Role of Physical Therapy in Trigeminal Neuralgia: A Case With 4-Year Follow-up

Abstract

BACKGROUND: Trigeminal neuralgia presents with acute stabbing unilateral facial pain along the nerve distribution precipitated by innocuous sensory stimuli. Trigeminal neuralgia can be unrelenting and can lead to severe physical and emotional consequences. Medical and surgical intervention often has adverse effects, and reports of physical therapy treatment are uncommon. CASE PRESENTATION: The patient in this case presented for physical therapy with a history of head/neck surgery, migraines and headaches, joint pain, and depression, with severe sharp shock-like pain aggravated by innocuous oral activity in the trigeminal nerve distribution. Over 10 sessions, she received manual therapy for joint, myofascial, and nerve mobilization, and upper limb stretching and strengthening. OUTCOME AND FOLLOW-UP: Her pain level decreased substantially and interfered with only 1 oral activity at 4-year follow-up. DISCUSSION: Her presentation may inform the differential diagnosis of craniofacial pain. Her management integrating manual therapy with exercise and the positive clinical outcome suggest a new avenue for treatment of trigeminal neuralgia. JOSPT Cases 2023;3(2):119–126. Epub: 13 April 2023. doi:10.2519/josptcases.2023.11446