Does CBD Oil Help Patients with Trigeminal Neuralgia? [Exploring the Science]
Trigeminal neuralgia is a painful condition affecting the nerves of the face. It can make everyday activities such as eating and talking unbearable and have a significant impact on a person’s life.
Furthermore, traditional painkillers often don’t help numb the agony of trigeminal neuralgia. Doctors sometimes prescribe anticonvulsant drugs, which can ease the pain but come with a long list of potential side effects. This situation has left many patients wondering whether natural remedies like CBD oil could help.
So, does CBD oil help patients with trigeminal neuralgia? Keep reading to find out.
What Is Trigeminal Neuralgia?
Trigeminal neuralgia is sometimes called tic douloureux. It is a condition that affects the fifth cranial (trigeminal) nerve. This nerve is one of 12 pairs that attach directly to the brain, and it connects to the face with three branches. These branches supply the:
- Upper, middle, and lower regions of the face
- Forehead and scalp
- Cheeks and upper jaw
- Lower jaw
Trigeminal neuralgia occurs when this nerve becomes compressed, leading to facial pain. The level of discomfort could interfere with everyday activities and severely reduce one’s quality of life.
Therefore, many patients with trigeminal neuralgia also suffer from depression, sleep problems, and anxiety.
Trigeminal Neuralgia Symptoms
The main symptom of trigeminal neuralgia is severe facial pain. This pain is sometimes unpredictable and arrives suddenly with little warning. Most people describe it as a shooting pain, which can feel like an electric shock in the jaw, teeth, and gums.
These symptoms usually affect just one side of the face. Occasionally, both sides are affected, but usually not at the same time.
Trigeminal neuralgia attacks can last for anywhere between a few seconds and two minutes.
In severe cases, they may occur hundreds of times each day. Bouts can last for days, weeks, or months at a time. At this point, patients may experience a symptom-free period (remission).
However, over time, these periods of remission can become shorter. Eventually, a patient may be left with a continuous throbbing, aching, or burning sensation, even between attacks.
Unsurprisingly, trigeminal neuralgia often causes other symptoms, such as weight loss if a patient is unable to eat properly.
What Causes Trigeminal Neuralgia?
Trigeminal neuralgia is the result of pressure on the trigeminal nerve. In approximately 95% of cases, the condition is due to a blood vessel pressing on the nerve. This is known as primary trigeminal neuralgia.
In other cases, the pressure could come from a cyst, tumor, or cluster of malformed blood vessels. It may also be related to multiple sclerosis or due to an injury or surgical damage. These cases are called secondary trigeminal neuralgia. Nobody is sure why some people develop trigeminal neuralgia and not others. However, it is more prevalent in women and those over 50 years of age.
Trigeminal Neuralgia Triggers
Even the slightest movement or touch can trigger an episode of trigeminal neuralgia. However, in some cases, the symptoms of trigeminal neuralgia can flare up without any apparent cause.
Some common triggers include:
- Washing the face
- Brushing the teeth
- Applying makeup
- Cold drafts/air conditioning
- Head movements
- Vibrations, including walking or traveling by car
Although it is impossible to avoid all of these triggers, patients can help themselves in some situations. Some find that wrapping a scarf around their face and avoiding drafts provide some relief. Drinking through a straw and liquidizing meals are also options, although they are not always practical.
Common Trigeminal Neuralgia Treatments (Not CBD Oil)
Regular painkillers have little effect on trigeminal neuralgia. Therefore, most doctors prescribe anticonvulsant drugs to help manage the condition. Although these medications are designed to treat epilepsy, they have the effect of slowing down nerve signals and relieving pain.
One of the most common examples is carbamazepine (Tegretol). Unfortunately, this medicine comes with a list of unpleasant side effects, including:
- Poor concentration
- Double vision
Furthermore, this drug can become less effective over time, leaving patients searching for an alternative.
Other treatments include surgery and percutaneous procedures. The latter involves intentionally damaging the nerve to block its signals. Therefore, it can leave patients with numbness or pins and needles on the affected side of the face.
