How to release pain on the face?

Acupuncture is effective for facial pain

Acupuncture was effective in pain reduction in patients with facial pain. It has immediate effect. A case reported by Goddard G was about effectiveness of acupuncture in patients with orofacial pain. 29 patients with chronic orofacial pain received acupuncture treatment. The pain was assessed before and after acupuncture treatment. Pain score was significantly reduced after the treatment.

Simma I et al studied the effect of acupuncture in patients with craniomandibular disorders, headache and local pain in orofacial, cervical and temporomandibular joint areas using randomized controlled trials. 23 patients were divided into two groups acupuncture group or placebo laser control groups. Pain was assessed immediately before and after the treatment. They found that pain reduction is significantly different between acupuncture group and control group.

Shen YF and Goddard G assessed the effect of acupuncture on chronic myofascial pain. There were 15 patients with chronic myofascial pain. 9 patients received acupuncture and 6 patients received sham acupuncture. Acupuncture was performed at acupoint LI4. The result showed that there was a significant reduction in face pain, neck pain and headache in acupuncture group. Pain tolerance in the masticatory muscles increase significantly more with acupuncture than sham acupuncture.

There was study of dry needling on myofacial trigger points in patients with myofacial syndrome using acupuncture needle. 39 patients were randomized into two groups 22 patients in dry needling group and 17 patients in placebo group. Needles were applied twice a week for two weeks and once a week for one week. They found That dry needling treatment is effective in relieving the pain and improving the quality of life in patients with myofacial pain syndrome.

Case report: Acupuncture for trigeminal neuralgia

Trigeminal neuralgia is a neuropathic pain syndrome. It presents episodic intense pain in the face within the region of the trigeminal nerve. It is often unilateral but can be bilateral. The pain is typically deteriorating which affects quality of life. Various pain killers can be used to treat the pain, but they all have many unwanted effects when they are taken for too long. The effective treatment with fewer side effects is preferred. Acupuncture is one of the effective treatments without side effects. Sert H et al reported a successful acupuncture treatment for a case of trigeminal neuralgia. This was a 66 year old woman with trigeminal neuralgia. She had pain on the left side of her face for 25 year. The pain was triggered by speaking, eating or touching. The pain was severe and on 10 out of scale of 10. The diagnosis by a neurologist was trigeminal neuralgia. All medication she took including carbamasepine, gabapentin and valproic acid did not reduce the pain. Nerve block and radiofrequency rhizotomy of the infraorbital brach of the trigeminal nerve did not work for her either. Based on her existing medication, she was given acupuncture. The points were used including local points TH17 and 21, GB2, SI18, ST2,3 and 7, GV26 and LI20, systemic point included TH5, LI4, ST36, ST44, ST45 and LIV 3. Auricular acupuncture points were also used (Shen Men, neuro face and long points). Needles were not manipulated, and no attept was made to elicit De-Qi. Every session was about 45 min, three times a week, After the fourth session, she reported that she had almost no pain. By the sixth week after 14 sessions of treatment, there was no pain at all. She evaluated the pain 0. There was still no pain at the end of 6 month of follow-up.

Temporomandibular disorder (TMD) is a condition affecting the movement of the jaw. Signs of TMD include: pain around the jaw, ear and temple; clicking noises when moving the jaw; a headache around the temples; difficulty opening the mouth fully; jaw locking when opening the mouth. The pain may be worse when chewing and stressed. TMD can affect sleep. The aim of the treatment is to reduce pain and increase the motion of the joint.

One review analysed the data to study the effectiveness of acupuncture in treating pain from TMD. The data is for 25 years from 1990 t2015. The result has shown that acupuncture treatment appears to relieve the signs and symptoms of pain in myofascial TMD. Another study was from 8 publications involved in 231 patients with TMD. The result indicates that conventional acupuncture therapy is effective in reducing the degree of pain in patients with TMD, especially those with myofascial pain symptoms. Butts R et al reviewed the non surgical treatments for this condition. Based on the research evidence they suggested that acupuncture can help to release the pain and improve the joint movement. For example a study by Gonzalez-perez et al investigated the effect of needling on temporomandibular disorder. 48 patients were divided into two groups needling group and medication group. Dry needling acupuncture was applied once a week for three weeks and assessment was carried out before and after treatment. They found that needling group has better pain reduction than medication group. Pain reduction, maximum mouth opening, laterality and protrusion movements compared with pre-treatment values had significant improvement. There was no side effect found in the needling group.

Simma I et al Br Dent J (2009) 207:E26.
Shen YF and Goddard G Pain Pract. (2007) 7:256-64
Goddard G Med Sci Monit (2005) 11:CR71-4
Tekin L et al lin Rheumatol (2012) Nov 9
Sert H et al Clinics (Sao Paulo) (2009) 64: 1225-6
Fermandes AC et al J Oral Facial pain Headache (2017) Summer;31(3):225-232. doi: 10.11607/ofph.1719.
Wu JY et al Medicine (Baltimore) (2017) Mar;96(9):e6064. doi: 10.1097/MD.0000000000006064.
Butts R et al J Bodyw Mov Ther (2017) 21:541-548
Gonzalez-Perez LM et al Med Oral Patol Oral Cir Bucal (2015) 20: e326-33

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