What is Trigeminal Neuralgia
Trigeminal neuralgia is a condition that affects the trigeminal facial nerves, causing facial pain. People may seek out non conventional treatment such as acupuncture for trigeminal neuralgia pain and in this article we will present some of the available research about acupuncture and trigeminal neuralgia. The trigeminal nerve itself is the 5th cranial nerve, it innervates the face and splits into three branches - ophthalmic, maxillary and mandibular branches. This chronic pain condition can be either episodic or continuous or both.
The episodic form of trigeminal neuralgia is known as the Typical form and it can be episodes of a couple of seconds through to a couple of minutes of extreme facial pain. These episodes can occur multiple times over a few hours.
The Atypical form can result in constant burning pain. Generally, episodes can be set off by circumstances such as wind blowing against the face, shaving, brushing teeth, face washing or other benign daily events. In the past this condition was known by the disturbing reputation of the being the suicide disease because the pain was so severe, it lead to depression and suicide ideation.
Treatment for Trigeminal Neuralgia
Typical treatment options for trigeminal neuralgia include surgery and medication. Initially medication is considered as a first line approach and typically anticonvulsants are used, these are successful in 80% of cases for pain and symptom management. For less tractable presentations of facial pain other medications may be looked at and as a last resort or in severe cases, surgical intervention may be an option.
Acupuncture for Trigeminal Neuralgia - The Research
There has been a small amount of research undertaken looking at the effect of using acupuncture for trigeminal neuralgia. Currently the available research is lacking and much of it tends to be case studies or comparing types of acupuncture treatment methodologies. Such research is considered lower levels of evidence when compared to well designed RCT's. We will include a couple of studies here for informational purposes and a more recent and promising RCT. We look forward to much more robustly designed RCT's with findings that acupuncture is helpful and a recommended treatment for trigeminal neuralgia pain. Acupuncture is reported as being effective for some types of pain, especially chronic pain.
Clinical Discussion on Treating Primary Trigeminal Neuralgia - Randomised Control Study
A study published in the Clinical Journal of Chinese Medicine, found that acupuncture was as effective, if not slightly more so, than the use of Tegretol (Carbamazepine). The 80 participants were randomly assigned to either a Tegretol only control group or a Acupuncture treatment group. This study showed that acupuncture was a promising alternative to pharmaceutics. Although the acupuncture treatment used for Trigeminal neuralgia was detailed it was difficult to ascertain how regularly treatment was given, or over what period of time. The researchers reported that acupuncture was more effective than the tegretol control in controlling the symptoms of facial pain. They also stated that combining regular treatment with acupuncture may result in greater outcomes.
A Clinical Pilot Study Comparing Traditional Acupuncture to Combined Acupuncture - Control Study
This 2011 study attempted to assess the benefit of using either traditional acupuncture, in this case korean 5 element acupuncture, or combined Traditional acupuncture and ear acupuncture in the treatment of trigeminal neuralgia, headache and retroauricular pain in bells palsy. The participants in this study were split into 3 groups, control, combined acupuncture and traditional acupuncture groups. It was unclear via the abstract how many total participants there were and what treatment if any the control received. As this was a pilot study the process was being used to iron out design issues and to help in putting together additional studies. Both the combined acupuncture and traditional acupuncture groups reported pain relief. The researchers called for a differently designed study in the future in order to better report whether or not acupuncture was effective on pain.
Acupuncture Treatment for Idiopathic Trigeminal Neuralgia: A Longitudinal Case-control Double Blinded Study.
This is the most recent of all the studies and was published in November 2017 in the Chinese Journal of Integrative Medicine. This seemingly well designed longtitudinal case control study had a total of 90 participants. 60 had idiopathic trigeminal neuralgia and 30 were healthy. The trigeminal groups were assigned to either a acupuncture, sham acupuncture or medication only (Tegretol) group. Pain bench marks were taken before the study, during treatment and 6 months after treatment. The sham acupuncture group reported increases in medical prescriptions. Reductions in secondary myofascial pain and mandibular limitations were also reported in both acupuncture groups, although only the true acupuncture group sustained these after 6 months. The researchers suggest that acupuncture to be a treatment option for trigeminal neuralgia due to its analgesic effects and it's ability to reduce the secondary myofascial pain associated with it
Acupuncture treatment approaches for trigeminal neuralgia
Typically the acupuncturist will have a chat to you about you about the symptoms you have from your trigeminal neuralgia, how long you have had them, whether or not it is the typical or atypical form and your current management. We will generally encourage to stay with their current course of conventional treatment and to use acupuncture for facial pain symptoms only as an adjunct.
Depending on the presentation of trigeminal nerve pain symptoms we may needle the face, hands and feet and possibly behind the neck. Generally in the beginning we take a very gentle approach to needling depending on your response to the treatment session and will discuss with you the needling approach we may take.
Typically, depending on the length of time you have had the facial neuralgia symptoms we look at treating with a regularity of once a week, and depending upon the severity of symptoms this may be expanded out to once a fortnight and in acute cases possibly even twice weekly. Your acupuncturist will speak to you about their recommendations for the regularity of your acupuncture sessions.