Complementary approaches include acupuncture, biofeedback, and meditation to help with pain management. However, there is sparse clinical evidence to support the use of these techniques.
With such limited treatment options available, it’s unsurprising that many patients are dissatisfied. Therefore, many are wondering whether CBD oil can help trigeminal neuralgia. Let’s take a look.
CBD Oil for Trigeminal Neuralgia
Cannabidiol, also known as CBD, is now among the most popular natural health products in the world. It is one of the many active compounds found in cannabis plants.
Unlike THC, CBD does not cause intoxication. However, it does have a wide range of both physical and psychological effects. These effects are primarily due to CBD’s ability to interact with the body’s built-in endocannabinoid system (ECS).
The Endocannabinoid System and Pain
The ECS is a complex network of cell receptors called cannabinoid receptors and chemicals called endocannabinoids. When these components bind together, they trigger a variety of responses that help to maintain a state of homeostasis (balance).
The ECS runs throughout the entire body, including the brain and nervous system. It is involved in controlling mood, movement, memory, and pain.
Scientists are still working hard to determine the exact role of the ECS in pain management. However, it appears to interact with several of the body’s other systems, including the endorphin/enkephalin system. These are the body’s natural analgesics, and it is the system that opioids act upon to relieve pain.
The ECS also has a close connection with pain receptors known as TRPV1. These receptors work to detect both heat and pain. For example, they become active when someone eats spicy food, such as chili peppers. They send messages to the brain via nerve fibers and help to trigger a healing response.
How CBD Could Work for Pain Relief
CBD works by increasing the levels of natural endocannabinoids. In this way, it can enhance the activity of the ECS and aid patients with inflammation and pain. It also has neuroprotective effects, allowing it to potentially protect nerve cells from damage.
There are few studies specifically on CBD for trigeminal neuralgia. However, there is some evidence that it can benefit neuropathic pain. For example, this 2008 review, Cannabinoids in the Management of Difficult to Treat Pain, suggests that these compounds show ‘great promise’ in the treatment of neuropathy.
Research is ongoing, but hopefully, in the future, we will see substantial evidence regarding the efficacy of CBD for trigeminal neuralgia
CBD Oil for Anxiety and Depression Associated with Trigeminal Neuralgia
Due to its debilitating nature, many people with trigeminal neuralgia also suffer from depression, anxiety, and sleep issues. Fortunately, this is another area where CBD oil may help.
A 2014 study for CNS and Neurological Disorders Drug Targets found that CBD has both antidepressant and anti-anxiety properties.
Again, this is due to how the compound interacts with the ECS. It increases the circulating amounts of a specific endocannabinoid called anandamide. This chemical is often referred to as ‘the bliss molecule.’
CBD may also help to support healthy sleeping patterns, as this 2019 study for The Permanente Journal demonstrated. Of its 72 participants, 57 experienced reductions in anxiety scores while 48 experienced better sleep.
How to Take CBD Oil for Trigeminal Neuralgia
Those living in a state where medical marijuana is legal may wish to apply for a medical marijuana card. Several states list neuropathic pain as one of their qualifying conditions. Patients in these locations can benefit from more potent products containing THC alongside CBD.
Those who don’t live in a legal state can try a CBD oil that comes from hemp. Hemp contains less than 0.3% THC and is widely legal in the US.
The most popular way of taking hemp-derived CBD is via an oil. The preferred method of taking CBD oil is to place the oil under the tongue and hold for 60–90 seconds before swallowing. CBD is also available in many other forms, including capsules, edibles, vape products, and topicals.
Each of these forms has its pros and cons. For more information, check out our article CBD Therapy: Which Is Best for You?
One thing to consider when purchasing CBD oil for trigeminal neuralgia is whether the product is full-spectrum or an isolate. Full-spectrum products are potentially more effective since they contain a range of other cannabis compounds alongside CBD.
This is relevant because other cannabinoids, such as CBC and CBG, and some cannabis terpenes also have painkilling properties. Many experts believe that these chemicals work together synergistically to produce enhanced effects.
