Trigeminal Neuralgiaaccording to TCM
Symptom families: Neurological Disorders, Neuralgias and Neuropathies
What is Trigeminal Neuralgia?
Trigeminal Neuralgia, often known as Tic Douloureux, is characterized by severe, shooting pain in the face, originating from the trigeminal nerve. This chronic condition can be triggered by mild facial stimuli and presents as acute, sporadic attacks of pain, typically affecting one side of the face.
It's named for the trigeminal nerve, which carries sensation from the face to the brain. The discomfort can be so intense it's been termed the suicide disease due to the significant impact it can have on a person's quality of life.
How does TCM view Trigeminal Neuralgia?
From the perspective of Traditional Chinese Medicine (TCM), trigeminal neuralgia is often seen as a disharmony where external pathogenic factors such as Wind, Cold, and Dampness invade the channels, leading to Qi And Blood Stagnation.
Recognizing the correct pattern of disharmony is crucial, as it guides the treatment strategy—be it acupuncture, herbal medicine, or a combination of modalities. Each case is treated individually, acknowledging the interplay of the patient's constitution, lifestyle, and emotional state.
Causes of Trigeminal Neuralgia According to TCM
TCM posits that trigeminal neuralgia may arise from a variety of imbalances. One common cause is the stagnation of Qi and Blood within the Channels, which can manifest physically as intense pain.
Another is the invasion of Wind-Cold, which can obstruct the flow of Qi and cause spasmodic pain. TCM treatments aim to restore balance by dispelling Wind, transforming Dampness, warming the channels, and moving Blood and Qi. Understanding these patterns allows practitioners to tailor treatments that address the root cause rather than just the symptoms.
TCM Herbal Formulas for Trigeminal Neuralgia
In treating trigeminal neuralgia, TCM emphasizes restoring harmony within the body's systems. Formulas such as Dang Gui Shao Yao San, with its key herb White Peony Roots, nourish Blood and harmonize the Liver and Spleen, potentially easing the spasmodic pain.
Tao He Cheng Qi Tang and Xue Fu Zhu Yu Tang both containing Peach Kernels, are used to invigorate Blood and remove Blood Stasis, which in TCM theory, may alleviate pain. Additionally, cooling herbs like Goldthread Rhizomes in Qing Wei San or Gypsum in Yu Nu Jian are chosen to clear Heat from the organs, which can also be a contributing factor to neuralgic pain.
Explore below some TCM herbal formulas used to address trigeminal neuralgia, organized by formula type.
- By Formula Type
- Formulas that invigorate blood and dispel blood stagnation
- Formulas that clear heat from the organs
- Formulas that warm and transform water and dampness
- Formulas that clear wind-Cold
- Formulas that warm and purge
- Formulas that clear exterior disorders with interior deficiency
- Formulas that tonify blood
- Formulas that nourish the heart and calm the mind
- Formulas that promote urination and leach out dampness
- Formulas that warm the middle and dispel cold
- Formulas that pacify and extinguish internal wind
Formulas that invigorate Blood and dispel Blood Stagnation
Trigeminal neuralgia can be treated by these formulas if it arises from poor blood circulation or stagnation of blood, which often manifests in pain or swelling.
One such formula is Dang Gui Shao Yao San, with white peony root as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that invigorate blood and dispel blood stagnation" recommended for trigeminal neuralgia
Formulas that clear Heat from the Organs
Trigeminal neuralgia can be treated by these formulas if it stems from an excess heat condition in specific organs, leading to internal disharmony.
One such formula is Qing Wei San, with goldthread rhizome as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear heat from the organs" recommended for trigeminal neuralgia
| Formula | Key herbs |
|---|---|
| Qing Wei San | Goldthread Rhizomes (Huang Lian) |
| Yu Nu Jian | Gypsum (Shi Gao), Prepared Rehmannia (Shu Di huang) |
| Yu Nu Tang | Gypsum (Shi Gao), Prepared Rehmannia (Shu Di huang) |
Formulas that warm and transform water and Dampness
Trigeminal neuralgia can be treated by these formulas if it is due to cold-dampness obstructing the body's functions, requiring warming and damp-transforming actions.
One such formula is Fu Zi Tang, with prepared aconite as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that warm and transform water and dampness" recommended for trigeminal neuralgia
| Formula | Key herbs |
|---|---|
| Fu Zi Tang | Prepared Aconite (Zhi Fu Zi) |
| Zhen Wu Tang | Prepared Aconite (Zhi Fu Zi) |
Formulas that clear Wind-Cold
Trigeminal neuralgia can be treated by these formulas when it stems from external pathogenic influences characterized by cold and wind symptoms.
