If you have ever felt a sudden, electric shock rip through your cheek or jaw because you dared to brush your teeth or catch a cold breeze, you know exactly why they call trigeminal neuralgia the "suicide disease." It is brutal. Honestly, it’s one of the most agonizing conditions known to modern medicine. When the pain hits, the only thing on your mind is whether this is your new permanent reality. You want to know, flat out: can trigeminal neuralgia go away, or are you stuck with this lightning bolt in your face forever?
The short answer is complicated. Trigeminal neuralgia (TN) rarely just "vanishes" for good on its own, but it does have a habit of disappearing for weeks, months, or even years at a time. These are remissions. They’re beautiful, quiet breaks in the storm. However, for the vast majority of people, the underlying cause—usually a blood vessel pressing against the trigeminal nerve—doesn't just move away of its own accord.
The Reality of Remissions vs. Cures
It’s easy to get hopeful when the pain stops. You might go three months without a single twinge and think, Okay, I’m healed. Doctors like Dr. Mark Linskey, a renowned neurosurgeon at UC Irvine, often point out that TN is characterized by these spontaneous remissions. In the early stages of the disease, it is completely normal for the pain to retreat.
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But here is the catch.
As time goes on, those pain-free windows usually get shorter. The "shocks" become more frequent. What started as a once-a-year event might turn into a daily battle. While you might find stories on forums about someone whose TN went away after they changed their diet or started taking a specific supplement, these are largely anecdotal. Scientifically speaking, if the myelin sheath (the insulation around your nerve) is worn down because a pulsing artery is thumping against it 70 times a minute, a green smoothie isn't going to fix that physical compression.
Why does the pain stop temporarily?
Nobody is 100% sure why the nerve suddenly decides to go quiet for a few months. Some researchers suggest that the nerve might temporarily recover some of its insulation, or perhaps the inflammatory response in the area dips. Whatever the reason, if you are in a "quiet" phase, enjoy it. But stay vigilant.
Understanding the "Why" Behind the Pain
To understand if can trigeminal neuralgia go away, you have to look at what’s happening at the base of your brain. Most cases (Type 1 TN) are caused by vascular compression. Think of it like a heavy boot standing on a garden hose. The hose—the trigeminal nerve—starts to fray.
There are other causes, though.
- Multiple Sclerosis: About 1% to 5% of people with MS develop trigeminal neuralgia because the disease attacks the myelin throughout the body.
- Tumors: Very rarely, a benign tumor might be pressing on the nerve.
- Aging: As we get older, our arteries can become more "tortuous" or elongated, making them more likely to slump onto a nerve.
If your TN is caused by MS, the "going away" part depends entirely on managing the broader autoimmune condition. If it's a blood vessel, the pain usually won't stop until that physical relationship between the vessel and the nerve is altered.
Treatment Paths: Can Surgery Make It Go Away?
Since the body usually won't fix the compression itself, medical intervention is the standard route. This is where we move from "waiting for it to go away" to "making it go away."
The gold standard for many is Microvascular Decompression (MVD). This is real brain surgery. A surgeon like Dr. Jannetta (who pioneered the procedure) goes in, finds the offending vessel, and places a tiny Teflon felt pad between the nerve and the artery. It’s like putting a cushion between a hammer and an anvil.
Does it work? For about 70% to 80% of patients, MVD provides immediate and long-term relief. For some, the pain literally never comes back. In that sense, yes, it goes away. But even MVD isn't a 100% guarantee; nerves have "memory," and sometimes the pain persists even after the pressure is gone.
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Non-Invasive Options
Not everyone wants their skull opened. I get it. Gamma Knife Radiosurgery is a popular alternative. It uses targeted radiation to purposefully damage the nerve root to block pain signals. It doesn't work instantly—it can take weeks to kick in—and the "cure" often lasts about three to five years before the nerve potentially heals enough to start misfiring again.
Then there’s medication. Carbamazepine (Tegretol) is usually the first line of defense. It’s an anticonvulsant that stabilizes the nerve. It doesn't make the condition go away; it just mutes the brain's ability to feel the shocks. Many people find the side effects—brain fog, fatigue, dizziness—almost as bad as the pain itself.
The Psychological Toll of the "Wait"
Living with a condition that might or might not flare up today is exhausting. It's "anticipatory anxiety." You stop eating crunchy foods. You stop kissing your spouse on that side of the face. You avoid air conditioning.
This lifestyle change is why many experts argue that even if the pain "goes away" for a few months, the condition is still present in the patient's mind. The trauma of the shocks lingers long after the shocks stop.
Specific Details: Atypical vs. Typical
You need to know which version you have.
- TN1 (Typical): Extreme, sporadic, sudden burning or shock-like pain. This is the one more likely to have remissions.
- TN2 (Atypical): A constant, lower-intensity aching or burning. This version is much less likely to "go away" on its own and is notoriously harder to treat with surgery.
If you have TN2, the "can it go away" question is even thornier. It’s often managed rather than cured. Gabapentin or Baclofen are frequently used here, but they are bandages, not cures.
Actionable Steps for Management
If you are currently suffering and hoping the pain will just vanish, here is the realistic roadmap you should follow. Don't just wait for it to disappear.
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1. Track the Triggers
Keep a "pain diary." Is it triggered by cold water? Wind? Chewing? If you can identify a trigger, you can protect the nerve. Some people wear a silk scarf year-round to keep the wind off their face. It sounds simple, but it prevents the "wind-up" effect where the nerve becomes hyper-sensitized.
2. Seek a High-Volume Surgeon
If you are considering surgery to make the pain go away, do not go to a generalist. You want a neurosurgeon who performs MVDs weekly, not twice a year. The Facial Pain Association (FPA) is a great resource for finding specialists who actually understand the nuances of the trigeminal nerve.
3. Dental Check-ups (With a Warning)
Many people have healthy teeth pulled because they think they have a dental abscess when it’s actually TN. If your dentist says your teeth look fine but the pain is unbearable, stop. Do not let them do a root canal. Consult a neurologist first.
4. Blood Work
Ask for a Tegretol level check if you’re on meds, but also check your Vitamin B12 and Vitamin D levels. While low vitamins don't cause TN, nerve health is heavily dependent on them. Anything you can do to support the myelin sheath is a win.
5. Mental Health Support
Because this condition is so isolating, find a support group. Talking to someone who understands the "electric shock" sensation can lower your cortisol levels. High stress is a known trigger for neuralgic flares.
The hard truth is that trigeminal neuralgia is usually a chronic condition. While it can go into long-term hibernation, you should always have a "flare plan" ready. Work with your doctor to have a prescription on standby so you don't end up in the ER on a Saturday night when the lightning returns. Understanding that the pain is a physical glitch, not a permanent curse, is the first step toward taking your life back. Reach out to a specialized neurologist to discuss if you're a candidate for decompression, as that remains the closest thing to making the pain go away forever.