Nerve block for atypical dental neuropathic pain

I have neuropathic pain in teeth at multiple places in my mouth. It has been tested that most of the pain is coming from central nervous system not local. I have tried several main stream anti depressant, anti seizure, muscle relaxant but nothing helps or helps very little with highest possible doses of medicines. I have severe side effect from many. Recently I visited Cider-Sinai in LA and the oral facial pain specialist suggest me two have stello and speno ( may be the spelling is wrong) two different type of nerve blocks on upper and lower side of mouth. She said nerve block has no side effects. Either it works or it doesn’t but no side effect at all. She said if nerve block works then I can start cutting down Lyrica and Aptiom which I am taking now. But when I spoke to my neurologist, he strongly denied. He doesn’t even thinking that route. He said when the nerve block starts weaning off after few month, something goes up in central nervous system and you will have more pain. My neurologist only wants me to try out different medicines. But it is been almost 2 years and I have very little pain relief. But in any condition, I don’t want to increase my pain. Please suggest. Thank you so much for your help and wise suggestion.

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I am glad you are still fighting!
It is hard for doctors when people do different things and then they need to pick up the family doctor will only dose me with tiny amounts of pain pills-until the pain doctors told him to up it quite a bit.
If you have tried everything else-this is what you have left.
I am trying essential oil now -rubbing along the nerve and behind my ear and the nape of my neck.Chamomile and peppermint.
Someone suggested gelsemium-which is homeopathic.
For 10 bucks you can see if that works.
I will have to look up aptiom-never heard of it.
Your neurologist may be concerned about rebound pain and having to manage it.
I hope someone who has had the blocks responds.
Wishing you wellness.
Not knowing what your pain level is now

Don’t get sucked into the “any port in a storm” phenomena. All of us with chronic pain have a time or two.

Rebound pain IS common with nerve blocks. Its seems their popularity is regional. They used to be common for some types of surgery and are not anymore. There is risk with them despite what the “specialist” says. If the needle touches the nerve at all things can be bad for a long while if not for ever.

I’m not saying don’t just to think long and hard about it.


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I had 2 of the nerve blocks that went up my nose, did nothing. I was going to have the one through the cheek but had a major snow storm and cancelled. Your Neuro is right. The rebound pain can be horrible. I’ve not heard of one person where it has helped for long. Very short term and you have to keep getting them.

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Yes, I don’t want the pain to be anymore than what i have. I rather not try it than try for some temporary relief and get more rebound pain. My neurologist doesn’t want to try anything except medicines. Ellen, yes i am using different oils. I actually made a mixture of oils with base sweet Almond oil. It really helps and edge off the pain when it is peak. I made a mixture of Genranium, eucalyptus, Peppermint, Rosemary, Basil, francancin, Hypericum. Thanks everyone who replied or would reply. Please write your experience with Nerve blocks. Thanks

Hi! I had a sphenopalatine nerve block which is the needle in the face. It didn’t work for me. And the pain was worse after. Maybe it works for some people? I felt it was worth a shot. My pain management doctor doesn’t want me on pain medication.
He wanted to do the other block but I am not ready to try that yet.
The hardest part is that my doctor finally has my pain at a level I can deal with but everything is so strict on pain medication that after 3 months he wants me to reduce my dose and then get off. Dreading next month.
I hope someone posts about a successful nerve block.

I have had facial pain for 3 years now. I went to Mayo clinic and had a stellate ganglion block. This shot is done in the operating room with no medication for pain, The shot is administered between your Corotic artery and jugular vein. You are begged to stay very still. Scary as heck for me. It was over quick. After the shot you have a droopy eye. This is a side effect for about 4 hours. The neurologists hope to see this as they know it went as planned. I was unable to cough for 4 hours and then it wore off. Much to my distress this was unsuccessful…I was told that I could have up to 5 of these. I did not continue treatment…

Cider Sinae doctor told me that they specialized in giving these nerve blocks and they are very successful. She said there is absolutely no side effect. Either it works or it doesn’t but no side effect for what so ever reason. She also mentioned that you have to take few of them before you know it works. It looked very lucrative for a patient like me who is suffering from toothache at various places in mouth to from last 2 yrs. I was hopeful that i would get some relief, but my neurologist even paid any attention. He said when the nerve block weans off, it makes an imbalance and increase the pain. I surely wants to hear more stories of people who experienced and had success or failure. Please share.

Hi, I have had neuropathic Trigeminal pain for 14 yrs. and have been a patient of The Pain Center at Cedars-Sinai for 10 yrs. About 8 yrs. ago, I had 2 nerve blocks which did not work at all. My pain management doctor there recently passed away so now I’m seeing his associate.

I know that any surgical procedure has its risks. I know, because I had a Gamma Knife , and a Glycerol procedure—both of which have caused permanent numbness and increased pain. ( This was before I started going to the pain center at Cedars Sinai.) The point I want to make is. be sure the diagnosis is correct. It was not in my case! Most surgical procedures are designed for typical, classical Trigeminal Neuralgia.