It is also essential to choose a CBD brand carefully. Some companies are selling inferior goods thanks to a lack of market regulation. Look for a brand that publishes third-party lab reports to confirm the cannabinoid content of their oils. It is also important to read plenty of reviews before buying.
Does CBD Oil Help with Trigeminal Neuralgia? Final Thoughts
Those who have pain due to trigeminal neuralgia may find CBD oil useful. Still, bear in mind that CBD may not be powerful enough to manage the condition by itself. However, it could potentially provide some additional relief alongside other treatment methods.
It should be noted that CBD can interact with many prescription and over-the-counter drugs and could increase the risk of adverse effects. Therefore, patients should consult a medical professional before taking CBD oil for trigeminal neuralgia. They will be able to monitor progress and adjust the amount consumed if necessary.
CBD Oil for Trigeminal Neuralgia: Is Cannabis a Viable Approach?
Neuropathic pain has many faces, one of which includes trigeminal neuralgia. This condition affects the nerves that transmit sensation from the face to the brain, causing severe discomfort comparable to an electric shock. The TN pain can be triggered by the slightest movement or touch anywhere on the face, commonly affecting the lips, gums, jaw, and cheeks.
People with trigeminal neuralgia usually suffer from flare-ups affecting one side of the face at a time. Although short-lived at the beginning, the episodes of burning sensation may become chronic, lasting for weeks or longer.
CBD has been mentioned by researchers as a potentially viable remedy for pain that is difficult to treat. Trigeminal neuralgia fits within this definition like a glove.
Today we’ll elaborate on the problem of TN pain and how to treat it with natural resources.
CBD Oil for Trigeminal Neuralgia: Highlights
- Trigeminal Neuralgia (TN) develops as a result of the damage caused to the trigeminal nerve, causing severe pain on the face.
- CBD’s interaction with the endocannabinoid system (ECS) may provide relief from neuropathic pain by mitigating the pain signals. According to a study published in Pharmacological Reviews, CBD strengthens nerve impulses in the ECS receptors, producing analgesic effects (1).
- A review of studies concluded that CBD might be useful in reducing neuropathic pain and sensitivity to pain signals (hyperalgesia) (2).
- Researchers have reported that hypertension (high blood pressure) increases the risk of trigeminal neuralgia. In a 2017 study, subjects who received CBD showed reduced resting blood pressure (3).
- More clinical studies on humans are needed to support the preclinical findings of CBD’s benefits for people with trigeminal neuralgia.
Why People Are Turning to CBD for Trigeminal Neuralgia?
The dysfunction of the trigeminal nerve can have debilitating consequences for the sufferers. It causes severe pain on the face that occurs upon even the slightest movement, such as touching, scratching, or rubbing. The condition may also cause muscle spasms and burning sensations on top of the shock-like pain.
The treatment of trigeminal neuralgia usually involves anticonvulsant medications, antispasmodic agents, surgery, and other procedures involving the trigeminal nerve. Antiepileptic drugs, such as carbamazepine and gabapentin have been used with some success, although they lack efficacy and intolerability with prolonged use.
This is where CBD starts to shine.
Studies on CBD and Trigeminal Neuralgia
CBD is an acknowledged antiepileptic treatment. Its anticonvulsant and neuroprotective properties have been recently posted in a study from the journal Molecules. These actions might be useful in reducing muscle spasms in TN patients (4).
Although studies haven’t analyzed the efficacy of CBD on spasms caused by TN, there is evidence that CBD may have significant benefits for treating chronic pain caused by the condition.
One review has pointed to CBD as the potential reliever of hyperalgesia (pain sensitivity). The review mentioned that CBD can effectively block the pain pathway’s neural transmission. The authors also highlighted the nociceptive effects of cannabinoids, describing them as the potential therapeutic approach to the management of TN pain.
The painkilling and anti-hyperalgesia effects of CBD were supported by an animal study published in the Journal of Experimental Medicine. The study suggested that CBD reduced pain and inflammation caused by neuropathy.
