I have just been told I have trigeminal neuralgia. What is it and what treatment is there for this condition?
Conventional remedy:
This term refers to a painful condition affecting the side of the face. The stabbing, darting and intense pain occurs in the area supplied by the trigeminal nerve - the cheek, the lips , the gums or the chin.
Paroxysms of pain recur frequently and although they tend to last for seconds or at most a minute, they are extremely unpleasant. They are often triggered by movement, pressure at a particular point on the face, or by intense cold or heat.
Initial treatment is with a drug called carbamezepine, which has the ability to block stabbing pain. It and another anti-convulsant medication, phenytoin, will usually bring some relief. A drug called lamitrogine is also used in difficult cases.
If this fails, surgical treatment is an option. There are two possible procedures: one involves decompressing the trigeminal nerve and the other involves its destruction using radio frequency or the injection of phenol.
For someone who has chronic trigeminal neuralgia, it is important to enrol in a pain management programme. Such a programme uses a combination of medical, psychological and physical therapies to bring about some degree of pain relief.
Alternative remedy:
Trigeminal neuralgia is a deep nerve pain. Sufferers have pain on one side of the face, in the gums, sometimes on the tongue and, in rare cases, in the eye. Some believe the problem to originate in the teeth and a few sufferers even attend a dentist and have extractions. However, this doesn't relieve the pain. My personal view is that, because of the side-effects, pain relief offered through conventional painkillers is not the best option. Herbal or homeopathic painkillers can be tried, of course, but acupuncture offers very good relief.
By sending messages to the brain from the nerve endings (at the needle points), acupuncture stimulates the brain to release its own natural morphine in the form of endorphins. The view of Chinese medicine is that pain is the result of a blockage of energy known as qi (or chi). When the blockage is removed through acupuncture, energy flows again and pain is relieved. In my 16 years' experience, I have seen acupuncture achieve up to 70 per cent pain control in trigeminal neuralgia.
In some mild cases, there will be 80 to 85 per cent pain control after four to six treatments. I would recommend two treatments a week initially for acute cases and one a week for more chronic cases. Some sufferers will require boosters once a month or so.
Apart from relieving pain, acupuncture also aids relaxation, which is important as sufferers from trigeminal neuralgia can become very tense and depressed.
The traditional acupuncture points for pain relief are the lymphs on the arms and legs. I would also use needles behind the head for this condition and at the most sensitive point of each individual's pain.
Dr Katherine Chan Mullen, GP and acupuncturist, is a member of the Irish Medical Acupuncture Society and can be contacted at tel: 01- 2887616.