Orofacial Pain: TMJ, Trigeminal Neuralgia

Acupuncture has been recognized by the National Institute of Health to be effective as a stand-alone or adjunctive treatment modality for patients with various types of pain.  One of the worst types of pain is that involving the head, jaw, and face.

Michelle Thelen, L.Ac. MSTCM is on staff with UNC Dental Faculty Practice where she provides acupuncture for patients undergoing dental procedures, both before and after, as well as patients with acute or chronic orofacial pain.  Some patients experience a lot of anxiety about surgical procedures and this is even more pronounced when it involves the head or face.  Reducing anxiety is one of the biggest and most lauded benefits of acupuncture.

how does acupuncture help relieve trigeminal neuralgia and temporomandibular joint disorder? 

Both of these are jaw-related disorders that can become chronic and recalcitrant to standard drug treatments.  Acupuncture can be a very useful tool to control and reduce pain levels, and may also help with remission, thereby giving the patient real hope for recovery.  

One patient seen recently by Michelle presented with severe right-sided maxilla (upper jaw) and buccal (cheek) pain that was unremitting.  The patient was in agony, not able to sleep at night, chew solid foods, or work during the day.  She described the pain as distending, with frequent episodes of sharp and burning pain.  Of note, the patient had tried oral splint, medications including anti inflammatories and pain medication, which provided only short-term relief.  After two acupuncture treatments, the pain level had reduced from 10/10 to 2/10. This patient returns for repeat treatments when her pain flares up, and is now a devotee of acupuncture for this problem.

Head and neck pain are often related. Acupuncture points must be carefully selected according to patient signs and symptoms. This usually means local points on head and neck are combined with distal points, as found on the abdomen, legs, and arms.  Selecting the correct set of points ensures that the whole person is treated, not just one body part.  Acupuncture works by realigning meridians to allow a free flow of lymph, blood, and oxygen to those areas that are temporarily congested or blocked.

Can acupuncture help migraines, and if so, how does it work?

I have treated many different types of headaches, yet the one that is the most challenging to treat is migraine. Migraines are arguably the most severe type of head pain, and once the episode begins, treatment is not very effective. Patients are not always able to predict when they are going to get a migraine, and thus, once there is an escalating pattern of pain, not only is it difficult for the patient to leave the house or darkened room, it is also difficult for me, as a practitioner, to stop a “running train.” In my experience, I have learned that treating migraines during the pre-prodromal period when symptoms start to occur (such as auras or blurry fields of vision, nausea, sensitivity to light and noise), or in between headache episodes, represents the best time to help decrease frequency and intensity of migraine headache.

That being said, I have helped a few people who did not want to go the emergency room by administering acupuncture treatment during their full blown migraine. For sufferers of frequent migraine there is a real dismay with having to go through all of the rigamarole in the ER, the waiting, and the side effects of the medications. Treatment has helped even during the worst phase of head pain, when I needle distal points on the feet to lead the yang downward.

Many people take NSAIDS, or stronger prescriptive medicines like DHE’s that block neurogenic inflammation. I can totally understand the need for pharmaceuticals in the event of severe head pain, one of the worst kinds of pain in the body. I do think that acupuncture and Chinese herbs can offer another tactic for helping to strengthen the body’s resistance to the triggers of migraine headaches. While meds may still be necessary while undergoing acupuncture treatment, it may be possible to lessen, the dosage and frequency for meds, with a gradual decrease spanning the course of a few weeks or months. Of course, the goal is to greatly reduce or even eliminate the need for prescriptive meds, that often have damaging effects to the Liver, and substitute with a holistic health approach that includes regular acupuncture, Chinese herbs, healthy nutritional balance and adequate exercise and water intake.