good morning, sorry it's not morning now; good afternoon. remember trigeminal neuralgia is a cranial nerve issue so i don't think it could directly cause TMJ pain. TMJ is a joint problem and not as much to worry about as trigeminal neuralgia. are you getting any effects whatsoever from the cymbalta and lyrica? if not a long course of high dose steroids may get you over the hump. Medrol [not the medrol dosepak because that not enough] at a high taper down dose for 3-4 weeks may work wonders. Decadron with the same dosing may be even better. Decadron [dexamethasone] is commonly used for nerve inflammation problems eg. spinal cord injury. some people with your problem are given steroids to keep on hand so if you feel it coming on you head it off by starting the steroid course, this pain is hard to control when it has already flared. you mention Xanax for sleep which is a good thing but Klonopin or Ativan may be more effective because they are indicated for the treatment of nerve pain in general and klonopin is longer acting than xanax. Lyrica is probably good for TR but you can consider Trileptal which is basically Tegretol without the effect on red blood cells, so you do not have to have blood draws every 6 months. Trileptal is very popular for trigeminal neuralgia and many people get great relief from it. a medication you could add in with your xanax/klonopin at sleeptime is Gabitril [tiagabine]. it is fairly safe and can prevent the nerve from flaring and it improves sleep patterns. a strong narcotic on hand for when it's bad is a essential: oxycodone, hydromorphone, or immediate release morphine, this pain takes a big gun. try to avoid pain killers like vicoden or percocet because they contain acetaminophen, that combine with your cymbalta is liver toxic. have a pain-free sunday.
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008,
current Rx: OxyContin 60mg 2x, Dilaudid 8mgs [brand] 4x p.r.n. brk., Phenergan 25mg 3x prn nausea, Lyrica 75mg 2x,Adderall 20mgs 1x A.M., Soma 350 mg 3X, Relafen 1000mg 1x, Klonopin 1mg H.S. or prn anxiety Supplements: CO-Q10 100mg, Vitamin D 2000IU, Fish-Oil1000mg EFA, B-Complex50 3x/day, GABA 750mg