8 doctors weighed in:

I have MS and trigem neuralgia and have terrible pain. Tried gaba, baclofen, norco, (hydrocodone and acetaminophen) elavil, tegretol, otc, etc...What is the best pain med for this?

8 doctors weighed in
Dr. Jack Mutnick
Internal Medicine - Allergy & Immunology
2 doctors agree

In brief: Trigeminal neuralgia

Sadly trigeminal neuralgia is a poorly understood disease that has an even worse track record for treatment.
Most patients suffer from this disease without much relief. There is a growing body of evidence looking into Lamotrigine as a treatment. Ask your prescribing doctor if this is an alternative.

In brief: Trigeminal neuralgia

Sadly trigeminal neuralgia is a poorly understood disease that has an even worse track record for treatment.
Most patients suffer from this disease without much relief. There is a growing body of evidence looking into Lamotrigine as a treatment. Ask your prescribing doctor if this is an alternative.
Dr. Jack Mutnick
Dr. Jack Mutnick
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3 comments
Dr. Sean Armin
for non-MS trigeminal neuralgia, the gold standard treatment is surgical: microvascular decompression of the trigeminal nerve.
Dr. William Gaya
Trileptal (oxacarbazepine) is a reasonable option. I have a patient with MS who responded very well to radiofrequency ablation.

In brief: Complicated

First, due to fact that your problem is part of MS, make certain you are taking a potent MS disease modifying agent such as Tysabri (natalizumab) or Gilenya.
You might try a course of steroids to cut down some of the pathology. Although Lyrica or Gralise are my favorites, would not be bad to seek a neurosurgeon who does transcutaneous balloon approaches to quell the nerve pain.

In brief: Complicated

First, due to fact that your problem is part of MS, make certain you are taking a potent MS disease modifying agent such as Tysabri (natalizumab) or Gilenya.
You might try a course of steroids to cut down some of the pathology. Although Lyrica or Gralise are my favorites, would not be bad to seek a neurosurgeon who does transcutaneous balloon approaches to quell the nerve pain.
Dr. Bennett Machanic
Dr. Bennett Machanic
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Dr. Stephen Rodrigues
Family Medicine

In brief: TN isn't easy define

Face pain is confusing to doctors.
Is it nerve, tension, tumor or not? So, I just use 2 types; Tumors or aneurysm or NOT. 2nd type is common from the stresses and strains of life collects in the muscles which can NOT be surgically “fixed.” This stress type needs treatment too but with a combo recipe concept. Wellness, minerals, myofascial release, massage, aerobics, soaking, Chiro and acupuncture.

In brief: TN isn't easy define

Face pain is confusing to doctors.
Is it nerve, tension, tumor or not? So, I just use 2 types; Tumors or aneurysm or NOT. 2nd type is common from the stresses and strains of life collects in the muscles which can NOT be surgically “fixed.” This stress type needs treatment too but with a combo recipe concept. Wellness, minerals, myofascial release, massage, aerobics, soaking, Chiro and acupuncture.
Dr. Stephen Rodrigues
Dr. Stephen Rodrigues
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Dr. Romanth Waghmarae
Pain Management

In brief: Trigem neuralgia

There is no best pain med.
Short term certainly stronger opioids may be tried but this is not a long term solution. You need to see someone about getting some nerve blocks etc.. Ultimately if nothing works then you have to consider a microvascular decompression of the nerve.

In brief: Trigem neuralgia

There is no best pain med.
Short term certainly stronger opioids may be tried but this is not a long term solution. You need to see someone about getting some nerve blocks etc.. Ultimately if nothing works then you have to consider a microvascular decompression of the nerve.
Dr. Romanth Waghmarae
Dr. Romanth Waghmarae
Thank
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