Treating Pain with Acupuncture and Oriental Medicine

• June 11, 2016
• siteadmin
• Health and Wellness
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Chronic and acute pain is a major driving force for health care systems within the United States, as well as the entire world. Some recent studies have estimated that as many as 116 million people (nearly one third of the U.S. population) experience chronic pain on a daily basis at any given moment. Pain is a complex thing involving our nervous systems, pain receptors, brains, injured tissues and disease. Pain is not just in our head –it is our body’s way of telling us something is amiss. It signals us to pay attention, respond and change our ways. Successful treatment of pain takes an integrated approach that considers all the factors involved. Oriental Medicine views pain as a complex system made up of roots and branches. The branches are where the pain is experienced and all that it consists of. The root is the underlying pattern in the body that allows it to stick around. Because of this integrated approach, Acupuncture and Oriental Medicine are very successful in treating a multitude of different pain patterns.

Pain is defined as an “unpleasant physical, sensory and/or emotional experience associated with uneasiness, discomfort, and/or actual or potential tissue damage”. Pain can come about for many complex reasons and factors. We might have slept poorly in an awkward position. We could also have an emotionally stressful day that induces tension in our shoulders. Or possibly, we may have a much more complex pattern disrupting our bodies with pain being merely the signal. Musculoskeletal pain has a number of factors that can induce it:

1) Overly explosive and quick movements.

2) Prolonged use with not enough rest.

3) Awkward movements.

4) Movements that extend beyond the range of motion your body is comfortable
with.

5) Trauma.

Internal causes of pain are too numerous to name, but include arthritis, fibromyalgia, headache patterns, menstrual disorders and many others. There are nociceptors (pain receptors) distributed throughout our bodies in skin, muscles, bones, joints, and organs. There are two types of nerve fibers located in these areas: C fibers and A fibers. C fibers are smaller, slower conducting, considered the second responder and affected by a broader spectrum of stimuli. A fibers are faster, bigger and considered the first responders. The cause of pain could be internal such as a kidney stone or external such as a burn or muscle strain. This stimulus causes the affected cells to release chemicals such as postogladins, bradykinin, potassium, and histamine.

These chemicals are called mediators. Mediators signal the nerve fibers to fire, which sends an impulse along the nerve fiber to the spinal cord. This impulse then travels up the brain stem and thalamus, making its way to multiple areas of the brain where they are processed. It now becomes a conscious experience. These other areas of the brain access the damage, intensity, location and type of pain. They also compare the pain to past experiences and memories. This helps us formulate an adequate response. The brain then signals the body through a nerve impulse to move away from the cause of pain if it applies. The limbic portion of our brain is also involved and helps us form a behavioral and emotional response.

Chronic pain can be due to a continued response of the nociceptors to injury or disease,
or to damage to these very receptors or pathways with no apparent cause. In addition, something called “wind up” can occur in which the neurons transmit an increasing number of pain impulses which become more hypersensitive and hyper excitable. “Wind up” can cause us to become sensitive to simple touch. With so many structures and tissues involved in the pain, it is no wonder it can become chronic, debilitating, and often times hard to treat.

In Oriental Medicine, pain is seen as an intermingling of external and internal factors. Initially, at the site or branch of the pain, Qi (energy) and blood stagnate. A famous saying goes, “Where there is stagnation there is pain and where there is pain there is stagnation”. An obvious example of this is a sprained ankle where the stagnation is extremely visible. Over time, if this stagnation is not cleared properly, internal and external factors can influence this.

All of us carry certain areas where there is too much energy, excesses and/or areas of too little energy (deficiencies). These are predicated on our internal balances of organs and meridians. If a certain organ or meridian is imbalanced, there can be a build up of pathogenic influences and an impaired ability to clear some of these influences. There are 4 main factors:

1. Damp: leads to swelling, heaviness, dull aching and decreased range of motion.

2. Wind: leads to migratory pain that comes and goes and could have a cramping
nature.

3. Heat: red, burning and often worse with heat and pressure.

4. Cold: fixed, stiff, deep pain.

These factors can intermingle and are affected by conditions in the environment. An example of this would be when a winter storm rolls in and a chronically stiff, painful ankle becomes exacerbated. This is an intermingling of wind, damp and cold. The storm rolling in is the wind. The damp is the moisture. The cold is from the low temperature weather.
Finally, certain organs and meridians can be in excess or deficiency, which can affect the muscles and tissues that lie along their tract. This can lead to an increased susceptibility to injury, stagnation and pain. This complex diagnostic method allows Oriental Medicine to thoroughly treat all aspects of the individual and the pain experienced. Allowing it to address both the root and the branch of the pain pattern.

With chronic pain, there are many precipitating factors that can cause it to stick around. Overuse, poor posture and biomechanics play a big role in chronic musculoskeletal pain, arthritis, fibromyalgia and even some internal pain patterns. From a young age we learn to do things in a certain manner, mimicking those around us and figuring out how to move through the world. But these ways of moving, standing, sitting and sleeping are not always the most efficient. When we are young, we have extra padding and lubrication in our joints, muscles and bodies. In addition, our bodies recover faster and consequently can take more abuse.

