Total Pain in People With Trigeminal Neuralgia: A Scoping Review
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Published on: May 10, 2017
Cremilson de Paula Silva1, Angela Bezerra Soares Perlamagna2, Marina Quintino Silva1
1Interdisciplinary Center for Studies in Palliative Care, School of Nursing, Federal University of Alfenas, Alfenas, Brazil.
Background:
Trigeminal neuralgia (TN) is a rare but profoundly disabling condition characterized by paroxysmal, electric shock-like facial pain. Although its burden is recognized as multidimensional, it remains unclear to what extent the literature has addressed suffering beyond physical symptoms.
Objectives:
To map how pain in people with TN, including its physical, psychological, social, and spiritual dimensions, has been described and operationalized in the scientific literature.
Methods:
A scoping review was conducted following Joanna Briggs Institute methodology. Five databases (MEDLINE, EMBASE, Scopus, Web of Science, and CINAHL) and gray literature via Google Scholar were searched. Studies of any design involving adults with TN and addressing at least one dimension of Total Pain were eligible. Data extraction was supported by NotebookLM and verified by two independent reviewers.
Results:
Forty-four studies published between 1983 and 2026 were included. Pain intensity was the most frequently investigated outcome (72.72%), predominantly assessed using unidimensional scales. Anxiety and depression were the main psychological outcomes (36.36%), largely measured with standardized psychometric instruments; qualitative studies also described fear, hopelessness, emotional exhaustion, and suicidal ideation. The social dimension was mainly operationalized through functional impairment and social participation, while qualitative findings highlighted isolation, relationship disruption, occupational difficulties, and delegitimization of suffering in healthcare settings. No study investigated the spiritual dimension.
Conclusion:
The literature on TN remains predominantly biomedical in its assessment of pain. Psychological and social dimensions are underexplored, and the spiritual dimension is entirely absent. Future research should adopt multidimensional, person-centered frameworks, including Total Pain.
Nursing Practice Implications:
Nurses should adopt multidimensional, person-centered pain assessments in trigeminal neuralgia, addressing physical, psychological, and social suffering. Spiritual concerns should also be explored, given their absence in the reviewed literature. Nursing care should recognize patients' lived experiences and promote holistic, individualized interventions.