One such formula is Ge Gen Tang, with kudzu root as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear wind-Cold" recommended for trigeminal neuralgia
| Formula | Key herbs |
|---|---|
| Ge Gen Tang | Kudzu Roots (Ge Gen) |
| Ma Huang Tang | Ephedra (Ma Huang) |
Formulas that warm and purge
Trigeminal neuralgia can be treated by these formulas if it stems from cold accumulation coupled with excess conditions, necessitating warming and purging actions.
One such formula is Da Huang Fu Zi Tang, with prepared aconite as a key herb.
Formulas that clear Exterior disorders with Interior deficiency
Trigeminal neuralgia can be treated by formulas that clear Exterior disorders with Interior deficiency if it arises from an external pathogen attacking a body with underlying weakness.
One such formula is Ma Huang Xi Xin Fu Zi Tang, with ephedra as a key herb.
Formulas that tonify Blood
Trigeminal neuralgia can be treated by these formulas when it is due to blood deficiency, requiring blood-nourishing and enriching actions.
One such formula is Shao Yao Gan Cao Tang, with white peony root as a key herb.
Formulas that nourish the Heart and calm the Mind
Trigeminal neuralgia can be treated by these formulas when it stems from a disharmony between the heart and the mind, often manifesting as emotional disturbances or sleep issues.
One such formula is Suan Zao Ren Tang, with jujube seeds as a key herb.
Formulas that promote urination and leach out Dampness
Trigeminal neuralgia can be treated by these formulas when it is caused by an accumulation of dampness in the body, requiring diuretic actions to promote fluid balance.
One such formula is Wu Ling San, with water plantain as a key herb.
Formulas that warm the middle and dispel Cold
Trigeminal neuralgia can be treated by these formulas when it is due to cold in the middle jiao (digestive region), necessitating warming and cold-dispelling actions.
One such formula is Wu Zhu Yu Tang, with evodia fruit as a key herb.
Formulas that pacify and extinguish Internal Wind
Trigeminal neuralgia can be treated by these formulas when it is due to internal wind, which is often associated with spasms, tremors, or dizziness.
One such formula is Zhen Gan Xi Feng Tang, with achyranthes root as a key herb.
Acupoints for Trigeminal Neuralgia
Acupuncture is another facet of TCM used to treat trigeminal neuralgia. Points such as Dicang ST-4 and Juliao ST-3 on the Stomach Channel are selected to expel Wind and alleviate pain. Yifeng TB-17 in the Triple Burner Channel is used to benefit the ears and dispel Wind, which can be associated with neuralgic pain. These points are strategically chosen to address the individual patterns of disharmony, aiming to reduce pain and prevent the recurrence of the neuralgia attacks.
Explore below some acupoints used to address trigeminal neuralgia, organized by meridian.
- By Meridian
- Stomach Channel
- Large Intestine Channel
- Extra Points: Head and Neck (EX-HN)
- Small Intestine Channel
- Triple Burner Channel
- Bladder Channel
Xiaguan ST-7
In the depression at the lower border of the zygomatic arch, anterior to the condyloid process of the mandible. Xiaguan ST-7 is located when the mouth is closed.
Hegu LI-4
Between the 1st and 2nd metacarpal bones, approximately in the middle of the 2nd metacarpal bone on the radial side.
Yingxiang LI-20
In the nasolabrial groove, at the level of the midpoint of the lateral border of ala nasi.
Yifeng TB-17
Posterior to the lobule of the ear, in the depression between the mandible and mastoid process.
TCM Herbs for Trigeminal Neuralgia
Explore below some TCM herbs used to address trigeminal neuralgia, organized by herb category.
- By Herb Category
- Herbs that invigorate the blood
- Herbs that warm the interior and/or expel cold
- Tonic herbs for blood deficiency
- Cool/Acrid herbs that release the exterior
- Warm/Acrid herbs that release the exterior
- Herbs that clear heat and dry dampness
- Herbs that nourish the heart and calm the spirit
- Purgative herbs that drain downward
- Herbs that drain dampness
- Herbs that clear heat and purge fire and/or clear summer heat
Herbs that invigorate the Blood
Trigeminal neuralgia can be treated by these herbs when it stems from stagnation or poor circulation of blood, helping to improve blood flow and alleviate related discomfort.
One such herb is Peach Kernels (Tao Ren), a key herb in some formulas recommended for trigeminal neuralgia, like Tao He Cheng Qi Tang.
