Pain Management

Written by:  Grant Weidler, L.Ac at Family Farm Health Food Store

 

PAIN – A Comparison of Traditional Chinese Medicine (TCM) and Western biomedicine philosophies

It is estimated that almost 100 million Americans suffer from chronic pain, which is more than cancer, diabetes, heart disease, and stroke combined.1  The prevalence of chronic pain for adults, is about 30% of the adult population, with women affected slightly more often than men.2

Types of Pain

  • Somatic – the most common.  Is well localized and occurs in skin, joints and muscles.  Affected by temperature, vibration, pressure and swelling.
  • Visceral – usually occurs in the abdomen, not well localized, due to inflammation, ischemia, stretching or necrosis. May be accompanied by nausea, vomiting, vital sign changes, “referred pain”.
  •  Neuropathic – pain due to no obvious stimulus.  May feel like electric shock, burning, cold, numbness or itching. “Pins and needles”. Generally due to nerve damage from trauma, surgery, chemo, diabetes. 

Western Treatments for Pain by type

  • Somatic — NSAIDS, Narcotics
  •  Visceral – Narcotics
  • Neuropathic — Anticonvulsants or Antidepressants.  Only partially relieved by narcotics.

 

Risks involved with medications

  •  Pain meds can cause stomach erosions, GI bleeding, constipation, elevated liver enzymes.
  •  Narcotics are addictive and can cause dependence, so more must be taken to achieve the same pain-relieving effect.
  •  Narcotics can also cause dizziness, drowsiness, fatigue, fainting, headache, and confusion.
  • Pain Management

Oriental/TCM Medicine Approach to Pain

“Qi” is defined as “vital life force” or “primal energy” that all beings have and is central to the theory of TCM.  In addition, “Qi” should flow easily and freely at all times otherwise, symptoms can arise.  As an example, pain in a particular part of the body indicates an imbalance or disharmony in the flow of “Qi” in that area. The role of the acupuncturist is to locate the source, type and location of the imbalance, and treat accordingly.  In general, the acupuncturist will:

  • Identify the specific location(s) of the pain – i.e. meridian(s) affected.
  • Perform a tongue and pulse diagnosis.
  • Inquiry – ask if the pain better in AM/PM, better with pressure, heat/cold, does it move or fixed location, etc.
  • Diagnose different patterns – Qi and blood stagnation, cold, damp, excess, deficient, organ-specific.
  • Treat accordingly, using the most appropriate method(s).

How does acupuncture work (TCM explanation)?

  • Acupuncture works by unblocking and promoting the free flow of energetic “Qi” throughout the body through a network of pathways called “meridians,” similar to the systems of nerves and blood vessels.
  • Pain or illnesses arise from the blockage of this free flow, like a dam blocking a stream to water the trees.
  • When acupoints are needled, it “activates” the flow of Qi to restore normal circulation, nerve conduction, cell communication, and mind-body connection, thus relieving the pain.

How does acupuncture work (Western biomedical perspective)?

  •  Acupuncture stimulates the release of norepinephrine, acetylcholine and several types of opioids, which relieve pain, and affects changes in the autonomic nervous system.
  • Acupuncture activates specific receptors that inhibit the transmission of painful stimuli.
  • Acupuncture results in activation and deactivation of specific parts of the brain.3    

Benefits to Receiving TCM Treatment:

  •  Minimal to no side effects (occasional bruise, soreness at the insertion point).
  • Addresses the root of the problem, not just the symptom.
  • Individualized approach: Two people having pain can experience different symptoms – thus they require different methods of treatment.
  • REFERENCES
  1. http://www.painmed.org/patientcenter/facts_on_pain.aspx#incidence.
  2. http://www.ncbi.nlm.nih.gov/pubmed/20797916
  3. http://www.vanderbilt.edu/AnS/psychology/health_psychology/Acupuncture.htm