It was many years ago that this started for me -- probably when I was between 35 and 45 -- I may not have all my facts straight and hopefully treatment and diagnosis has gotten better since then. I started with my dentist. He couldn't find anything wrong and eventually gave me a bite splint to wear -- first at night but then I didn't get much improvement and I had to wear it during the day too (mine fit inside my lower teeth and I could talk with it I just couldn't eat with it -- it looked a lot like those Invisalign braces but was fit on the inside of my lower teeth). That dentist eventually diagnosed me with TMJ and sent me to a specialist for that. I went to see him periodically and he would adjust the bite splint (regrinding surfaces and whatever) and also gave me pain meds (I lived on darvasette at the time) and muscle relaxers to help keep me from grinding my teeth when I slept. Grinding at night is a vicious cycle..........you grind your teeth, it causes pain, which causes you to grind your teeth more,which causes more pain, and so on. Yes there were times I wanted to put a gun to my head and pull the trigger. I actually went so far as to get the gun out of the cabinet one day but my husband had hidden the bullets and came home to find me in a heap on the floor crying because I just didn't want to live with the pain anymore. Eventually I was sent to a ENT who told me the whole problem was my sinuses and talked me into sinus surgery. Well, my sinus headaches got better (that was NOT a pleasant surgery believe me) but my TN/TMJ pain remained the same. I saw a chiropracter. I was in so much pain after she worked on me I never went back. I saw a neurologist who had me try several meds, mostly anti-spasm meds. All had awful side effects, I had an allergic reaction to some. Eventually I was told there was nothing else that could be done and they sent me to a pain clinic. I finally found some help there. They actually gave me a test where they injected morphine directly into the trigeminal nerve area. Didn't touch the pain. They kept adding more and asking "are you still in pain?" and I'd just nod my head with tears rolling down my face. They put me on an antidepressant which was also used for nerve pain -- Elavil (it was about all they had back then). I gained weight like crazy on it, but it seemed to help the pain, or at least helped me live with it. Then one of my docs saw an article where TN patients where helped by blood pressure meds. They put me on Verapamil along with the Elavil. Finally, things started getting better, but not great. That's when they scheduled the Gamma knife surgery. They said there'd be no after effects -- ha!! for weeks afterwards I felt like someone was driving nails into the top of my head. They'd call from the hospital wanting to know if I'd had any improvement and were always surprised when I said no. Gamma knife can take from 6 months to 2 years to have results. In my case, it took 2 years. They try to kill the pain-causing nerve, so it depends on how it heals, or something like that. I lived with a lot of pain all during most of those years that all this went on. Doctors visits were endless. Anyway, I had to have a hysterectomy in Jan 2001. A couple of weeks into recovery from that, I realized, the pain in my jaw/ear area was much much better than it used to be. Well I was so scared that it was going to return, that I was afraid to quit taking the Elavil or the Verapamil. I waited a year and said ok........I didn't like the side effects of the Elavil so my doc said it was ok to wean myself off it, which I did, and that went fine, I didn't need it. When I tried going off the Verapamil completely, I started having some pain again, so we ended up just cutting that dose in half, and I still take it to this day.
It's been almost 9 years since my hysterectomy. Most of the time I'm fine. During times of extreme stress (when my dog died last week and I cried for 24 hours straight for example while I'm having an allergic reaction to the stitches used in my foot for bunion surgery and it's been 2 months and it's not healing and so on) it flares up, but I know it's only temporary and if I can zap it with 600 mg Advil before it gets bad, and chill out for a while (beach days do wonders) it goes away. The majority of the time, I'm fine. I can feel when it's coming on, and I know what to do when it's coming, but sometimes, nothing much helps and I just have to ride it out for a few days.

There used to be a support group for TN sufferers, The Trigeminal Neuralgia association. I'll look and see if I can find a link for you. I used to get their newsletter, but I found for some reason I really couldn't relate so I stopped getting it..........everybody's pain and results were different and it just didn't click for me if you know what I mean, but it might help you out.

Don't give up. Many times I wanted to, but things did get better (although in my case it took a long long long time, thank God for my husband he was my rock during all that time) and while I wouldn't wish what I went thru on anyone, I can only tell you that you have to keep trying til you find what works for you.

Oh one final thing -- when I got off the Elavil I dropped 30 lbs and have never gained it back. And yes I went to the gym thru all the stuff I mentioned above, and traveled with my husband, and tried to keep going the best as I could...........it helped to take my mind off the pain. So do what you can, but if you're in too much pain to do whatever, that's ok too. You have to deal with it in whatever way works for you, but don't give up on trying to find help.