Trigeminal neuralgia is a debilitating condition characterized by severe facial pain. While conventional treatments often provide limited relief, acupuncture offers a promising alternative. This trigeminal neuralgia case report explores the experience of a 45-year-old man who found significant pain relief from trigeminal neuralgia through acupuncture therapy.
What is Trigeminal Neuralgia?
Trigeminal neuralgia (TN) is a chronic pain disorder affecting the trigeminal nerve. This condition is characterized by sudden, severe, and stabbing facial pain, typically on one side of the face. The pain can be triggered by various stimuli, such as touching the face, chewing, talking, or even a light breeze. Despite advancements in medical treatments, many patients experience inadequate pain relief and intolerable side effects. Acupuncture, rooted in traditional Chinese medicine (TCM), has emerged as a potent alternative therapy for managing TN symptoms.
Etiology
The exact cause of trigeminal neuralgia is often unknown, but it is thought to result from compression or irritation of the trigeminal nerve, usually by a blood vessel pressing on the nerve as it exits the brainstem. Other potential causes include multiple sclerosis (MS), tumors compressing the nerve, or trauma to the face.
Symptoms
The hallmark symptom of trigeminal neuralgia is intense, electric shock-like pain that can last from a few seconds to several minutes. The pain is typically unilateral, affecting one side of the face, and can be triggered by everyday activities like brushing teeth, talking, or eating. Between episodes of pain, individuals with TN may experience periods of remission, although the condition can worsen over time.
Conventional Treatment Approaches
Medications
The first-line treatment for trigeminal neuralgia involves anticonvulsant medications such as carbamazepine (Tegretol) or oxcarbazepine (Trileptal). These medications help reduce nerve firing and alleviate pain in many patients. Other medications like gabapentin (Neurontin) or baclofen (Lioresal) may also be prescribed to manage pain.
Surgical Interventions
For individuals who do not respond to medication or experience intolerable side effects, surgical options may be considered. Microvascular decompression (MVD) surgery involves relocating or removing the blood vessel compressing the trigeminal nerve. Other surgical procedures include gamma knife radiosurgery, which uses focused radiation to target the trigeminal nerve or percutaneous procedures like radiofrequency ablation or balloon compression.
Nerve Blocks
Some patients may benefit from nerve blocks or injections of medications like lidocaine or steroids to temporarily numb or block pain signals transmitted by the trigeminal nerve.
Neurostimulation
Techniques such as transcutaneous electrical nerve stimulation (TENS) or deep brain stimulation (DBS) may modulate pain signals and relieve individuals with refractory trigeminal neuralgia.
Western Medicine Limited Benefits
Despite these treatment options, trigeminal neuralgia can be challenging to manage, and some individuals may continue to experience debilitating pain. In recent years, there has been growing interest in complementary and alternative therapies like acupuncture, which offer potential benefits for pain management and symptom relief in patients with trigeminal neuralgia.
Acupuncture Treatment for Trigeminal Neuralgia
From a Traditional Chinese Medicine (TCM) perspective, trigeminal neuralgia is understood as a manifestation of underlying imbalances in the body’s energy (Qi) and blood circulation, as well as disharmonies among the organ systems. Acupuncture and other TCM modalities like herbal medicine and dietary therapy aim to rebalance these energies and restore harmony within the body to alleviate pain and improve overall well-being.
TCM Diagnosis
In TCM, the diagnosis of trigeminal neuralgia involves a comprehensive assessment of the patient’s overall health, including their medical history, lifestyle factors, and specific symptoms related to TN. Practitioners may also utilize traditional diagnostic techniques such as tongue inspection, pulse diagnosis, and palpation of acupuncture points to identify patterns of disharmony within the body.
Patterns of Disharmony
TCM identifies several patterns of disharmony that may contribute to the development of trigeminal neuralgia. Some of the more common imbalances include:
Liver Qi Stagnation: Emotional stress and frustration can lead to stagnation of Liver Qi, resulting in energy blockages and pain along the course of the trigeminal nerve.
Blood Stasis: Poor circulation or stagnation of blood flow may cause sharp, stabbing pain characteristic of TN.
Kidney Deficiency: Weakness or deficiency in the Kidney organ system, which governs the bones and nervous system in TCM, can manifest as chronic pain conditions like TN.
Phlegm-Dampness Accumulation: Excess phlegm or dampness in the body can obstruct the flow of Qi and blood, contributing to nerve compression and pain sensations in the face.
