Thank you for the advice. I was hoping that it was more of a flare and would calm down ...not so much. Seems like when I increase the tegretol it helps for a while but the pain gets worse again.

Pain stresses your body and will make your health worse.
Nobody wants to take more meds than they need.
But pain will wear you down and out. Take what you need.
The less stress you have, the healthier you will stay for a longer stretch.
Good luck to you.

That was my experience, too. If it really was just a flare (and sometimes that is the case), once you have been stable for awhile, you can try decreasing and see what happens. Early in my experience with TN I had a period of escalation, I maybe got up to 600 mg of Tegretol. After awhile my doc had me decrease and I got down to 200 for awhile. But after it flared a second time, I never had a time when it didn't keep escalating.

I got up to 1200 mg of Tegretol once and felt like it changed my whole personality. And I still had pain, that's when I had a radio frequency rhyzotomy, the first of three procedures/operations.

I hope you can get the pain under control and maybe you will be able to decrease the meds later on.