Trigeminal Neuralgia

Trigeminal neuralgia is a facial pain that can be felt as continuous, aching, like an electric shock, burning or stabbing. The pain can show up spontaneously (without a trigger) or from a non-painful trigger such as applying make-up, brushing teeth, touching a tooth with the tongue, eating, drinking or even talking! Yikes. This can mean significant disruption in daily life activities. There can also be loss of sensation or dysenthesia as well as weakness of the area. The pain level can be moderate to severe, and some even develop anxiety in anticipation of the next episode of pain. The emotional toll from these sudden shocking episodes of pain can be heavy.

Trigeminal neuralgia pain is typically a one-sided experience. As we can see from this drawing of the trigeminal nerve, the nerve pathway originates near the upper ear and branches into three: the ophthalmic nerve, the maxillary nerve and the mandibular nerve. The mandibular nerve is what is most commonly felt.

Trigeminal neuralgia can have many causes. The most common root cause is nerve compression from a hardened or twisted blood vessel that presses on and wears down the myelin sheath of the trigeminal nerves. Other causes include MS (degeneration of the myelin sheath of the nerve which then exposes the nerve), post-herpetic neuralgia after a shingles infection, or facial injury from trauma to the head such as after a car accident or dental surgery.

For those with a stabbing type of pain, this symptom gives valuable information on the internal environment. In Eastern medicine, a stabbing sensation means the blood has stagnated, otherwise known as stasis of blood. This can also show up in tongue diagnosis where the colour of the tongue is purple. As strange as that sounds, I see purple tongues routinely in my office because blood stasis creates a lot of pain. This is a more progressed pathology than simply energy stagnation and correspondingly, the pain will be more severe. For some with this condition, they may report the pain feels as strong as passing a kidney stone. This level of pain can trigger anxiety. Acupuncture for these cases will first be about getting the blood moving more freely throughout the body, primarily in the head. Simply improving blood flow will reduce intensity of the pain in these cases by a lot. The second strategy will focus on the individual channels of the face that are affected by the trigeminal nerve pathway.

Trigeminal neuralgia pain is often felt in the lower jaw, but can also affect the nose, forehead and scalp. Acupuncture for cleaning up this pain will be focused on which meridians are affected. Patients will be asked to point with one finger to where they feel the strongest pain sensations. As you can see from this picture, there are eight acupuncture channels running through the face and head. Note that the acupuncture channels are not the same as nerve pathways. Acupuncture channels run along fascia. They are two separate but interconnected systems.

The mandibular nerve crosses through the Stomach, Large Intestine and Small Intestine channels. The maxillary nerve crosses through these same channels as well as the Gall Bladder and Triple Energizer channels at the temple. The ophthalmic nerve crosses through the Urinary Bladder, Gall Bladder and Governing Vessel channels. If there are many channels affected, will that be a lot of needles? No, and in many cases more needles does not improve pain relief or outcomes. As the pain clears with each treatment, what I have seen, is that the pain will start to localize to one or two main channels that become the main focus of treatment.

Trigeminal neuralgia pain is often felt in the lower jaw, but can also affect the nose, forehead and scalp. Acupuncture for cleaning up this pain will be focused on which meridians are affected. Patients will be asked to point with one finger to where they feel the strongest pain sensations. As you can see from this picture, there are eight acupuncture channels running through the face and head. Note that the acupuncture channels are not the same as nerve pathways. Acupuncture channels run along fascia. They are two separate but interconnected systems.

The mandibular nerve crosses through the Stomach, Large Intestine and Small Intestine channels. The maxillary nerve crosses through these same channels as well as the Gall Bladder and Triple Energizer channels at the temple. The ophthalmic nerve crosses through the Urinary Bladder, Gall Bladder and Governing Vessel channels. If there are many channels affected, will that be a lot of needles? No, and in many cases more needles does not improve pain relief or outcomes. As the pain clears with each treatment, what I have seen, is that the pain will start to localize to one or two main channels that become the main focus of treatment.

A burning pain sensation points to the issue of Internal Heat in Eastern medicine, which is another way of saying inflammation. Burning pain may be felt along a particular acupuncture channel or it may be globalized. It’s well known that inflammation creates pain all on its own. Clearing the inflammation may take care of most of the burning pain. Thankfully there are some great anti-inflammation points. One of them is Large Intestine 4, which also happens to be the command point for the head and face which means it’s a great point for head and facial issues as well as being a great pain reliever.

The good news is that trigeminal neuralgia can be treated using distal points so that no needles need to go into the face. This is a relief to many people. Distal areas for treating the face include points of the back of the hands, top of the foot (I avoid the soles and the palms as much as possible), as well as elbows and knees. I use a very targeted approach palpating for sensitive areas that will bring greater amounts of relief to the individual. Microcurrents can also be added using frequencies that target nerve healing and reducing inflammation.

Some feel relief for a few hours or a day after one treatment but it will take a course of treatments 10, 20, 30 or so for someone to be able to hold the pattern set in place by the acupuncture. At first, acupuncture relief is short-lived, but with each treatment, the healing momentum builds to where a person gets relief for several days to a week and then frequency of treatment can be reduced as their body responds and regains function.

Those who’ve had the issue longer, or a worse case of it, may find that they feel more relief the following day or two after treatment once they’ve had a good night or two of sleep that allows for the immune system to get the repair work completed. Our bodies do most of the repair work during sleep when in a relaxed state. The trajectory for nerve cell repair and renewal is about three months in the best case scenario. Eating healthy fats and avoiding transfats will also assist with nerve cell regeneration. With a full course of treatment trigeminal neuralgia pain can be a thing of the past.

If you or someone you love is suffering from facial pain that may be trigeminal neuralgia, call Kingsville Acupuncture at 519-800-4903 and let’s get you relief.

Yours in health,

Cynthia McGilvray, R.Ac.