Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 41
Resources
American Association of Neurological Surgeons. 2019. "Trigeminal Neuralgia—Causes, Symptoms and Treatments." www.aans.org/
Patients/Neurosurgical-Conditions-and-Treatments/Trigeminal-Neuralgia.
Ingraham, Paul. 2019. "The 3 Basic Types of Pain." www.painscience.com/articles/pain-types.php.
Kontzialis, Marinos and Mehmet Kocak. "Imaging Evaluation of Trigeminal Neuralgia." Journal of Istanbul University Faculty of Dentistry 51,
no. 3 Suppl 1 (December 2, 2017): S62–68. https://doi.org/10.17096/jiufd.27242.
Kratz, Susan Vaughan. "Manual Therapies Reduce Pain Associated with Trigeminal Neuralgia." Journal of Pain Management and Therapy 1,
no. 1 (2017). www.alliedacademies.org/abstract/manual-therapies-reduce-pain-associated-with-trigeminal-neuralgia-6141.html.
Lubin, Edward. 2018. "Trigeminal Neuralgia (Facial Nerve Pain)." https://comments.emedicinehealth.com/trigeminal_neuralgia_facial_nerve_
pain/viewer-comments_em-282.htm.
McAllister, Murray J. "Trigeminal Neuralgia." 2015. www.instituteforchronicpain.org/common-conditions/neuralgia/trigeminal.
Sime, Andrea. "Case Study of Trigeminal Neuralgia Using Neurofeedback and Peripheral Biofeedback." Journal of Neurotherapy 8, no. 1
(March 25, 2004): 59–71. https://doi.org/10.1300/J184v08n01_05.
Zakrzewska, Joanna M. and Mark E. Linskey. 2014. "Trigeminal Neuralgia." BMJ Clinical Evidence. www.ncbi.nlm.nih.gov/pmc/articles/
PMC4191151.
WHAT ABOUT MASSAGE THERAPY?
Stress management is a challenge for people
with TN. Massage therapy helps with
stress management. However, no research
articles, case reports, or other rigorous
analyses of the potential for massage to
harm or help people with TN have been
published, at least where I could find them.
We don't have evidence to declare
that receiving massage might decrease the
severity or frequency of TN episodes, but
with care it seems reasonable to propose
that our work might improve the quality
of life of people with this condition in
other ways. My interviews with people
who have TN suggest that massage
therapy could be helpful for mood, a
sense of self-efficacy, and musculoskeletal
holding or guarding patterns that might
cause pain or interfere with best function.
And because TN carries some risk of
complication to central sensitization and
chronic, self-fulfilling pain responses,
anything that can turn down the volume
on pain and fear is likely to have a positive
influence on this condition (Image 2).
All of that said, of course it is vital
to conduct massage in a way that does
not elicit TN symptoms. Because each
person's experience is unique, that might
mean adjusting positioning to avoid the
face cradle for some clients and avoiding
touch to the face altogether for others.
This must be guided by the needs and
tolerance of the client and cannot be
predicted for all people with TN (Image 3).
The drugs used to treat TN often
have significant side effects in the form of
fatigue and lethargy, and we want to be sure
that our massage doesn't exacerbate those
problems. Another accommodation has to
do with lingering facial numbness or other
neurological signs that may occur after
surgery or rhizotomy treatments. These
may leave patients with permanent facial
paresthesia or numbness. This doesn't fully
contraindicate massage therapy, but it does
require increased caution, since signaling
from the affected tissues will be limited.
Massage therapy is unlikely to "fix" the
situation for clients who have unpredictable
sharp, shooting, electrical zapping pain
on one side of the face. But it could be
a way to cope with the stress, guarding,
and fear that is likely to accompany this
challenging disease. If you have clients
who have TN, I hope what you found
here will help you work with curiosity,
compassion, and confidence to see what you
can contribute to their quality of life.
"You know, the universe will let me be as
miserable as I want to be. I choose NOT to
be miserable. Some days it's harder than
others. But the great thing is that every day
is a new start. I'm optimistic!" —SF
Notes
1. Bruce Blaus, "Trigeminal Nerve," August 3,
2017, Illustration, https://commons.wikimedia.
org/wiki/File:Trigeminal_Nerve.png.
2. Emilio Lozupone et al., "Imaging Neurovascular
Conflict: What a Radiologist Need to Know and
to Report?," Text for ECR Poster (March 3, 2012),
http://dx.doi.org/10.1594/ecr2012/C-1933.
Ruth Werner is a former massage therapist,
a writer, and an NCBTMB-approved continuing
education provider. She wrote A Massage
Therapist's Guide to Pathology (available at
BooksofDiscovery.com), now in its seventh
edition, which is used in massage schools
worldwide. Werner is available at www.ruthwerner.
com or wernerworkshops@ruthwerner.com.
Watch "Trigeminal Neuralgia"
