Acupuncture Treatment For Trigeminal Neuralgia: A Traditional Chinese Medicine Approach

Trigeminal neuralgia is one of the most frequently encountered conditions in acupuncture clinics. Acupuncture has been widely used to relieve pain and improve circulation in such cases. This condition often requires a combination of local and distal point selection to achieve optimal results. It is crucial to determine whether the patient is in the acute or remission phase before beginning treatment. During the acute phase, the primary goal is pain relief, and distal points are usually emphasized.

Acute Phase Treatment Strategy

In the acute stage, the combination of Hegu (LI4) and Waiguan (TE5) is commonly used. High-frequency electroacupuncture at 100Hz is applied for 15 minutes, followed by a transition to a 2/100Hz dense-disperse wave for an additional 30-60 minutes. This approach helps to modulate pain signals effectively. Local treatments should be performed cautiously to avoid triggering pain points. Excessive stimulation of trigger areas may worsen symptoms, so gentle techniques, superficial needling, and minimal point selection are advised in this phase.

Targeted Local Point Selection Based On Nerve Branch

When treating specific branches of the trigeminal nerve, acupuncture points are selected according to the affected area. For the first branch (ophthalmic division), points such as Taiyang (EX-HN5), Yangbai (GB14), and Yuyao (EX-HN4) are commonly used. For the second branch (maxillary division), acupuncturists often choose Xiaguan (ST7), Quanliao (SI18), Sibai (ST2), and Yingxiang (LI20). In the case of the third branch (mandibular division), Jiache (ST6) is typically selected as the main local point.

Management During The Remission Phase

During the remission phase, local needling becomes the primary focus, while distal points are still used to enhance overall effectiveness. Superficial needling techniques are preferred for local points, and these may be combined with low-frequency electroacupuncture at 2Hz for 30-60 minutes. Distal points such as Hegu (LI4), Waiguan (TE5), Sanyinjiao (SP6), and Zusanli (ST36) can be included to regulate the flow of Qi in the Yangming and Shaoyang meridians.

Emotional Regulation In Chronic Pain Management

Due to the recurrent nature of trigeminal neuralgia, patients often experience emotional distress, particularly anxiety. Integrating emotional regulation into treatment is essential. Acupuncture points such as Neiguan (PC6), Shenmen (HT7), and Taichong (LR3) are commonly used to soothe the liver, regulate Qi, and calm the mind. This holistic approach not only addresses physical symptoms but also supports the patient's mental and emotional well-being.