Philip Niño Tan-Gatue
Learning from Experience: Trigeminal Neuralgia
Originally Posted October 14; I had to restore the site from a backup that did not include this post. Trigeminal Neuralgia is one of the most debilitating conditions that a person may experience. Imagine being unable to tasks as simple as brushing one’s teeth or even having a loved one giving a peck on the cheek without having the feeling of stabbing pain.
As its name indicates, trigeminal neuralgia involves nerve pain along the pathway of the trigeminal nerve. This nerve comes from the brain itself instead of the spinal cord, and divides into three areas in the face. Hence, pain along the trigeminal nerve encompasses areas from around the eye to the cheek to the mouth. Sufferers can have electric pain triggered by the slightest of contact.
Modern pharmaceutical medicine has options for treatment. Many times, this is enough. However there are patients who seek acupuncture as an adjunct treatment. As a practitioner, I have encountered several of these unfortunate fellows. I would like to share my experience.
First and foremost, it is of vital importance that expectations not be unrealistic. Most of the time, the pain will not go away like magic. It is best to use a step-ladder approach. What do I mean?
Many patients come to try so-called “alternative” methods of healing because conventional pharmaceuticals have either not provided sufficient relief or any relief at all. However, that does not mean that we can immediately just stop these medications and replace them. In my practice, I have found that it is best to let the medicines take effect with the help of acupuncture.
For example, a patient would come to me on a high dose of medication, which relieves the pain but not totally. I would explain the strategy to the patient thus: first we must achieve total pain relief with the medication. Immediate total pain relief with acupuncture alone without medication is possible but doesn’t happen all the time.
Once total pain relief is achieved, we then, with the permission of the attending neurologist, of course, reduce the dose. The goal is to use acupuncture as a crutch while the body copes with the attacks. At this stage patients usually notice that some pain returns. However, they happily report that it is nowhere as strong as the original pain. The patients may even say that the area covered by the pain is reduced.
Again, we look for total pain relief with reduced doses. The end goal now is to have the patient have tolerable or no pain at all with the minimum dose possible. Hopefully that dose is zero.
TCM theory wise, I have found that it is not enough to simply drain Wind. Blood must be nourished so as to extinguish Wind. I am also conservative on the number of needles on the face and on the amount of electroacupuncture to use. I feel that moxibustion on UB 20 Pishu and UB 17 Geshu help speed things up.
Prevention wise, we cannot caution patients to avoid the cold enough. From a purely physiologic point of view, cold causes muscle contraction and may stimulate the trigeminal neuralgia by tightening of connective tissue around the nerves. Wind inducing foods such as chicken should be avoided as well.
I hope that Trigeminal Neuralgia sufferers out there may consider Acupuncture and Oriental Medicine in their search for pain relief and wellness. God bless!