Neuropathy stems from dysfunction or damage in the nerves that may trigger pain, tingling sensation, muscle weakness, and numbness.
On top of the above findings, the authors of the study added that CBD was able to curb hyperalgesia in mice models. There was a conclusion that CBD reduced persistent inflammation and neuropathic pain.
Another paper from the European Journal of Pharmacology demonstrated remarkable anti-inflammatory and immunomodulatory effects of CBD. Cannabidiol was administered to rats with induced sciatic nerve pain. The research team found that CBD treatment lowered inflammation and reduced hyperalgesia (5).
Experts hypothesize that trigeminal nerve pain can be caused by the contraction of blood vessels in the trigeminal nerve. This contraction damages the trigeminal protective tissue. Furthermore, researchers noticed that high blood pressure contributes to the development of trigeminal neuralgia (6).
A 2017 preclinical study found that CBD has benefits for the cardiovascular system. The authors reported that healthy individuals (age 21–29) with hypertension caused by a stressful event showed lower blood pressure after taking CBD (7).
Since the majority of the studies on CBD and trigeminal neuralgia have been conducted on animal models and preclinical human samples, longitudinal clinical studies are needed to further prove CBD’s ability to treat the condition.
How Does CBD Oil Work for Trigeminal Neuralgia?
The benefits of CBD for trigeminal neuralgia are attributed to the human endocannabinoid system (ECS). The ECS is the major regulatory network engaged in maintaining homeostasis in the central nervous system, peripheral nervous system, immune system, and organs. The ECS contains receptors that are found throughout the body, including CB1, CB2, and glycine receptors.
Studies have found that the modulation of the ECS might promote the healthy functioning of biological processes, providing a wide range of therapeutic benefits.
For example, a study published in the Journal of Experimental Medicine found that modulating the ECS translates into therapeutic effects for pain management. The authors also mentioned that glycine receptors in the central nervous system are important targets for reducing neuropathic pain. According to the study, cannabinoids such as THC and CBD might enhance the activity of the glycine receptors, resulting in analgesic effects.
Glycine receptors are ion channels that control the transmission of pain signals from the nerve to the brain.
The study found that oral CBD products resulted in a binding glycine activity that lowered neuropathic pain and hyperalgesia in animal models.
The Pros and Cons of CBD Oil for Trigeminal Neuralgia
- Numerous studies have demonstrated the therapeutic potential of CBD in pain management thanks to its ability to modulate receptors in the ECS.
- Researchers agree that CBD might strengthen nerve impulses and increase pain resistance.
- Animal studies have found that oral CBD solutions might be useful in lowering one’s sensitivity to pain.
- CBD can reduce blood pressure in healthy volunteers, indirectly reducing the risk of trigeminal neuralgia
- Many international medical organizations agree that CBD is well-tolerated in humans and has a high safety profile.
- There is not enough clinical evidence to support CBD’s efficacy in treating trigeminal neuralgia
- CBD has a few mild side effects, including dry mouth, reduced appetite, drowsiness, and CBD-induced drug interactions
- According to one animal study, extremely high doses of CBD can cause liver toxicity. However, these results haven’t been confirmed on human subjects.
CBD vs. Alternative Treatments for Trigeminal Neuralgia
There are limited options when it comes to alternative treatments for trigeminal neuralgia. The alternative anticonvulsants, except for CBD, aren’t supported by scientific studies. Recently, acupuncture has been touted for its effectiveness in treating neuropathic pain. There are lots of reports from TN patients who claim to have successfully treated TN with acupuncture.
Acupuncture is part of traditional Chinese medicine that uses tiny needles to balance the energy flow within the body. Studies also mention acupuncture’s ability to support homeostasis in the ECS. However, direct studies are needed to find out how acupuncture affects cannabinoid receptors.
One study from Frontiers of Molecular Neuroscience has found that electroacupuncture increased receptor activity in the rat models of osteoarthritis, resulting in reduced pain. Electroacupuncture is performed by sending electric signals through the microneedles (8).