Hang in there. Be positive. There are many non-surgical avenues such hypnosis, meditation, cold packs, and whatever you learn about!

Sorry to hear about your pain. Did you ever get remission or you always had this pain with you since last14 years. I don’t know what type of pain and where you have pain but I read and heard from many places and people that the dental atypical pain mostly go away in 2-3 years. I hope it happens in my case. I know your doctor who passed away . His name is mentioned in the striking back book many times. I hope you are getting the good treatment from his followers. I am doing Taichi, yoga and cold therapy, aroma therapy. But nothing is a permanent treatment… thanks

Swayam, I have never heard that! Hopefully that is indeed the case, and gives me some hope. I’m at 1 1/2 years now, maybe it is just a matter of time.

Me too-yay
We will all get better at the same time
Touch wood.

Dear Swayam, Ziggy, and Ellen5, I don’t want to give you the impression that your kind of nerve pain won’t go away. I hope and pray it will. Mine was caused by the injuring of Trigeminal Nerve (2nd) branch during sinus surgery. The two procedures I had during the next few years were designed to further injure the nerve, including now the 3rd branch, so that the nerve would be killed .So, you see, its not dental atypical at all!
No, actually, my condition has gotten worse every year and it never goes away. (I think I’m the world’s worse pill popper, taking large doses of meds. 6- times a day.) Now considering taking marijuana so maybe I can go off some of the opioids. Thanks for letting me vent! Keep positive and yes, I think alternative therapies may be the answer.

Hi Jat
I have not found a strain that helps the pain.I find that the indica oil helps me stay asleep.If you do find a marijuana strain that helps then please let me know.Ziggy found the burning pain stopped when she quit the opiates.
The marijuana can make me immobile and still have pain.At least with opiates-I can still function somewhat.
But I do like rubbing in the peppermint essential oil on the outer skin.Another tool in the kit.
Wishing you wellness

I tried nerve block. It was extremely painful procedure. Your neurologist is correct it became more painful for me. . You might work with the pain specialist and neurologist as a team. Best of luck!

Hi everyone,

I’ve recently been diagnosed with what I hope is now the correct diagnosis of Atypical Trigemnial Neuralgia.

I have done several nerve blocks for sure. Pain started 4 years ago, slowly changed and progressed to what is now matching ATN. I’ve had some incorrect diagnosis which led to radiation treatment of both of my eye orbits, and almost two years of high dose pulse IV pulse steroids, and all kinds of other things which helped temporarily, but I have had a wee bit of success with some nerve blocks.

I’ve done the Botox migraine protocol which was definitely the most effective one.

The sphenopalatine block was not as effective. They’ve done both the hollow tube up the nose where the dripped lidocaine periodically down the tube to the area over a period of 45 mins., as well as the giant Q-tip covered in a jelly like coating of their conception smeared over the area in a matter of minutes.
The initial SPG block/45 minute version lasted 3 weeks, whereas the later only two hours and ended up in a massive flare up/ER visit due to unbearable pain.

They recently tried the SPG block through the cheek from the side which was not effective at all.

The botox was still the most effective but still needed to go along with my other meds being Topiramate, Butrans pain patches, Cymbalta, Vimovo, and CBD oil.

I have to say that I too recently replaced hydromorphone with CBD oil and a version of CBD/THC for breakthrough pain which absolutely shocked me…I had noooo idea MM could handle this kind of pain! I’ve never been into it but wow!

I couldn’t renew my script when my GP cancelled my appointment and left town for two weeks, and I had no other options, so I tried it and it worked! ??

I’ve had two different blocks and neither worked (my pain is also neuropathic in nature). There’s not sufficient evidence supporting nerve blocks for our type of pain. Personally, I would skip it.

I’ve had 2 nerve blocks for TN. The first one lasted for the rest of the day. The second didn’t kick in until 2 weeks. I’m not having any more done. I really don’t think they work. What I’ve been doing is juicing celery with other veggies or fruit. They say that celery helps with nerve pain. I also do acupuncture which I really enjoy

I have had TN for 7 years. I have been on disability for 3 years because of the pain. I had Gamma Knife done in Dec with no relief. I am on a high dosage of medicine and it makes me so tired but if I miss one dose the pain is unbearable. My doctor suggested a nerve block but after reading the comments I don,t think it sounds like a good idea. I started going to pain management 4 months ago for pain pills. They help some but it does not take the pain away when I am having a severe attack. It controls my like. I am afraid to drive or leave the house. I plan everyday of my life around my pain level. The worst part is you can feel fine and then 5 minutes later you can be crying with the pain. I have just decided I have to deal with it and enjoy the good days when I have them. I have a cream that my doctor prescribes that is from a specialty pharmacy sometimes it helps. If I am going somewhere I put it on my face and behind my ear hoping it will help ward off an attack.