Flu and trigeminal neuralgia: how infections trigger facial pain and what to do
Flu and trigeminal neuralgia: Flu is not “just a bad cold”. Symptoms often come on suddenly and can include a high temperature, severe tiredness, body aches, headache, a dry cough and a sore throat.
For many people, the flu is miserable but short-lived. For people living with trigeminal neuralgia (TN) and other facial pain conditions, flu and winter infections can be uniquely destabilising. A respiratory virus can trigger a pain flare through a combination of whole-body inflammation, congestion and sinus pressure, repeated coughing or sneezing, poor sleep, dehydration and medication disruption.
Save this guide. It is designed to be a “return-to” page every winter.
What flu does, and why timing matters in TN
Flu is very infectious. The NHS notes you are more likely to pass it on to others in the first 5 days. It spreads through germs from coughs and sneezes, which can live on hands and surfaces for 24 hours.
That matters in TN because early rest, reducing spread at home, and acting quickly on symptoms can prevent a mild illness from turning into a longer, more painful flare.
Why flu and winter infections can worsen trigeminal neuralgia
TN does not start because of flu. The issue is amplification. Infections can push a sensitised trigeminal system into a higher pain state.
1) Inflammation can lower the pain threshold
Flu activates the immune system and increases inflammatory signalling. TN research increasingly supports an inflammatory component in at least some patients.
A 2023 paper found significant elevations of inflammatory mediators in the cerebrospinal fluid of patients with trigeminal neuralgia, consistent with neuroinflammation.
A 2025 review of inflammatory biomarkers in TN discusses raised pro-inflammatory cytokines, including IL-1β, IL-6 and TNF-α, reported in serum, CSF or saliva specimens from TN cohorts across the literature.
In plain terms: when your whole body is inflamed, your pain threshold can drop, and TN triggers can feel sharper, more frequent, and harder to settle.
2) Congestion and sinus pressure can provoke trigeminal pain
Flu often involves nasal congestion and facial pressure.
Those symptoms sit close to the trigeminal branches and can make common triggers worse, especially bending forward, blowing the nose, talking, chewing, or sudden changes in pressure.
3) Coughing and sneezing multiply mechanical triggers
The flu increases coughing and sneezing.
For many people with TN, repeated facial and jaw movement can act as a trigger. During infection, it is the frequency that matters as much as the force.
4) Rare but serious neurological complications exist
Neurological complications of influenza are uncommon, but well documented, including seizures, encephalitis, myelitis and Guillain–Barré syndrome.
This is not a reason for alarm. It is a reason to know red flags and seek urgent care when needed.
Vaccination: neutral facts for people with TN
The NHS offers the flu vaccine each year to eligible groups, including people aged 65 or over and people with certain long-term health conditions, as well as pregnant women, carers and some health and social care workers.
For TN specifically, evidence is limited because large vaccine studies do not usually analyse TN as a distinct subgroup. Experiences vary. The most defensible approach is shared decision-making with your GP, practice nurse or neurologist, taking into account your medical history, medicines and any additional conditions that clearly increase flu risk.
If you are unsure whether you are eligible for a free NHS flu vaccine, start with the NHS eligibility list and discuss it with your clinician.
Top 10 tips to stay safer from flu if you live with TN
These steps are designed for people living with TN and facial pain. They align with UK infection prevention advice on staying home when unwell, fresh air, hygiene and vaccination eligibility, while also reflecting common TN triggers.
1) Know your personal risk profile beyond TN
Write down your other conditions and medicines. Flu risk is higher with long-term conditions, and UK public health advice explicitly notes that flu can worsen long-term conditions even if they are usually well controlled.
2) Get prescriptions sorted early
Check repeats before winter pressures peak. If you are unwell, the last thing you need is running out of essential TN medication.
3) Agree on a written “flu flare plan” with a clinician
Ask for a short plan covering: what to do if infection triggers a severe flare, when to seek urgent advice, and what symptoms should trigger emergency care. Keep it on your phone and on paper.
4) Use respiratory hygiene properly: Catch it, bin it, kill it
Carry tissues, use them to catch coughs and sneezes, bin them straight away, then wash your hands.
5) Wash your hands and avoid touching your face when out
The NHS notes flu germs can live on hands and surfaces for 24 hours. Treat hand hygiene as pain prevention as well as infection prevention.
6) Ventilate indoor spaces
Good ventilation reduces the spread of respiratory infections. Government guidance recommends improving ventilation and using fresh air to reduce transmission, including opening windows (even a little in cold weather).
7) If you are unwell, stay home and limit close contact
UKHSA winter advice is clear: if you feel unwell, stay at home, and when meeting indoors, open a window for fresh air.
8) Consider a mask in crowded indoor spaces if you are high risk, or symptomatic
Mask use is a personal choice in the UK, not a legal requirement, but during surges some health leaders and reporters
have encouraged symptomatic people to wear a mask in public spaces to reduce spread.
9) If symptoms start, prioritise fever control, hydration and rest
Standard UK patient guidance on influenza emphasises rest, fluids, and symptom management.
For TN, dehydration and sleep disruption can lower pain tolerance, so basics are protective.
10) Know the red flags and act early
Seek urgent advice (NHS 111 or your GP/out-of-hours) if you are in a higher-risk group and become unwell, or if you are not improving and are getting worse.
Call 999 or go to A&E for emergency symptoms such as severe breathlessness, chest pain, sudden confusion, collapse, seizures, or new neurological deficits.
Quick checklist to save or print
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I know my risk factors, and I have a winter plan
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My prescriptions are organised
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I have tissues, hand gel, and a thermometer at home
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I am ventilating indoor spaces
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I am using respiratory hygiene consistently
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If symptoms start, I rest, hydrate, and manage fever safely
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I know when to use NHS 111 and when to call 999
What TNA UK is doing to protect members this winter
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Keeping this guidance updated and signposting the safest routes for urgent help, including NHS 111 and 999.
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Encouraging people living with TN to agree a written “flu flare plan” with their GP or neurologist.
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Sharing practical winter trigger advice through our helpline, regional support groups and online community.
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Using anonymised patient experience to inform professional education and policy work on facial pain.
FAQs
Does the flu make trigeminal neuralgia worse?
It can. Flu may worsen TN through whole-body inflammation, congestion and sinus pressure, increased coughing and sneezing, and disruption to sleep and hydration. TN research also supports an inflammatory component in at least some patients.
How long am I likely to be most infectious?
The NHS notes you are more likely to pass flu on to others in the first 5 days.
Should I get the flu jab if I have TN?
Eligibility and suitability depend on your wider health and medicines. Start with NHS eligibility guidance and discuss personal risks and benefits with your clinician.
Summary: Flu and trigeminal neuralgia
Flu seasons vary, but the way infections can aggravate facial pain is consistent. For people living with trigeminal neuralgia, prevention is not cosmetic. It can reduce avoidable flares, reduce crisis points, and protect your ability to eat, speak, sleep and function.
If you do one thing this winter, do this: plan early, act early, and treat warning signs seriously.
By Aneeta Prem MBE, Chief Executive Officer, TNA UK
Last reviewed: 12 December 2025
Purpose: This guide explains flu and trigeminal neuralgia and why winter infections can trigger facial pain, plus what to do to reduce avoidable flares and recognise urgent warning signs.
Medical note: This is general information, not individual medical advice. For personal advice, consult your GP, neurologist, or pharmacist. If you think you are seriously unwell, seek urgent help via NHS 111 or call 999 in an emergency.
CEO commitment: TNA UK will review and update this guidance annually, in line with the evolution of NHS and public health advice.