Weird as it may sound, CBD has similar effects on the body to electroacupuncture. One study has found that the modulation of adenosine receptors resulted in mitigated pain and lower inflammation in mice after they took CBD (9).
Vitamin B12 is another alternative for trigeminal neuralgia. Research shows that vitamin B12 has painkilling properties that may aid patients in managing neuropathic pain.
Several clinical studies have reported positive results after treating patients with methylcobalamin, a form of B12. These studies examined patients with different types of neuropathy, such as trigeminal neuralgia and diabetic neuropathy (10).
How to Take CBD Oil for Trigeminal Neuralgia?
CBD comes in different forms, concentrations, and formulas. It may be taken orally in the forms of capsules or gummies, or sublingually as oil drops. Some people vape CBD, while others use it topically for localized relief. The choice of the product boils down to your individual situation.
CBD oil is the most common format. It contains a hemp extract infused into an inert oil, such as MCT oil or olive oil. CBD oil comes with a dropper for easier and more accurate dosing. You just squeeze the preferred amount using the dropper, place a few drops under your tongue, and wait for up to 60 minutes until it absorbs through tiny capillaries in your mouth. The calming effects of CBD should be felt within 15–20 minutes.
If you don’t like the taste of CBD oil, capsules and edibles are a good alternative. CBD capsules are available in the form of soft gels, providing a fixed dose of CBD per serving. They are better suited for busy people who take their CBD on the go. Since the CBD needs to pass through the digestive system before absorbing into the bloodstream, capsules have a delayed onset, usually around 40–90 minutes depending on your metabolism and whether or not you’re taking CBD oil on an empty stomach.
Edibles work in a similar fashion, but they are made with fun flavors that make the whole experience more enjoyable. The most popular forms of CBD edibles are gummies and honey sticks.
If you’re looking for the most effective way to deliver CBD to your system, CBD vape pens will be your best bet. Vaporized CBD gets into the bloodstream through the lung tissue, producing its effects within minutes after inhalation. CBD vapes also offer the highest bioavailability of all consumption methods, ensuring that up to 56% of the ingested substance is absorbed.
Finally, you may try a topical formulation, such as CBD creams for localized relief. Topicals work best for flare-ups because they address inflammation by interacting with the CB2 receptors in the skin’s endocannabinoid system. The absorption rate and duration of CBD topicals vary between products; you may need to reapply the dose after a few hours for consistent results.
Dosage of CBD Oil for Trigeminal Neuralgia
There are not enough clinical trials to determine the effective CBD dosage for specific health conditions.
According to a study published in the British Journal of Pharmacology, a low dose may vary from less than 1 to 50 milligrams per one kilogram per day. Everybody is different, and factors like your age, gender, metabolism, weight, overall health, and prior experience with CBD will affect your optimal dosage range.
It will take some experimentation until you find out what works for you. It is recommended to start with a low dose, say, 10 mg of CBD once or twice daily for one week — and observe the results. If you don’t feel any pain relief after that time, add another 10 mg to the dosage and continue for another week. Once you’ve found an effective dose, you can stick to it — people don’t build a tolerance to CBD.
If you’re thinking about adding CBD oil to your trigeminal neuralgia treatment, consult a holistic doctor experienced in CBD and cannabis therapies in general. Doing so will help you determine the right dosage range for your condition on top of avoiding potential negative CBD-induced drug interactions.
Summarizing the use of CBD for Trigeminal Neuralgia
Studies support CBD’s therapeutic effects in a range of painful conditions, including neuropathic pain. CBD modulates the activity of the cannabinoid receptors in the ECS, mitigating pain signals and reducing inflammation throughout the body. Moreover, CBD has been found to reduce blood pressure when administered under stressful conditions. All these effects can have a positive impact on the symptoms of trigeminal neuralgia. CBD is also an acknowledged anticonvulsant and neuroprotectant, so it can prevent further damage to the trigeminal nerve.
More direct clinical trials are needed to prove CBD’s efficacy specifically in alleviating TN pain. However, current findings, as well as reports from patients, are very encouraging.
