and shoulder aching. At her 24th visit, she reported further improvement in facial pain and said she could return to daily chores. The authors recorded additional improvements at her final review, after 36 visits.

You can read the original case report published by the Asia-Pacific Chiropractic Journal for the full patient history, care details, and reported outcomes.

The woman’s experience is encouraging, particularly because the report considers daily function alongside pain. It is also one person’s experience. Her results cannot predict how someone else will respond or establish which part of her care contributed to the changes she reported. The case is best understood as a starting point for discussion and further research.

Where might chiropractic care fit?

Chiropractor gently examining an elderly man’s upper neck during care for trigeminal neuralgia.

Some people with facial pain also experience neck stiffness, reduced neck movement, or shoulder discomfort. A chiropractor can assess those musculoskeletal concerns and discuss whether chiropractic care is appropriate for them. Any proposed treatment should have a clear goal, and the chiropractor should explain how your response will be monitored.

Every patient’s symptoms, health history, and response to care are different. Evidence that chiropractic care treats trigeminal neuralgia itself remains limited. A chiropractor can review your concerns, explain whether care is appropriate for you, and work alongside your medical team as your progress is assessed.

Questions to ask before starting chiropractic care

If you have trigeminal neuralgia and are considering a chiropractic consultation, these questions can help you understand the proposed care:

What are you assessing? Ask whether the chiropractor is evaluating neck or shoulder problems, and how those findings relate to your treatment goals.
How will we measure progress? Useful measures may include your ability to perform daily activities, neck movement, and changes in symptoms you report.
When would I need another referral? Your providers should communicate when symptoms change, the diagnosis is uncertain, or pain remains difficult to manage.
How does this fit with my current treatment? Make sure the chiropractor knows about your prescribed medication and any recommendations from your medical specialist.

Taking the Next Step Toward Relief

If facial pain keeps returning or makes it difficult to eat, sleep, or brush your teeth, arrange a medical or dental evaluation. Keep track of where the pain occurs, how long each episode lasts, and what seems to trigger it. These details can help your healthcare provider understand your symptoms and recommend appropriate care.

If you also experience neck stiffness or shoulder discomfort, Cucci Chiropractic can evaluate those concerns and discuss whether chiropractic care may fit into your overall care plan.

Schedule an appointment and bring any diagnosis, imaging results, and medication information to your visit so your care can be tailored to your needs.

Sources

Rai S, Postlethwaite R, McIvor C. “Reduction in Trigeminal Neuralgia, and increase in muscle function and Quality of Life in 72-year-old female: A case report.” Asia-Pacific Chiropractic Journal. 2025;6(1).
National Institute of Dental and Craniofacial Research. “Trigeminal Neuralgia.”

Medical disclaimer: This article is for educational purposes only and does not provide medical advice or diagnosis. Trigeminal neuralgia is a complex neurological condition that requires formal medical or dental evaluation to rule out serious underlying causes. Chiropractic care focuses on co-managing associated musculoskeletal tension and does not replace prescribed neurological treatments or medications. Always consult a physician or neurologist regarding severe or sudden facial pain.