Relieving Chronic Pain with Acupuncture
Pain, as defined by the International Association for the Study of Pain, is "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described by the patient in terms of such damage." However, pain may not always be a signal of tissue damage or injury. Pain can also come from a functional disturbance in the nervous system.
What is pain?
There are two primary types of pain. Acute pain is defined as Pain that is created by inflammation, tissue damage, injury, illness or recent surgery, often accompanies by redness, increased local temperature and swelling. Acute pain usually ends after the underlying cause is treated or has been resolved. Chronic pain persists for weeks, months or years. It overwhelms all other symptoms and may become the problem in and of itself. It can cause people to lose their appetites, and be exhausted by any physical activity. Many people suffer from chronic pain in the absence of any past injury or evidence of illness. The most common type of chronic pain is from an abnormal function in the nervous system, described as "neuropathic pain." This is a major medical condition, and should be treated accordingly.
A person preoccupied with chronic pain may become depressed and irritable. This depression and irritability often leads to insomnia and weariness, which in turn compounds the emotional distress and pain. This vicious cycle is called the "terrible triad" of suffering, sleeplessness and sadness. The urge to stop the pain can make some people drug dependent, and may drive others to have repeated surgeries, or resort to questionable treatments.
Specific treatment for chronic pain should be determined based on:
- age, overall health, and medical history
- extent of the condition
- tolerance for specific medications, procedures or therapies
- expectations for the course of the condition
- personal opinion or preference
Chronic pain involves all aspects of a person's life. Therefore the most effective treatment includes not only relief of symptoms, but other types of support. Management of pain may involve several different specialists, including the following:
- neurologists and neurosurgeons
- physical and occupational therapists
- anesthesiologists
- psychiatrists and psychologists
- acupuncturists
Western Treatment Methods for Pain
In western (allopathic) medicine, treatment for chronic pain may include any or a combination of the following:
- Over-the-counter (OTC) medications. These generally include nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen, ketoprofen and acetaminophen. All of these can cause negative side effects, such as gastric irritation and liver damage, particularly when used long-term.
- Heat and Cold treatments. These can reduce stiffness and pain, particularly of arthritis. Cold packs numb the sore area and are particularly effective for severe joint pain and swelling. Heat treatments relax muscles, and may include dry heat methods, such as a heating pad or heat lamp, or moist heat methods, such as a bath or hydrocollator pack.
- Prescription Pain Medications. Prescription pain medications, including the opiate-related compounds, can usually provide stronger pain relief than OTC medications. However, all of these drugs have some potential for abuse, and may have unpleasant and even harmful side effects. In combination with other medications or alcohol, some can be extremely dangerous.
- Prescription antidepressants. Prescription antidepressants can benefit some patients who report that pain relief happens before any uplift in mood. Specialists attribute this result to the antidepressant's ability to increase the production of serotonin. However, because psychiatric drugs attain their results by causing brain dysfunction, they all have harmful side effects, such as addiction and withdrawal.
- Local electrical stimulation. Local electrical stimulation, the application of brief pulses of electricity to nerve endings under the skin, can provide pain relief to some chronic pain sufferers. This procedure, called transcutaneous electrical nerve stimulation (TENS), blocks pain messages to the brain and modifies pain perception.
- Brain stimulation. Brain stimulation is another type of electrical stimulation, mainly used for controlling pain that is widespread and severe. After the electrodes are surgically implanted in the brain, the patient controls the delivery of electrical stimulations by operating an external transmitter.
- Psychological treatment. Psychological treatment for pain may include psychoanalysis and other forms of psychotherapy, relaxation training, meditation, hypnosis, biofeedback and behavior modification. The philosophy common to these approaches is that patients can do something on their own to control their pain, whether changing their attitudes, feelings or behaviors, or understanding how unconscious forces and past events contribute to their present condition.
- Surgery. Surgery may be considered for chronic pain. While it can bring relief, it may also destroy other sensations, or become a source of new pain. Relief is not necessarily permanent, and pain may return.
The Treatment of Pain in Traditional Chinese Medicine
In the treatment of pain, the primary difference between Traditional Chinese Medicine and western medicine is that TCM methods such as acupuncture and herbal treatments have virtually no side effects. This is because acupuncture works in an entirely different manner. For example the NSAIDs commonly used to relieve pain provide short-term relief by blocking the production of pain-creating substances called prostaglandins. But in addition to creating pain, prostaglandins are also vasodilators, which help enhance circulation. Therefore inhibiting their production has the harmful side effect of decreasing blood supply to the muscles and joints, which ultimately slows the recovery process.
Traditional Chinese Medicine (TCM) creates an entirely opposite effect. Acupuncture, tui na and herbal applications work to stimulate the central nervous system, which in turn releases chemicals into the muscles, spinal cord and brain. These chemicals either alter the perception of pain or release other chemicals that influence the body's self-regulating systems. These biochemical changes support the body's natural healing abilities, improve circulation, and promote physical and emotional well-being. When circulation in the tissue improves, muscle relaxation occurs and pain is reduced. In some cases, improved circulation may cause the pain to increase, but this is followed by accelerated repair of the tissue. Proper circulation is important not only for the blood to nourish the tissue, but also for eliminating muscle fatigue and pain-causing substances such as lactic acid.
The "Gate Control" theory of pain asserts that stimulus, such as acupuncture, that activates nerves that do not transmit pain can block signals from pain fibers and can inhibit a person's perception of pain. Think of it as two people speaking to you at the same time. If that happens, then you cannot focus on just one person. So, the words spoken to you become unclear. With regular acupuncture treatments, the brain can be trained to control the types of pain and degrees of pain that are perceived. In other words, using acupuncture, the brain can be taught to turn off types of pain that are not useful.
In 1997, the National Institutes of Health (U.S.) officially recognized acupuncture as an effective treatment for pain. According to the 1997 NIH panel, clinical studies showed that acupuncture therapy is helpful in treating many types of chronic pain, including headaches, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, neck pain, low back pain and carpal tunnel syndrome. Recent studies also suggest that topical herbal compounds like those used in Traditional Chinese Medicine are very effective for reducing chronic pain.