Conservative Management of Trigeminal Neuralgia and Degenerative Cervical Myelopathy: A Case Report

It is hypothesized that degenerative cervical myelopathy (DCM) may induce or exacerbate trigeminal neuralgia (TN) through mechanisms such as direct compression of the spinal trigeminal tract, inflammation, or vascular issues, leading to ischemia within cervical segments C3-C4, where the spinal trigeminal nucleus extends. Here, we report the potential therapeutic impact of chiropractic treatment in a 55-year-old female with TN resistance to medical therapy and DCM. The patient received targeted chiropractic care, consisting of high-velocity, low-amplitude (HVLA) spinal manipulation of the C3-C7 and T1-T4 vertebral segments to address joint dysfunction, coupled with intermittent mechanical cervical traction for 20-minute sessions, and focused radial shockwave therapy aimed at myofascial trigger points within the trapezius and levator scapulae muscles. After initiating the chiropractic care plan, the patient experienced a significant reduction in the frequency and severity of TN pain, which persisted throughout the treatment period. Notably, this alleviation in symptoms was maintained at the six-month follow-up, suggesting a sustained therapeutic effect rather than a transient improvement. The lasting nature of the pain reduction provides a compelling argument for the long-term benefits of chiropractic intervention in the management of TN, particularly in cases with concurrent DCM.