Acupuncture Treatment for Trigeminal Neuralgia
Acupuncture offers a holistic approach to treating trigeminal neuralgia by addressing the underlying patterns of disharmony identified in each patient. Treatment involves the insertion of fine needles into specific acupuncture points along meridians related to the affected area and points located on distant parts of the body to rebalance energy flow and address systemic imbalances.
Overall, acupuncture treatment for trigeminal neuralgia from a TCM perspective focuses on restoring balance and harmony within the body’s energy systems. It addresses the condition’s symptoms and root causes to promote long-term pain relief and improved quality of life.
Trigeminal Neuralgia Case Report
Our patient in this trigeminal neuralgia case report was a 45-year-old man who had been experiencing severe nerve pain in the upper and middle facial nerves for the past three months. The pain came in fifteen to sixty-second intervals, 10 out of 10 in intensity, about fifteen to twenty times a day. Pain medications barely touched the pain. He was at his wit’s end, unable to concentrate at work and a wreck at home.
He had initially been prescribed carbamazepine, an anticonvulsant medication, as a first-line treatment to reduce nerve firing and alleviate pain. When that didn’t help, his doctor added gabapentin and tricyclic antidepressants. These reduced his pain by ten percent, but no more than that. At this point, he did not want to have surgery. He was nervous about possible adverse effects and not convinced that it would significantly help. In addition, the cost was prohibitive.
Acupuncture Treatment Plan
The constant pain had spiked his stress levels, which was reflected in his pulse, which was tight and wiry. His tongue displayed heat and stress, displaying a red body and rough edges. Due to the pain, he was unable to sleep well and was irritable and short-tempered. His bowel movements were regular, however his digestion was off, with bloating and stomach pain. We determined his Chinese medicine pattern imbalance to be Liver Fire and Spleen Qi deficiency.
Acupuncture Treatment
Our patient’s treatment in this trigeminal neuralgia case report included local face points to quiet the overacting nerves as well as distal body points to correct his Liver/Spleen imbalance. Acupoints included BL2, Yuyao, GB14, Taiyang, ST3, ST7, ST6, ST4, and SI18 on side of his face in pain. Systemic points included LV2, LV3, KD6, ST36, LI11, LI4, and GV20.
He received treatment once a week for four weeks, at which time his pain was reduced by thirty percent, both in frequency of attacks, duration, and intensity. He continued once a week for another four weeks, leading to a sixty percent decrease in pain. At this point, he dropped down to once every two weeks. After four additional sessions, his pain was ninety percent relieved. He stopped treatment at this point. A month later, a follow-up phone call revealed that he was only experiencing limited, infrequent, short-duration episodes, and even these were continuing to reduce.
Discussion
Compared to Western pain medications, the acupuncture in this trigeminal neuralgia case report provided much more effective and long-lasting pain relief. Treating the affected nerves locally on the face sped their healing and reduced their uncontrolled firing. Likewise, the systemic acupoints on the body helped restore balance to our patient’s physiology, helping to strengthen his body’s healing potential and speed up the healing process.
Conclusion
Our patient experienced significant pain relief and functional improvement through acupuncture therapy, with no adverse effects. While not all patients respond as well or as quickly, our experience over the past twenty years is that acupuncture is an excellent treatment for reducing trigeminal neuralgia pain. The best way to know if acupuncture can help is to come in and try a few sessions. We typically recommend coming once a week for four weeks, at which time we step back and assess your progress. If the treatments are working, we continue. If there is no improvement at that time, we stop treatment. Most patients find benefit to some degree.
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What our Clients are Saying
My dentist damaged a nerve in my face that triggered terrible trigeminal neuralgia. The pain in my face was way more than 10 out of 10. I could not think, could not work, could not sleep. I truly thought my life was over. But thanks to Raleigh Acupuncture Associates I am 95% better. It took three months of treatment, but it was worth it. My regular doctor had no solution for me. His pain medicine did not work. I tried an $8000 procedure of laser cutting, and that did not work. But acupuncture DID work. I’m telling you, if you have trigeminal neuralgia in your face, come to these guys. I love them!
I woke up one morning and started getting these excruciatingly painful shooting electric pains on the left side of my face. My wife took me to the emergency room and they said I had trigeminal neuralgia. They gave me some pain medicine, but a nurse there suggested I try acupuncture. She had this pain once and it was cured by acupuncture. She gave me the name of Raleigh Acupuncture. When I explained the situation they took me in the same day. After just one treatment I started feeling better. They saw me every day for six days, at which point the pain was completely gone. What a life saver. I strongly recommend getting acupuncture for trigeminal neuralgia.
