Neuropathic pain from TN is caused by damage or obstruction of one or more branches of the trigeminal nerve. Acupuncture is effective in many cases because of its ability to modulate the perception of pain along nerve pathways (Robinson, 2016). There is an acceptance being granted in the field of neuroscience towards acupuncture as more studies show evidence that acupuncture has the ability to dampen pain signals as well as affect multiple centers of the brain including the autonomic system, the reticular brain, and the brainstem (Robinson, 2016).
Acupuncture is amazing in its ability to promote microcirculation to the tiny capillaries and compartments between soft tissues of the body including the face, head, neck, and jaw.
Studies show that acupuncture is effective for neuropathic pain in two important ways: (1) it alters the pathway from the limb or distal body to the brain thereby modifying sensory inputs that relay pain sensation (Ma et al., 2022), and (2) it activates pain-reducing chemicals including norepinephrine and opioids from the higher centers in the brain and spinal cord (Ma et al., 2022).
While acupuncture is beneficial for many conditions, and not limited to treating pain, it can offer real and lasting relief in many types of pain syndromes. Because TN is marked by severe and often recalcitrant pain that is often resistant to medications, acupuncture offers an avenue of hope.
Neurological indicators for some acupoints used to treat TN can be helpful. For instance, a point on the face, Stomach 2, is located along the superior border of the infraorbital bone, just beneath the eye on top of the bony ridge, and in line with the pupil. This point supplies innervation to the upper cheek, and upper lip mucosa, which explains its neurological effects on the cheek area.
TCM indicators for acupoints are of equal importance. The same point, Stomach 2, has been listed as a point for trigeminal neuralgia in Chinese texts for much longer than western medical studies have explored its use. Knowing some of the other indicators for the point can also inform the acupuncturist as to its multiple benefits. Stomach 2 is used for eye disorders such as itchy eyes and conjunctivitis, as well as for pain in the face.
Stomach meridian acupoints are very useful for conditions in which blood circulation has been impeded since this meridian is the most replete in qi and blood. The Stomach is part of the yangming system, meaning it represents a more superficial and expansive pool of qi and blood, and thus it is easier to access than those compartments that correspond with deeper layers of the body. The skin, being the most superficial or external of our anatomy, is accessed most expeditiously through the Stomach meridian and its corresponding acupoints. This adds to an informed decision about using this point since in most cases of neuropathy it is the outer layer or skin that is affected by some degree of sensory loss.
Energetically the Stomach has a descending and cooling action. Acupoints on the Stomach channel, and in particular those on the face, have the ability to cool and clear heat (inflammation) and redness. Plus the Stomach channel is known to benefit the head and face in general.
In my practice, I make sure to choose acupoints based on symptoms, location of pain, and a review of health history. All of these are crucial to attaining successful outcomes. This starts by identifying the particular branch of the trigeminal nerve that is affected. The ophthalmic, maxillary, and mandibular branches represent the pathways and usually one of these is most affected. Specific acupuncture protocols exist for the treatment of each of these branches.
Modern advances in neurology allow for the measurement of neural feedback loops and signaling. In my view, it is important to NOT lose the essence of acupuncture which is an energetic medicine steeped in bonafide protocols, while also surveying the “new” discoveries of neuroscience. Scientific studies provide another textual layer of understanding that is not incongruent with the core principles of TCM. Unionizing these eastern and western principles, by a skilled practitioner versed in both, can amplify treatment results.
Ma, Chen, Yang… (2022). Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Frontiers in Neuroscience, 16. https://www.frontiersin.org/articles/10.3389/fnins.2022.940343
Robinson, N. (2016). Interactive medical acupuncture anatomy. Teton NewMedia.