Columbia Pain & Spine Institute

Trigeminal Nerve Block

A trigeminal nerve block is a targeted, image-guided injection that interrupts pain signals along the branches of the trigeminal nerve to help relieve trigeminal neuralgia and other forms of chronic facial pain.

OVERVIEW

What a trigeminal nerve block is and how it works

The trigeminal nerve is the fifth cranial nerve and the main carrier of sensation for the face. It divides into three branches: the ophthalmic (forehead and eye region), the maxillary (cheek and upper jaw), and the mandibular (lower jaw). When this nerve becomes irritated or hypersensitive, it can produce the sudden, electric, stabbing facial pain that is characteristic of trigeminal neuralgia.

During a trigeminal nerve block, one of our physicians places a small amount of local anesthetic, often combined with a corticosteroid, near the affected branch or branches of the nerve. The anesthetic temporarily quiets the nerve’s pain signaling, and the steroid helps reduce inflammation around it. A block can serve two purposes. As a diagnostic tool, it helps confirm that a specific trigeminal branch is the source of your facial pain. As a therapeutic tool, it can provide a period of relief and, in some patients, help calm a flare so that other treatments can take hold.

Diagnostic or therapeutic. Your physician will explain which goal applies to your specific block, since the medication used and what we learn from your response can differ between the two.

CONDITIONS

What a trigeminal nerve block treats

This procedure is used for facial pain that follows the distribution of the trigeminal nerve, particularly when oral medications alone have not provided enough relief.

Commonly treats

Trigeminal neuralgia Chronic facial pain Atypical facial pain Post-herpetic facial neuralgia Post-traumatic facial pain Post-surgical facial nerve pain

Trigeminal neuralgia and related facial pain can be difficult to pin down, so your physician will first confirm that your symptoms follow a trigeminal branch before recommending a block. A trigeminal nerve block is one of several nerve blocks we use to diagnose and manage nerve-related pain.

YOUR VISIT

What to expect

Before

Your physician reviews your history, imaging, and current medications and identifies which trigeminal branch is involved. Let us know if you take blood thinners, since these may need to be adjusted beforehand. The procedure is performed on an outpatient basis, and you should arrange for someone to drive you home.

During

You rest comfortably while the skin is cleaned and numbed. Using image guidance such as fluoroscopy or ultrasound, your physician directs a thin needle toward the target branch and injects the anesthetic, sometimes with a steroid. Most blocks take roughly 15 to 30 minutes.

After

You are monitored briefly and can usually go home the same day. You may notice numbness in part of the face for several hours as the anesthetic wears off. Many patients return to light activity the next day. Relief can begin within hours; when a steroid is used, the fuller anti-inflammatory benefit may build over several days. The duration of relief varies from person to person, and your physician will discuss whether repeat blocks or additional treatments are appropriate.

FAQ

Common questions

Is a trigeminal nerve block a cure for trigeminal neuralgia?

No. A nerve block is a pain management tool, not a cure. It can interrupt pain signaling to provide relief and help confirm the source of your facial pain, but it does not permanently change the nerve. Your physician will explain how it fits into your overall plan.

Will the injection hurt?

The skin is numbed first, so most patients feel pressure rather than sharp pain during the block. Any soreness at the injection site is usually mild and short-lived.

How soon will I know if it worked?

Because the local anesthetic acts quickly, many patients can tell within hours whether the targeted branch was the pain source. If a steroid is included, additional relief may continue to develop over the following days.

NEXT STEPS

Facial pain care in Gresham and Portland

At Columbia Pain & Spine Institute, our fellowship-trained physicians care for patients across the greater Portland and Gresham area. If facial pain is disrupting your daily life, a trigeminal nerve block may be part of the answer. This procedure is one of several nerve blocks we offer, and you can review our full range of services to learn more.

Occipital Nerve Block

Targets the nerves at the back of the head for certain headaches and scalp pain. Learn more

Sphenopalatine Ganglion Block

Addresses facial pain and some headache disorders through a nerve cluster behind the nose. Learn more

Sympathetic Nerve Block

Targets the sympathetic nerves for certain chronic pain conditions such as CRPS. Learn more

Referrals welcome. Physicians can send referrals by fax to (503) 382-8120. To discuss whether a trigeminal nerve block is right for you, please contact our office or call (503) 382-8100.