Other herbs of this category are listed in the table below.
"Herbs that invigorate the Blood" recommended for trigeminal neuralgia
| Herb | Formulas they belong to (if applicable) |
|---|---|
| Peach Kernels (Tao Ren) | Tao He Cheng Qi Tang | Xue Fu Zhu Yu Tang |
| Safflowers (Hong Hua) | Xue Fu Zhu Yu Tang |
| Szechuan Lovage Roots (Chuan Xiong) | Xue Fu Zhu Yu Tang |
| Achyranthes Roots (Niu Xi) | Zhen Gan Xi Feng Tang |
Herbs that warm the Interior and/or expel Cold
Trigeminal neuralgia can be treated by these herbs if it is due to internal coldness or deficient Yang energy, working to warm the body and dispel cold.
One such herb is Prepared Aconite (Zhi Fu Zi), a key herb in some formulas recommended for trigeminal neuralgia, like Da Huang Fu Zi Tang.
Other herbs of this category are listed in the table below.
"Herbs that warm the Interior and/or expel Cold" recommended for trigeminal neuralgia
| Herb | Formulas they belong to (if applicable) |
|---|---|
| Prepared Aconite (Zhi Fu Zi) | Da Huang Fu Zi Tang | Fu Zi Tang | Zhen Wu Tang |
| Evodia Fruits (Wu Zhu Yu) | Wu Zhu Yu Tang |
Tonic herbs for Blood Deficiency
Trigeminal neuralgia can be treated by these herbs in cases of blood deficiency, working to nourish and replenish the body's blood supply.
One such herb is White Peony Roots (Bai Shao), a key herb in some formulas recommended for trigeminal neuralgia, like Dang Gui Shao Yao San.
Other herbs of this category are listed in the table below.
"Tonic herbs for Blood Deficiency" recommended for trigeminal neuralgia
| Herb | Formulas they belong to (if applicable) |
|---|---|
| White Peony Roots (Bai Shao) | Dang Gui Shao Yao San | Shao Yao Gan Cao Tang |
| Prepared Rehmannia (Shu Di huang) | Yu Nu Jian | Yu Nu Tang |
Cool/Acrid herbs that release the Exterior
Trigeminal neuralgia can be treated by these herbs when the body needs to harmonize with external environmental changes, particularly when there's a need to expel pathogenic factors like wind or cold without overly cooling the body.
One such herb is Kudzu Roots (Ge Gen), a key herb in some formulas recommended for trigeminal neuralgia, like Ge Gen Tang.
Warm/Acrid herbs that release the Exterior
Trigeminal neuralgia can be treated by these herbs when there is a need to dispel external cold and warm the body, especially in cases where there is insufficient Yang energy internally.
One such herb is Ephedra (Ma Huang), a key herb in some formulas recommended for trigeminal neuralgia, like Ma Huang Tang.
Herbs that clear Heat and dry Dampness
Trigeminal neuralgia can be treated by these herbs when caused by excessive dampness and heat within the body, aiming to restore balance by drying dampness and clearing heat.
One such herb is Goldthread Rhizomes (Huang Lian), a key herb in some formulas recommended for trigeminal neuralgia, like Qing Wei San.
Herbs that nourish the Heart and calm the Spirit
Trigeminal neuralgia can be treated by these herbs when it is linked to deficiencies in heart nourishment, addressing both physical and emotional imbalances.
One such herb is Jujube Seeds (Suan Zao Ren), a key herb in some formulas recommended for trigeminal neuralgia, like Suan Zao Ren Tang.
Purgative herbs that drain downward
Trigeminal neuralgia can be treated by these herbs in cases of severe constipation or internal heat, using strong downward movement to purge accumulation.
One such herb is Rhubarb (Da Huang), a key herb in some formulas recommended for trigeminal neuralgia, like Tao He Cheng Qi Tang.
Herbs that drain Dampness
Trigeminal neuralgia can be treated by these herbs when caused by excessive dampness in the body, aiding in eliminating damp through diuretic action.
One such herb is Water Plantain (Ze Xie), a key herb in some formulas recommended for trigeminal neuralgia, like Wu Ling San.
Herbs that clear Heat and purge Fire and/or clear Summer Heat
Trigeminal neuralgia can be treated by these herbs when it arises from excessive internal heat or fire, aiding in cooling the body and balancing internal temperature.
One such herb is Gypsum (Shi Gao), a key herb in some formulas recommended for trigeminal neuralgia, like Yu Nu Jian.