As we age, our natural protective mechanisms wear down and our bodies become less efficient. If we have been doing things that compromise joints, muscles, bones, etc., things can start to break down and chronic pain can appear. Therefore, actions that seemed to once be okay no longer work. Some examples of such actions would be sleeping in a strange position night after night, bending over to pick up heavy objects, sitting hunched over our computers, or exercising hard every day without adequate recovery.

Another factor in our pain response is hydration. Caffeine, specifically, dehydrates us. But it also leaches out the minerals, calcium, potassium and magnesium, which are important for smooth muscle contraction. Without adequate fluids and minerals to lubricate the muscles, joints, tendons and ligaments, injury can set in and chronic pain cannot only begin –but persist. This can affect the heart, smooth muscles, digestion etc.
Furthermore, coffee has the additional effect of blocking the sites where opiates (our natural pain reducers) attach in the brain. It consequently reduces our tolerance for pain and reduces the effectiveness of things like exercise, acupuncture, massage etc. Coffee also contains oxalic acid, which readily binds to calcium, magnesium, and potassium, blocking our ability to absorb them. This can create mineral deficiencies which increases muscle tightness, spasm and chance of injury. Oxalic acid also increases kidney stone and bone spur formation.

High sugar consumption also contributes to pain for two reasons. Firstly, sugar (including alcohol and refined flours) causes the kidneys to leach calcium, magnesium, and potassium from the blood and excrete them in the urine. This leads to the same complications listed above. Secondly, sugar or glucose is converted to fat if it is not immediately needed for energy. This conversion to fat mediated by insulin leads to the byproduct arachidonic acid. Arachidonic acid, or AA, can be converted to an inflammatory substance called “prostaglandin II”. This conversion happens more readily when AA levels are high so, anyone with a history of inflammation should only consume small amounts of substances (such as sugar) that increase AA levels. Other foods that are high in AA are red meats, organ meats, and egg yokes.

Additional factors that play a significant role in pain are stress and sleep. Stress naturally keeps us tense and ready for action. This continual slight muscle contraction depletes and overuses the muscles, joints and tendons. Consequently, they are given inadequate time to recover, which can lead to potential injury. When we are stressed, our bodies do not repair damaged tissue as readily. This can lead to a normally small injury becoming a significant one. Stress also decreases digestion and our ability to absorb minerals and nutrients needed for recovery and proper function.

Poor sleep is another important factor in pain, injury and disease. When resting and sleeping at night, our bodies recover and repair. If sleep is inadequate, our bodies begin to break down and cannot repair injuries properly. Not sleeping also means we are often lying there stiffly, with our muscles contracted and overworking. Fortunately, Acupuncture and Oriental Medicine can really help chronic pain, reduce stress, and improve sleep. With thorough diagnosis and questioning, I make sure to address all of these factors in treatments in order to get the maximum results from my acupuncture treatments.

Almost all chronic pain patterns have some relation to underlying imbalances and lifestyle factors. While life is supposed to be fun and experiential, reducing caffeine, coffee, sugar and saturated fat will help diminish pain. Increasing water, potassium, calcium and magnesium will also improve chronic pain patterns, especially if you are eating some of the foods mentioned above. Another helpful nutrient in decreasing pain is essential fatty acids found in foods such as spirulina, borage oil, black current oil, dark leafy greens, cold water fish, flax, chia, and pumpkin seeds. All these foods deeply nourish the body, decrease inflammation and reduce blood stagnation. It is also helpful to strengthen your weakest muscles, your core, as well as other areas of your body. Make a point to stretch regularly and rest between workouts, maintain good ergonomics in workouts and at work, decrease stress and get enough sleep, which allows the body to rebuild and repair.

When a patient has an injury with chronic or acute pain, I do a thorough inquiry on all symptoms, type of pain, when it is felt and what it is aggravated by, etc. In assessing the body, I look for deficient or excess energy in the meridians, tight or weak muscles and tissues, inflammation, postural imbalances, etc. I then form a complete diagnosis based on this information.

Treatment might include specific acupuncture points in the area of injury including trigger point work. Trigger points are small specific injured areas in the muscle fibers which when worked on release the muscle, increase blood flow and help the whole area to heal. An additional adjunct therapy that I use is electro- acupuncture. In this remarkable treatment, a small battery powered device is hooked up to acupuncture needles which very specifically increase blood flow and Qi to the injured tissues and consequently enhance the healing effects. I also add cupping, as well as the application of essential oils
and liniments to aid healing. Finally, a treatment would not be complete without needling the various affected meridians to address underlying imbalance and root cause. When applicable, I prescribe certain exercises, rest, lifestyle and ergonomic changes, herbal formulas and herbal plasters to aid recovery.

Pain is not something we have to just live with or be mystified by. While it may not be realistic for everyone to make “perfect” lifestyle choices 100% of the time, my goal with this article is simply to inform, so that you may take this information and make your choices consciously –armed with knowledge and free will. Fortunately, Acupuncture and Oriental Medicine have the ability to thoroughly diagnose and address the underlying root of pain, as well as the specific pain pattern. This can greatly reduce the time spent injured and in pain –allowing true, deep healing to become your reality.