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I have suffered from Trigeminal neuralgia for the past 3 years.

File under neuro - neuralgia

We have been asked several times about TN, the most recent answer we gave to this question was:

Trigeminal neuralgia is a very painful and quite often intractable condition. We have been asked about it a number of times, and  we have factsheets about both facial pain and neuropathic pain

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/facial-pain.html

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/neuropathic-pain.html

The evidence underpinning a recommendation for acupuncture treatment is limited, but as you can see from the evidence button on the neuropathic pain sheet acupuncture has on several occasions been shown to be superior to the standard drug treatment, which suggests that it is worth trying. 

In a previous response on the same question we said that if you look through these various responses, however, you will see much the same advice in each one. The evidence is encouraging but far from conclusive, although it would be fair to say that the gold standard of research in western medicine, the randomised double blind control trial, is not the most appropriate tool for assessing traditional acupuncture. However, there are a number of treatment possibilities within the paradigm of Chinese medicine, to do with blockages or deficiencies in the flow of energy, or 'qi' as it is called, which a practitioner might be able to identify and correct. Your best bet here is to contact a BAcC member local to you and seek a brief face to face assessment of whether they think acupuncture may be of benefit.

We have to say, however, that trigeminal neuralgia or neuropathy does appear to be a rather intractable condition, and we are usually relatively cautious about the prognosis when we take on patients in whom this is their main complaint. You will note that in one or two replies we have suggested that cranial osteopathy may offer another treatment option. The pathway of the trigeminal nerve is easily compromised by some of the physical structures around the tempero-mandibular joint, and subtle manipulation may offer possibilities.

We think that this remains the best advice that we can give. We have no doubt that acupuncture treatment can deliver temporary pain relief, and the amount of research which has been done to investigate this aspect of acupuncture's effects has been very considerable. However, as with all forms of pain relief, it is relief, not removal altogether, which is what the treatment delivers, and even when treatment works the extent of the relief it can give and its sustainability do not seem to us to be sufficient to warrant making a recommendation to try to use acupuncture as a long-term pain relief option.

If you did decide to visit a practitioner local to you, we would recommend that you are very clear about the review periods at which you can assess how successful the treatment has been, and also that you try to establish very clear outcome measures, i.e. changes which you can actually measure rather than simply soundings based on how you feel on the day. With conditions like this there are good days and bad days, or more accurately bad days and worse days, and it helps to try to bring a measure of objectivity where possible to the proceedings.

In your own case the backdrop of MS would appear to make the situation a little more complex, but it is important to recognise that the diagnostic categories of Chinese medicine are entirely different from the conventional medicine paradigm. From this perspective how a patient presents is far more important than the disease labels which they carry. That is not to say that Chinese medicine offers a chance of change where conventional medicine doesn't; in the modern parlance of sales, once it's gone it's gone. If a nerve is demyelinated there is no evidence to suggest that acupuncture treatment can reverse the damage. 

However, MS, as you know very well, can sometimes plateau and often have periods of remission, and our general sense is that treatments like acupuncture which are aimed at maintaining balance in the system may well be a contributory factor in staying well. This was, after all, the basis of ancient Chinese medicine,, helping people to stay well rather trying to get them better after they got ill, which was said to b e 'like forging a spear after the battle had started or digging a well when you were already thirsty.'

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