Why trigeminal neuralgia may be connected to your upper neck
Trigeminal neuralgia (TN) affects the trigeminal nerve, the largest of the nerves that come directly from the brain. It carries feeling from your forehead, cheek, jaw, teeth and lips. When that nerve becomes irritated, ordinary sensations such as a touch, a sip of water or a cool breeze can set off a jolt of pain that many people describe as the worst they have ever felt.
Physicians look first for known causes of TN. The most common is a blood vessel pressing on the nerve where it leaves the brainstem. Less often, TN is linked to multiple sclerosis or another condition that shows up on an MRI. That is why a neurologist’s evaluation matters so much. For many people, though, the scans do not fully explain why the nerve has become so reactive.
This is where the upper neck comes in. Part of the trigeminal nerve’s processing center, called the spinal trigeminal nucleus, extends down from the brainstem into the very top of the spinal cord, at the level of the first two neck bones. In this area, signals from your face and signals from your upper neck meet and are sorted together. It is one reason neck problems can be felt as pain in the head and face.
The atlas, the top bone of your neck, surrounds this region. When the atlas shifts out of its normal position, often after a fall, car accident, sports injury or years of strain, it may add mechanical stress and muscle tension around the brainstem and upper spinal cord. Our view is that this extra stress can make an already sensitive nerve system more likely to fire.
We want to be honest about the limits. NUCCA care cannot move a blood vessel off a nerve, and it does not treat multiple sclerosis. Our goal is narrower: to find out whether an upper neck misalignment is a contributing factor in your TN and, if it is, to correct it as precisely and gently as possible.
Trigeminal neuralgia or another kind of facial pain?
Not every face pain is TN. Jaw joint problems, dental issues, sinus trouble and nerve irritation at the back of the head can all cause pain in similar areas. If your pain is a deep ache around the jaw that gets worse with chewing, you may also want to read about TMJ and jaw pain relief. Sorting out the source is part of our exam, and we will refer you if your symptoms point somewhere else.
How NUCCA care helps trigeminal neuralgia
NUCCA (National Upper Cervical Chiropractic Association) care focuses on one thing: the alignment of the atlas and how it sits under the skull. You can learn more about the method on our NUCCA upper cervical care page. For TN, the process has three parts.
1. We measure first. Your visit begins with a careful health history, including when your attacks started, which side they affect, what triggers them, and any past head or neck injuries. We then use non-invasive exams and precise imaging of the upper neck to measure how your atlas is positioned, down to fractions of a degree. No correction is made until we know exactly what we are correcting.
2. We correct gently. You lie comfortably on your side while the doctor applies light, sustained pressure just behind the ear. There is no twisting, no popping or cracking, and no forceful movement of the neck. This matters for people with TN, because the face is often a trigger zone. The correction does not require touching your face, and we will always work around any sensitive areas you point out.
3. We monitor how well it holds. After the correction, we recheck your alignment to confirm the change. Over the following weeks, we track your attacks: how often they happen, how strong they are, and which triggers still set them off. The aim is a correction that holds, so your nervous system has time to settle. Each follow-up visit starts with a check, and we only correct again when your measurements show the atlas has shifted.
Throughout care, you stay under the supervision of your physician or neurologist. We do not ask anyone to stop or change prescribed medication. If you and your doctor decide to adjust your medication as your symptoms change, that decision belongs to the two of you, and we are glad to share our notes to support it.
What the research says
Research on upper cervical care for trigeminal neuralgia is still early. Published case reports describe people with TN, including some who had not responded well to medication, reporting less facial pain after upper cervical correction.1 Case reports are valuable because they describe real patients in detail, but they follow individuals rather than large groups. They cannot tell you how likely you are to improve.
What we can say from more than 30 years of clinical experience is that people with TN who also have a measurable upper neck misalignment are often worth evaluating. Some notice changes in the frequency or intensity of their attacks. Others notice less. We will share our findings honestly at every step.
The established options for TN include anticonvulsant medications, nerve blocks, and procedures such as microvascular decompression or radiosurgery. These treatments help many people, and NUCCA care is not a replacement for them. Many of our patients choose to explore the upper neck while continuing to work with their physician, or before they make a decision about surgery with their specialist.
What to expect at Ennis Chiropractic
Ennis Chiropractic is a father-son NUCCA practice led by Dr. Michael Ennis and Dr. Brandon Ennis, located at 16852 Titan Drive in Clear Lake, serving Houston and the Bay Area. We are one of the few NUCCA practices in the Houston area, and patients with facial pain often travel to see us.
Your first step is our $79 New Patient Screening (regularly $250). It includes:
- A detailed review of your health history and your TN pattern
- Non-invasive exams of your posture, balance and upper neck
- A one-on-one consultation with the doctor
- A report of findings that tells you whether you’re a good candidate for NUCCA care
Please bring a list of your medications, any MRI or imaging reports, and notes from your neurologist if you have them. A simple attack log, noting when attacks happen and what triggered them, is also very helpful.
If our findings suggest your upper neck is not a factor, we will tell you plainly and point you back to your physician. If you’re a good candidate, your doctor will walk you through your recommended NUCCA care program and its costs at your report of findings, along with your care plan materials, before any care begins. Program costs are separate from your $79 screening, and there’s no obligation. We are an insurance-free practice, so there are no surprise bills, and HSA and FSA cards are welcome.
If your attacks have been controlling your days, a single visit can help you find out whether your upper neck is part of the story. Many of our TN patients also deal with migraines and headaches, and we look at the whole picture when we build your plan.