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Still dealing with headaches or migraine
that never fully clear ... especially with
neck pain or stiffness?

Trigeminal neuralgia (TN) is a pain condition affecting the trigeminal nerve

—the main sensory nerve for the face.

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The trigeminal nerve has three main branches:

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V1 - forehead and eye region

V2 - cheek and midface

V3 - jaw and lower face

When this nerve becomes irritated or overly sensitive, people can feel:

  • Electric shock–like jolts

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  • Stabbing or burning facial pain

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  • Pain triggered by light touch, talking,
    chewing, or brushing teeth

In many cases, TN is related to irritation of the nerve closer to the brainstem, such as vascular compression, multiple sclerosis, or other central causes. That’s why neurologic evaluation and imaging (like MRI) are so important to rule out serious problems and identify cases that may need medication or surgery.

Why your neck might matter

What’s talked about less often is the relationship between the trigeminal system and the upper cervical spine.

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Inside the brainstem, trigeminal sensory pathways blend with sensory input from the upper neck, especially the C1–C3 levels. This region is sometimes referred to as the trigeminocervical complex.

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That means:

  • The brainstem areas that process facial pain also receive information from
    the upper neck joints and tissues

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  • Irritation or abnormal mechanics in the upper neck may, in some people, amplify or
    modulate how facial pain is perceived​

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  • This doesn’t mean “the neck causes all TN,” but it does mean the neck can be a
    meaningful contributor in certain patterns​    ​    ​​

At Keystone, we’re interested in those borderline, complex cases where:

  • Facial pain doesn’t fit perfectly into one simple box

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  • Prior imaging has not shown a clear surgical target

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  • Symptoms seem to change with neck position, posture, or strain

Our role is to ask:

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​"Is there an upper neck mechanical or sensorimotor component here
that has been overlooked?"​

Not all Trigeminal Neuralgia is neck driven

To be very clear: not all TN comes from the neck and not all TN improves with upper cervical treatment. Select patients need medications, procedures, or surgery
as their primary route of care. 

That’s why we respect and work alongside neurologists, neurosurgeons,
and pain specialists—not against them.

Where Keystone fits:

You’ve already had appropriate imaging and medical work-up

You’ve been told surgery isn’t clearly indicated, or you’re not ready for it

Pain seems to interact with neck posture, head position, or old head/neck injuries

You’re looking for a mechanical and sensorimotor evaluation of the upper neck,
not a replacement for your medical team

In those situations, we use the Keystone Neuro-Cervical Approach to:

  • Assess upper cervical joint mechanics and alignment with advanced imaging

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  • Evaluate how neck position affects your symptoms, balance, and visual system

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  • Apply gentle, instrument-based upper cervical corrections and targeted neuro-rehab where there’s a logical mechanical/sensory rationale

We don’t promise to “cure” TN.
We look for neck-driven contributors we can actually measure and address,
and we’re honest about what we see.

Is a Keystone evaluation worth considering?

You may be a good candidate for an upper neck-focused evaluation if:

You’ve had neurology/ENT workups and appropriate imaging (MRI, etc.)

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There is no clear surgical target, or you’re still symptomatic despite medications

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Your facial pain changes with neck posture changes or movement

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You also experience neck stiffness, headaches, or occipital/upper neck pain

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You’re looking for a detailed, one-on-one assessment of how your neck mechanics
and sensorimotor systems are behaving

If you’re living with facial pain or trigeminal neuralgia and wondering whether your upper neck could be part of the picture, the next step is simple.

Schedule a Discovery Call to talk through your history, your prior workups, and whether a Keystone evaluation is a logical next move—not a blind leap.

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