The Neuralgias

The neuralgias are a collection of poorly understood and frequently painful conditions. The more common and clearly defined types of neuralgia will be discussed in the following section.

Trigeminal neuralgia usually presents with severe unilateral facial pain. Its cause is unclear but the painful facial spasms are often precipitated by cold or wind. The Chinese claim to be able to gain some improvement, with acupuncture, in about 70 per cent of cases of trigeminal neuralgia. Judging by the experience of Western acupuncturists this success rate represents a rather high figure, although acupuncture can undoubtedly have a beneficial effect on this type of pain.

Postherpetic neuralgia is the pain that occurs after an attack of shingles. Shingles is a viral infection of the nerves, and the nerves affected by shingles can occasionally continue to cause severe pain after the shingles has cleared.

Postherpetic neuralgia is an uncommon disease in China; this may be because the Chinese treat all cases of shingles with acupuncture before the postherpetic neuralgia can develop. There are other possible explanations for its decreased incidence in China, perhaps postherpetic neuralgia is affected by diet, or racial characteristics; however, it is much more reasonable to suggest that the dearth of postherpetic neuralgia in China is due to the daily treatment of shingles with acupuncture. It seems that of those patients with established postherpetic neuralgia, about 40 per cent gain some degree of long term benefit from acupuncture. If this figure could be substantiated with proper clinical research work, it would represent a significant advance in the treatment of this condition.

There are a vast number of aches and pains that are often described as neuralgic. Many of these occur as facial pain and most of them cause severe discomfort. It is always worth while to attempt to alleviate these pains by using acupuncture. Some people respond and others do not; it is impossible to give figures for success, or even estimates, without going into great detail about the exact cause and type of neuralgia being treated.

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Written by George T. Lewith MA MRCGP MRCP

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