Trigeminal neuralgia involves a recurrent paroxysmal sharp pain in the area of the trigeminal nerve. The cause of the disease remains unclear, but spasms, neural degeneration, and microvascular compression are thought to play roles.
In TCM, trigeminal neuralgia falls under facial pain, cheek pain, and wind pain of the face. In general, trigeminal neuralgia is caused by external pathogens attacking the facial sinews or the obstruction of blood and qi. In the former, if wind-cold attacks the sinews of the yangming channels, congeals and stagnates in the sinews, the obstructed blood and qi will cause facial pain. Alternatively, obstructed qi and blood can be caused by an invasion of wind-heat toxins. In the latter, trauma or long-standing qi and blood obstruction can affect the local collaterals to cause facial pain.
Clinical manifestations of trigeminal neuralgia
- Trigeminal neuralgia is mostly seen in the middle-aged and elderly, and slightly more often in women.
- The pain can be electric-shock-like, cutting, burning, tearing or prickling, and occurs in the area innervated by the trigeminal nerve. Each occurrence begins and ends abruptly, lasting several seconds to a few minutes. The patient is often completely pain-free during the intervals.
- The pain is mostly unilateral, but bilateral cases are sometimes seen. Trigger points can be found and serious cases can involve facial tics on the affected side.
- The symptoms are periodic, staying or leaving for days, weeks or months at a time.
5 Acupuncture points for trigeminal neuralgia
The basic therapeutic principles are to unblock the channels and relieve pain. Acupoints are chosen based on channel pathways in the affected area.
1. ST 7 Acupoint (Xiaguan)
Location: In front of the ear in the depression formed by the zygomatic arch and the mandibular notch.
Effect: Dispels wind, unblocks the collaterals, relieves pain.
2. ST 2 Acupoint (Sibai)
Location: On the face directly below the pupil, in the depression of the infraorbital foramen.
Effect: Dispels wind, and relieves pain.
3. GB 20 Acupoint (Fengchi)
Location: Below the occipital bone in the depression between the superior-lateral trapezius muscle and the superior-posterior sternocleidomastoid muscle.
Effect: Dispels wind, dissipates cold, clears and disinhibits the head and eyes.
4. EX-HN 4 Acupoint (Yuyao)
Location: On the forehead directly above the pupil, in the eyebrow.
Effect: Unblocks the collaterals, and relieves pain.
5. EX-HN 19 Acupoint (Jiachengjiang)
Location: On the face, 1 cun lateral to the middle of the mentolabialis sulcus.
Effect: Dispels wind, relieves pain.
Moxibustion treatment methods
- Single-point mild moxibustion on ST 7 on the affected side. The patient should feel the heat penetrate deeply and expand over the area. Located on the foot yangming stomach channel, ST 7 can dispel wind, unblock the collaterals and relieve pain.
- Single-point mild moxibustion on ST 2 on the affected side. The patient should feel the heat penetrate deeply and expand over the area. Located on the foot yangming stomach channel, ST 2 can dispel wind and relieve pain.
- Single-point mild moxibustion on EX-HN 19 on the affected side. The patient should feel the heat penetrate deeply and expand over the area. EX-HN 19 can dispel wind and relieve pain.
- Double-point mild moxibustion on GB 20. The patient should feel the heat penetrate deeply and expand over the area. Located on the foot shaoyang gallbladder channel, GB 20 can dispel wind, dissipate cold, and clear and disinhibit the head and eyes.
- Single-point mild moxibustion on EX-HN 4 on the affected side. The patient should feel the heat penetrate deeply and expand over the area. An extra point, EX-HN 4 can unblock the collaterals and relieve pain.
Treat once a day, choosing one or two groups of the above acupoints each time. Ten treatments make a treatment course. Give two or three courses total, with two to five days in between for rest.
Conclusion
Moxibustion effect on trigeminal neuralgia is due to its ability to unblock the collaterals and relieve pain. However, a complete cure is often difficult to achieve. Patients should be optimistic and avoid becoming irritable or worried.