Do you take CBD for trigeminal nerve pain? What products work best for you? Share your thoughts in the comment section!
- Pacher, Pál et al. “The endocannabinoid system as an emerging target of pharmacotherapy.” Pharmacological reviews vol. 58,3 (2006): 389-462. doi:10.1124/pr.58.3.2
- Liang, Ying-Ching et al. “Therapeutic potential of cannabinoids in trigeminal neuralgia.” Current drug targets. CNS and neurological disorders vol. 3,6 (2004): 507-14. doi:10.2174/1568007043336833
- Turner, C L et al. “Measurement of pulse pressure profiles in patients with trigeminal neuralgia.” Journal of neurology, neurosurgery, and psychiatry vol. 74,4 (2003): 533-5. doi:10.1136/jnnp.74.4.533
- The U.S. Food and Drug Administration. The FDA Approves First Drug Comprised of Cannabidiol.
- Costa, Barbara et al. “The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain.” European journal of pharmacology vol. 556,1-3 (2007): 75-83. doi:10.1016/j.ejphar.2006.11.006
- Trigeminal Neuralgia Overview.
- Jadoon, Khalid A et al. “A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study.” JCI insight vol. 2,12 e93760. 15 Jun. 2017, doi:10.1172/jci.insight.93760
- Yuan, Xiao-Cui et al. “Electroacupuncture Potentiates Cannabinoid Receptor-Mediated Descending Inhibitory Control in a Mouse Model of Knee Osteoarthritis.” Frontiers in molecular neuroscience vol. 11 112. 6 Apr. 2018, doi:10.3389/fnmol.2018.00112
- Russo, Ethan B. “Cannabinoids in the management of difficult to treat pain.” Therapeutics and clinical risk management vol. 4,1 (2008): 245-59. doi:10.2147/term.s1928
- Zhang, Ming et al. “Methylcobalamin: a potential vitamin of pain killer.” Neural plasticity vol. 2013 (2013): 424651. doi:10.1155/2013/424651
Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.
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Trigeminal Neuralgia Or Neuropathy treated using CBD and THCa
Trigeminal Neuralgia is a specific variant of neuropathy that primarily effects the Fifth Cranial or facial nerve.
Trigeminal Neuralgia is often seen after facial or facial nerve trauma. The pain is neuropathic in nature, meaning it is severe, burning and often “suicidal” in nature. Neuropathic pain is often described as “suicidal” as it is often so severe, the patients will often consider suicide as a way out of this very severe neuropathic disorder.
The patients treated, generally are taking moderate doses of narcotics and often are being treated with acupuncture as well as other modalities in attempts to relieve the pain.
In recent months, we have tried using combinations of CBD and THC-Acid as treatment for neuropathic pain and in particular Trigeminal Neuralgia.
We have also found that THC-Acid is a very good therapy for neuropathic or neuralgic pain. Combining THC-Acid with CBD generally gives very good results in treating neuropathic or neuralgic pain.
THC-Varin is also therapeutic in the treatment of neuropathic or neuralgic pain. Combining THC-V and THC-A should give patients relief as well.
1. “For several years, I was taking medication for my trigeminal neuralgia that had severe side effects. Since Dr. Frankel prescribed cannabis medication, my pain has been under control with no side effects. Because of my very positive experience, I recommend that patients with trigeminal neuralgia to try cannabis-based medication instead of the standard treatment.”
2. “i do not have any more pain in my face and the swelling of my gums is almost normal. Can’t tell you how happy that makes me. I am very please with the outcome. “
Allan Frankel, MD Dr Allan Frankel is one of the few physicians in the US who truly understands Cannabis as a medicine. All treatments suggested have been well studied. Every patient seen by Dr Frankel is given a personally created Treatment Plan created with the patient’s specific issues defined. Plant medicine requires “tuning” of the dosing. Dr Frankel works with his patients thru a messaging portal. The use of this portal, allows quick and simple follow up contact with Dr Frankel. Patients are not charged for these messages, as this is how Dr Frankel has learned what he has learned. Follow up appointments in person or by phone/video are also available when needed
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