Living With Severe Facial Pain? A New Treatment May Help

August 03, 2026

It can strike out of nowhere or be triggered by something as ordinary as brushing your teeth, chewing or speaking. It’s facial pain called trigeminal neuralgia, and it often goes undiagnosed for years, while patients cycle through dentists and doctors searching for answers.

Michael Staudt, MD, a neurosurgeon at University Hospitals, explains what trigeminal neuralgia is, how it’s treated, and the new, minimally invasive treatment approach that’s offering patients relief.

What Is Trigeminal Neuralgia?

Trigeminal neuralgia starts in the trigeminal nerve, which carries sensations from the face to the brain. When something irritates that nerve, it can trigger sudden, severe bursts of pain on one side of the face. The pain typically affects the eye, cheek, jaw or a combination of those areas.

“It presents as an electric shock-like, stabbing pain,” says Dr. Staudt. “The pain episodes are often brief but intense, and they can happen repeatedly throughout the day. The pain is often triggered with touching and chewing.”

The condition affects less than 1% of the population, but it’s the most common and well-known facial pain syndrome. It tends to appear after age 50 and is more common in women than men. While people with the condition can experience pain-free periods over weeks or months, trigeminal neuralgia rarely goes away on its own.

A Delay in Diagnosis

Despite the severity of its symptoms, trigeminal neuralgia is frequently misdiagnosed, often leaving people to seek answers for years. Because the pain often occurs in the jaw or cheek, patients commonly see their dentist, who may suspect an abscess or fractured tooth. From there, many patients work their way through a primary care physician and other specialists before finally reaching a neurologist or neurosurgeon who recognizes the condition.

When trigeminal neuralgia is suspected, an MRI is essential to understand what’s causing the nerve irritation. The most common cause is a blood vessel pressing on the nerve where it exits the brainstem. While trigeminal neuralgia can be caused by nerve damage associated with multiple sclerosis (MS) or a tumor in the area, there’s often no identifiable cause. “Our understanding of trigeminal neuralgia is still incomplete,” Dr. Staudt acknowledges. “The important thing is to properly diagnose the condition so we can treat it.”

Finding Relief: Treatment Options for Trigeminal Neuralgia

Medications are always the first treatment for trigeminal neuralgia. The drugs used are typically for epilepsy or neuropathic pain, and while they can be effective, they can also come with significant side effects such as fatigue, cognitive effects, and rare skin or blood-related complications. Some people require several medications to manage their pain, and many still don’t find adequate relief.

For the 30% of patients who don’t respond to medication, there are three surgical approaches:

Microvascular Decompression: The most long-lasting approach is for patients whose MRI shows a blood vessel pressing on the nerve. A surgeon accesses the base of the brain, moves the offending blood vessel away from the nerve and places a small synthetic cushion between them. “For most people, this procedure provides sustained relief,” says Dr. Staudt. The surgery takes three to four hours and requires a brief hospital stay.
Radiosurgery: For patients who aren’t candidates for open surgery, radiosurgery uses focused radiation to target the nerve without a surgical incision. Pain relief typically takes about three months to set in.
Radiofrequency Rhizotomy: A minimally invasive procedure that targets the nerve directly through the skin, without opening the skull.

A New Approach to Radiofrequency Rhizotomy

Dr. Staudt’s team was the first in the world to use a new system, the OneRF^® Trigeminal Nerve Ablation System, that makes radiofrequency rhizotomy faster and more precise. They adapted the technology, which was originally developed for epilepsy. During the 30-minute procedure performed under light sedation and X-ray guidance, a needle is inserted through the cheek to treat nerve fibers in the skull with heat. The patient goes home the same day.

Relief typically lasts three to five years, after which the procedure can be repeated. In the first 15 patients treated with the new system, 14 experienced complete pain relief. “The vast majority of patients, over 90%, should expect to be pain-free after the procedure,” says Dr. Staudt.

For patients who aren't candidates for open brain surgery or who simply prefer a less invasive option, RF rhizotomy offers a new option for relief. The bigger challenge, Dr. Staudt says, is that too many patients never find help. Between the time it typically takes to reach the right diagnosis and the lack of awareness around advanced treatment options, many people suffer longer than they need to.

“Trigeminal neuralgia has been undertreated for too long,” Dr. Staudt says. “The technology is here to give these patients relief. They just need to be educated about it.”