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Other hearing diseases

Trigeminal neuralgia and ear pain

If you experience episodes of sharp, stabbing pain in your face or your jaw, it might be due to trigeminal neuralgia. This condition affects nerves that branch out to different parts of the head and face, and ear pain can be associated with it as well.

Key takeaways

  • Trigeminal neuralgia is a nerve disorder that causes sharp, intense, “stabbingpain, most often in the face or jaw.
  • Ear pain is a less common symptom of trigeminal neuralgia, but it can be associated. It’s often described as feeling like an earache.
  • The dense arrangement of nerves of the head and face can lead to interactions that cause ear pain with trigeminal neuralgia.
  • The first course of treatment for trigeminal neuralgia is typically medications such as anti-seizure medications or muscle relaxers.
  • Surgery is an option for more extreme cases of trigeminal neuralgia.
  • Botox and acupuncture are alternative treatments for trigeminal neuralgia, but should not be explored prior to medical treatment.
  • Other treatments for trigeminal neuralgia focus on learning to cope with the pain through activities like meditation, yoga or therapy.
  • Physiotherapy exercises can also be an option for attempting to reduce the pain.

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What is trigeminal neuralgia?

Trigeminal neuralgia is a nerve disorder that causes intense, sharp pain mostly in the face and jaw. The pain can come in sudden flareups but is sometimes almost constant. It typically happens on just one side of the face, but can happen on both — just not at the same time.

Neuralgiarefers to pain that occurs along the branches of a nerve, and “trigeminalindicates that the pain is happening in the trigeminal nerve. This particular nerve has a junction that sits just in front of the ear and three branches that spread outward across the face; one up toward the eyebrow, one across the cheek, and the other down toward the jaw.1

Trigeminal neuralgia is typically caused when pressure is put on the nerve, causing it to misfire pain signals. It’s often an artery or blood vessel that does this, but it can also be caused by a tumor. Other causes could include multiple sclerosis, in which the protective myelin sheath around the nerve is damaged; stroke; or a traumatic facial injury

Can trigeminal neuralgia cause ear pain?

While it is a less common symptom than facial or jaw pain, trigeminal neuralgia can be associated with ear pain. Many nerves are concentrated in the head and around the ears, and their close placements and interrelations can lead to overlapping symptoms that can be hard to tease apart.2 Several studies about the relationship of tinnitus and trigeminal neuralgia indicate that problems with the trigeminal nerve could affect nerves related to the inner ear. 3

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Trigeminal neuralgia symptoms

Trigeminal neuralgia symptoms include:

 

 Facial pain

● Jaw pain

● Ear pain

 

Those symptoms also have specific characteristics such as:

 

● Sudden, intense episodes of pain, sometimes described as electric shocks” that last seconds or minutes

● Longer episodes of pain that last days, weeks or months

● Pain triggered by mild touching of the face, brushing teeth, chewing, applying makeup or even wind

● Pain on one side of the face at a time

 Pain that gets worse over time, with episodes becoming longer

 

Trigeminal neuralgia facial pain can be triggered spontaneously or even by soft touch. This can result in intense, debilitating episodes of pain. It is one of the two most common symptoms of trigeminal neuralgia, along with jaw pain, and can occur from the eye area downward.

Trigeminal neuralgia jaw pain can be triggered by chewing or brushing teeth, which often causes people to go to their dentist first. However, because branches of the trigeminal nerve extend into the jaw, it’s not tooth pain causing the issue. This, along with facial pain, is one of the two most common symptoms of trigeminal neuralgia. 

If you experience trigeminal neuralgia jaw and ear pain, it may indicate that other nerves are being affected, or that the trigeminal neuralgia pain is radiating back toward the ear

Trigeminal neuralgia pain behind the ear can also be a symptom, though more rare than facial or jaw pain. It may feel similar to an earache.

Treatments for trigeminal neuralgia with ear pain

Trigeminal neuralgia treatment (with ear pain or without) typically starts with medication. Your doctor will prescribe it based on your specific symptoms and condition, but anti-seizure medications and muscle relaxers are common choices. Unfortunately, it’s not unusual for medications to become less effective for this condition over time.

In cases where medication isn’t effective, various surgical options are available. These can include surgeries to move or remove blood vessels or arteries that interfere with the trigeminal nerve, or injections that target the nerve fibers causing pain. 

Calming trigeminal neuralgia can be a challenge. Though it still needs further study to be recommended as a treatment, some people get Botox injections to help calm the pain. Other options for coping with the pain and lifestyle disruptions from trigeminal neuralgia include:

● Acupuncture

● Meditation

● Talk therapy

● Yoga

It’s important to seek medical treatment for trigeminal neuralgia before trying alternative medicine therapies that are not scientifically proven. 

A physiotherapist may be able to help you develop a routine of exercises to relieve trigeminal neuralgia, such as:

● Tilting the head from side to side

● Turning the head from side to side

● Bending the head forward and backward

A professional can determine how often to repeat these exercises, how long to hold them and how dramatic the movements should be. Work with them to learn the movements that you can practice either under supervision or at home. 

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*Miracle-Ear does not provide advice for or treatment of trigeminal neuralgia.

Sources

Shankar Kikkeri N, Nagalli S. Trigeminal Neuralgia. [Updated 2024 Mar 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554486.

Szymanski A, Geiger Z. Anatomy, Head and Neck, Ear. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470359/.

3 Cheng, YF., Xirasagar, S., Yang, TH. et al. Increased risk of tinnitus following a trigeminal neuralgia diagnosis: a one-year follow-up study. J Headache Pain 21, 46 (2020). https://doi.org/10.1186/s10194-020-01121-6.

Dr. Tom Tedeschi

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Dr. Thomas Tedeschi, Au.D.

Chief Audiology Officer, Miracle-Ear

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