Departments: Ask the Experts
Smith, Jonathan H. M.D.
Jonathan H. Smith, MD, is an assistant professor of neurology at University of Kentucky in Lexington, KY. Dr. Smith is a member of the American Academy of Neurology.
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Your Questions Answered
Q Does physical exercise affect trigeminal neuralgia pain?
DR. JONATHAN H. SMITH RESPONDS:
A Moderate exercise may improve pain symptoms in trigeminal neuralgia (TN), a neurologic condition that causes chronic facial pain. The presumed cause of TN is a blood vessel pressing on the trigeminal nerve in the head. TN is more common after the age of 40. When it occurs in young people (usually women), it is most often associated with multiple sclerosis.
TN pain is most often felt in the lower half of the face, typically on one side only. It is most often brief, intense, and described by patients as “electrical,” “sharp,” and “stabbing.” While these attacks of pain have characteristic triggers—chewing, talking, smiling, light touch—exercise is not one of them. Most patients improve with medication, such as the anticonvulsant carbamazepine. The symptoms of TN may go away on their own for months at a time, especially early on. However, as time goes on, TN has a tendency to become more persistent. Many patients need surgery to control their pain.
Pain impacts many aspects of life. It can cause stress, depression, and limit your overall functioning. Exercise is a great way to relieve stress, improve mood and sleep, and provide a healthy distraction during tough times. However, certain activities, such as swimming or running outside, may prove problematic—the contact of water or wind on the face may trigger an attack of pain for people with TN. Indoors activities, such as running on a treadmill, may be more tolerable.
No clinical trials have been conducted to determine the effect of exercise on TN. In other pain conditions—such as fibromyalgia, chronic low back pain, and headache—aerobic exercise has been found to be helpful in improving pain. Aerobic exercise causes your body to release chemicals called endorphins, which naturally inhibit pain. However, moderation is important: overdoing it may be counter-productive and aggravate pain, an observation noted in studies of exercise in other pain conditions. Don't forget to talk to your doctor before beginning any new exercise regimen.