Pain can be life altering, as any sufferer can tell you. It changes personalities, erodes relationships, impedes physical activity, and blocks a person's enjoyment of life. It's a huge societal drain, with countless work hours sacrificed. Pain management, in all its manifestations, is a multi-billion dollar industry.
It is no wonder that one of the most common reasons people seek acupuncture treatment is for the resolution of pain. Indeed, acupuncture typically is a very successful modality for pain relief. Even main stream medical doctors are beginning to recommend it when the prognosis of their patients falls beyond the boundaries of conventional medical care. Western medicine basically has only a few options in dealing with pain – rarely surgery, drugs and physical therapy. These options can be very powerful and healing and I would highly recommend them where appropriate. My general philosophy about medical intervention, however, is that it is most wise to start with the least invasive methods first, saving the most invasive measures as the last resort. All too often this process gets reversed. In my fantasy world of truly integrative medical care, acupuncture would be considered as a viable treatment, either primary or adjunctive, very early in the process. Determining at what point and to what extent acupuncture should be part of a treatment strategy depends upon the nature of the source of the pain, as I will later detail more fully.
Beginning a discussion on how and why acupuncture gives relief beyond the Western approach requires a brief exploration of pain from a Chinese medical point of view. In Chinese medicine, we refer the functioning of the body to the role of the Qi. Qi is very difficult to translate, but generally is described as vital energy that flows through the body, much like the blood circulatory system. Freedom from pain requires the unimpeded flow of Qi in a continuous circuit. Think of a moving water system like a stream. If nothing obstructs the pathway, the water flows freely. If rocks, trees or a beaver dam are present, the water, to varying degrees, stops flowing. There is less water flowing downstream, a backup of water upstream, and increased water pressure at the point of obstruction. If we substitute the concept of Qi for the water, we can get less Qi flowing downstream (sometimes numbness or coldness), an excess stagnation of Qi upstream (sometimes edema or distention), and pain at the point of obstruction.
Acupuncture treatment strategies for treating pain are reliably straight. If the Qi is obstructed, the goal is to relieve the obstruction and return the free flow of the Qi to its natural continuous circuit. Diagnostically, the nature of the pain will reveal the nature of the Qi obstruction and guide treatment strategies. Dull pains tell us one thing, sharp stabbing pains another, roving pains something different again. Other clues will be the location and duration of the pain, influences from either heat or cold application, etc.
The successful treatment of pain with acupuncture lies, not only in identifying the nature of the obstruction, but also in correctly analyzing the details of its underlining causes. It is here that we start to discern what interplay, if any, acupuncture should have with conventional medical treatment. For this discussion, it is helpful to categorize pain into two general classes: pain with a known physiological cause and those without a known physiological cause.
The first category usually comes with a meaningful Western diagnosis, sometimes through x-ray, MRI, CT scan, sonogram, or other medical technology. What is usually at issue here is a physical injury or trauma or detection of some abnormality in form (arthritis, tumors, nodules, bone spurs, degenerated disks). This diagnostic information is effectively helpful in determining the likely prognosis and in choosing appropriate treatment strategies. Generally speaking, the more intractable the physiological issue is, the more temporary the relief from acupuncture will be. This is because acupuncture will not reverse an under permanent cause. This is typically the case with degenerative arthritis, or bony growths such as spurs. With sustained treatment, acupuncture can often achieve impressive pain relief in these cases. Patients do, however, need to understand that it becomes a pain management tool, likely to be needed indefinitely. Patients may find this acceptable, particularly where traditional Western approaches are either inappropriate or are undesirable. Sometimes patients can not have surgery, have maxed out on pain medications or have taken physical therapy as far as it can go. Obviously, there are also times when surgery and / or physical therapy are the best treatments possible. In these cases, acupuncture can play an important adjunctive role in speeding healing time, reducing the need for drugs and reducing post-operative pain.
One other purely physiological cause of pain that is often overlooked by doctors is pain as a side effect of certain prescription drugs. In particular, statin drugs, such as Lipitor and Crestor, are known to cause nerve and muscular pains. The Chinese medical remedy to drug induced pain is to cease taking the drug. Alternative approaches can be explored.
Now to a more interesting topic: those painful conditions that have no known physiological cause. These cases often come with no diagnosis at all or with a Western diagnosis that lacks meaning. Fibromyalgia is a prime example of a meaningless diagnosis. It is not that I think fibromyalgia is not real. I have successfully treated many patients with this label and they all had very real pain. The diagnosis lacks meaning from a Western medical perspective because there is no physical cause ascribed to it and there before there is no effective curative model of treatment. The drugs used for fibromyalgia are for temporary symptomatic relief only.
Now we have touched the real where Chinese medicine is absolutely advantageous and, frankly, should be used as primary care. There is real pain, but no cause that shows up physically. No tumors, no injuries, no arthritis. This covers a huge spectrum of chronic pain sufferers. We can include in this list most migraines and headaches; menstrual pain; non-arthritic joint pain; fibromyalgia, premenstrual breast pain; lingering pain from statin drugs, even after they are out of the bloodstream; post surgical or injury pain where the physical exam reveals the tissue is completely healed; and really any pain where the doctor shrats his shoulders and hands out a prescription for pain killers and Xanax. This is where we look to the energetic causes of the Qi obstructions that in turn cause the pain. Common causes we recognize in Chinese medicine would include a lingering Qi obstruction from old injuries or surgeries (even decades old); past exposure to extreme cold (including in an operating room); exposure to toxic heat (such as radiation); stored emotional or physical trauma, particularly in the case of sexual abuse; systemic imbalances that cause the Qi to rise forcefully to the head without completing its circuit downward (causing a headache). In short, we identify and treat any underlying Qi imbalance that would tend to create a disruption in the proper flow of Qi.
From the vantage point of Chinese medicine, the sources of pain can be viewed and treated as including both physical and non-physical. Because it is a more holistic paradigm, acupuncture can often successfully treat pain beyond the limits of Western medicine. It is a reliably non-invasive treatment that offers immeasurable relief of needless suffering at low cost and low risk. Any sufferer of pain, whether chronic or acute, should consider it a viable treatment option.