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Trigeminal Neuralgia, an Oriental Medicine Approach to Pain That Is Not Resolved Even With Medication | Incheon Trigeminal Neuralgia
Blog September 25, 2025

Trigeminal Neuralgia, an Oriental Medicine Approach to Pain That Is Not Resolved Even With Medication | Incheon Trigeminal Neuralgia

Dr. Yeonseung Choe
Dr. Yeonseung Choe
Chief Director

Trigeminal Neuralgia: A Traditional Korean Medicine Approach to Pain That Cannot Be Resolved with Medication

This is the story of a woman in her mid-40s, B.

For several months, she had been struggling with daily life due to severe facial pain. Initially, she thought it was a simple toothache, but even after having a healthy molar extracted following a dental examination, the pain remained unchanged.

So what is the real cause?

Neuralgia medication works by inhibiting the conduction of nerve cell excitation to prevent pain signals from being transmitted to the brain. This is like flipping a switch so that the 'siren' called pain does not sound.

However, Person B's pain continued to sound even when the switch was pressed with medication. If this pain had been simply a matter of nerve excitation, it would have been sufficiently controlled with analgesics. This is an important clue showing that the root cause of the pain may not lie solely in the 'excessive activation of the nerves' itself.

In Korean medicine, chronic pain such as trigeminal neuralgia is not viewed simply as a nerve problem. Rather, the imbalance of the entire body is examined along with the patterns in which the pain appears.

The 《Dongui Bogam》 states, “Tong-jeuk-bul-tong, bul-tong-jeuk-tong (通則不痛, 不通則痛).” This means 'if there is flow, there is no pain; if there is no flow, there is pain,' concisely showing that the essence of all pain lies in the 'stagnation of circulation.'

Then, what is it that blocks communication?

In Korean medicine, the primary causes that induce pain are'Wind (風)', 'Heat (熱)', 'Phlegm (痰)', and 'Blood Stasis (瘀血)'cited. These elements, like floating debris in a river, obstruct the flow of blood and Qi (氣) and block the pathways through which nerves pass, thereby inducing pain. This can be interpreted as a concept similar to the inflammatory response or nerve compression mentioned in Western medicine.

In the case of Person B, nerves may have become hypersensitive due to overtime work and stress, leading to the accumulation of 'heat (熱),' and 'phlegm (痰)' may have developed due to irregular meals and lack of sleep. In particular, the pattern where pain was severe in the morning and subsided in the afternoon was an important clue suggesting that the state of the body's qi and blood circulation differs by time of day.

This approach is likea sophisticated strategy for identifying allies and enemies in war.

Indiscriminately suppressing nerve excitation with painkillers is like conducting an indiscriminate bombing without distinguishing between allies and enemies. In contrast, herbal medicine treatment first closely diagnoses the patient's physical condition to accurately identify the root cause of the pain (wind, heat, phlegm, etc.) and employs a customized strategy accordingly.

Herbal medicine is not a simple pain reliever. Herbal medicine removes floating debris such as 'wind, heat, and phlegm' accumulated in the nerve pathways and facilitates the circulation of Qi and blood to help the nerves recover their function. In other words, it aims to prevent recurrence by treating the 'cause' of the pain. The reason why the neuralgia medicationLyrica (Pregabalin)did not work lies exactly at this point.

Are you perhaps suffering every day from facial pain that cannot be resolved simply with painkillers alone?

Instead of focusing only on the hypersensitivity of the nervous system, an Oriental medicine approach that finds and treats the causal patterns of pain provides a new perspective on chronic trigeminal neuralgia. This is not medical advice for a specific individual. Rather, it can be a journey of listening to the imbalance signals of our body and searching for the hidden causes of pain.

[Key Takeaways]

  • The extreme pain of trigeminal neuralgia may be caused by 'stagnation of Qi and blood circulation'.

  • Herbal medicine treatment aims to prevent recurrence by removing the 'cause' of the pain.

  • Rather than relying solely on painkillers, it may be effective to identify the hidden cause patterns of pain through a Korean medicine diagnosis.

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Dr. Yeonseung Choe

Dr. Yeonseung Choe Chief Director

I have met many patients who came after visiting multiple medical institutions and departments for persistent or recurrent conditions. Symptoms normally handled by different specialties—such as abdominal pain, headaches, palpitations, dizziness, and insomnia—may overlap in one person. Sometimes there is no clear improvement despite taking medication for each symptom, and being unwell gradually becomes part of daily life. In these cases, I look beyond individual diagnoses and examine how the symptoms connect and change together. Asking only about the most uncomfortable symptom today does not reveal the full course. I look at when the body first began to change and what happened after illness, surgery, childbirth, or starting and stopping medication. I also review changes in weight, diet, and sleep, then trace which symptoms improved with previous treatment and which remained. Test results, diagnoses, and the course of previous treatment are important for understanding the current condition. Clinical research in modern Korean medicine, physiological and pathological research in modern medicine, and observations recorded in classical Korean medicine texts offer different perspectives on the same body. Rather than fitting a patient into one perspective, I consider what each can and cannot explain and look for clues that connect symptoms and treatment histories that were previously considered separately.

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