by Jacob Cain McRae, L. Ac.
The following is meant for educational purposes only. Always acquire an evaluation by a licensed medical professional before pursuing new therapies.
Pain: Perspectives and Paradigms
Pain, especially chronic pain, is one of the main reasons people seek Acupuncture, Bodywork and Traditional Chinese Medicine. The quality of a person’s pain can range from a bruise-like feeling, to sharp pains, burning or tingling sensations, as well as deep, excruciating sensations. The pain can be constant, in waves, or be related to past illness, as well as physical or psychological trauma, stress, posture, diet, among other pertinent qualities of lifestyle. Pain can afflict any part of the body, at any level, in varying tissues, the organs, or the bones. It is this active, multidimensional network of painful and pleasurable sensation felt by the body that has inspired and informed much of traditional acupuncture theory.
Modern pursuits in neurology have provided detailed maps that elucidate the expansive web of nerves in the body, as well as their respective relationship to the brain and the nervous system’s trajectories through the flesh and bone. Research has shown the spinal cord to possess A-delta or C fibers, which conduct electrical charges at varied rates and thresholds. Pain conducted by the A-fibers is described as sharp and acute, and is typically experienced first. The subsequent dull pain is related to the C-fiber. A complex dance and exchange of chemistry inputs the brain with data that then is “felt,” in correspondence to the region of anatomy presently afflicted.
It is the impetus of acupuncture theory to comprehend not only this electrical & chemical feedback loop between the nervous system, musculo-skeletal & fascial structures, but also how emotional and psychosomatic phenomena affect and afflict the body. It is reiterated within the Merck Manual that a plethora of pathology are induced by stimuli coined “psychogenic” causes, or those causes developing/ being born from psychological conditions. This notion of psychogenic pathology is neither new nor novel, and it has been extensively analyzed over aeons by Oriental Medicine practitioners. Remote pain and sensations, that seem inexplicable and confounding, can commonly be rationalized by acupuncturists.
Acupuncturists have always sought to relieve pain, and so many methods have been originated and adapted through varied tradition and unique clinical experiences. Perhaps the most united acupuncture theory is rooted in philosophical platform that the internal body (the quality of blood, lymphatic fluid, body fluid, as well as etheric components of the human body, such as the Shen, or spirit) express through predictable trajectories on the external body. These meridians correspond to internal organs like the spleen, kidney, heart and so on, as do anatomical structures like skin, bone and blood.
Meridians are subject to blockages due to stagnation of qi and blood, a common etiological cause of pain in the body. The pursuit of acupuncture and its adjunct therapies is to positively regulate the flow of qi and blood through the meridians, thus improving the health of the surrounding tissues and anatomical structures.
Qi and blood stagnation is a very common and general way of differentiating pain disorders in Traditional Chinese Medicine. These concepts can be paralleled to hypoxia, a deficiency of oxygen, and ischemia, a blockage of the blood vessels. The impeded flow of nutrients and fluids can promote local dysfunction that potentiates chronic issues in relation to the organ. Conversely, the manifestation of pain in a meridian that has not been traumatized by external forces, could indicate dysfunction in the visceral organ of the afflicted meridian.
Understanding these trajectories affords an acupuncturist the ability to intuit and anticipate constitutional imbalances in the system. Such disorder is typically reiterated through the qualities of the tongue, pulse, bowel movement and urination. An acupuncturist targets the whole body: internal, external, every muscle, every emotion, every cell is considered and calibrated for better health and well-being.
Methods & Actions of Acupuncture
Acupuncture has centered around exploring how to work with multiple dimensions of the anatomy in order to relieve local tension and inflammation, while also impacting visceral functions to improve systemic disorders that are destabilizing the body’s innate pH balance. For example, if there is rotator cuff dysfunction, an analysis of the corresponding meridians will be conducted. Local acupuncture can be applied directly into points like Tianzong, SI-11—a point located in a tender depression one third of the distance from the midpoint of the inferior border of the scapular spine to the inferior angle of the scapula—and this can lead to immediate relief and improvement of the joint function. Application and proper needle manipulation can disengage muscular tension, break up coagulations and resolve local inflammation by triggering endogenous opioid production, such as the Enkephalins.
In many cases, additional points can be selected that are distal (further away from the source of the issue) in order to address energetic imbalances, improve endocrine and immune function and relieve inflammatory by-products. Houxi, SI-3, a point on the ulnar border of the hand, in the substantial depression proximal to the head of the fifth metacarpal bone, could be used to relieve scapular dysfunction, too. The pain experienced at the point of affliction is often translated both functionally and energetically to external parts of the body.
The selection of particular points could also derive from the premise of balancing methodology or improving the functional of visceral organs to regulate their behavior. If a person is having chronic headaches combined with emotional outbursts, the indication could require a vastly different treatment than if the headaches correspond with particular postures or movements, or stomach pain, or nasal allergies. For this same reason, if a person only treats an issue locally, the pathos may only resolve temporarily, if at all.
Herbalism and bodywork, such as tuina, guasha and cupping, have historically been combined with acupuncture to bring aspects of the body back into harmony. The point prescription and herbal formulae prescribed to each patient varies greatly with each individuals circumstance and their chief complaint. Coincidentally, two persons with the same chief complaint could still be treated with dramatic variation between the applied therapy. An acupuncturist would scarcely treat shoulder pain caused by overwork at a desk job the same way she would treat a patient with postoperative pain from a laminectomy.
This adaptive, individuated, patient-centered approach is what makes legitimate acupuncture research elusive. The present model of pain-relief pivots almost solely upon chemical maintenance. The frequent failure of this method in treating chronic issues is leading to more interest in therapies that implore more physical commitment such as Acupuncture & Tai Chi.
Despite the quality or circumstances that generated the pain, any quality of pain can reach a point that incapacitates the suffering person from working, or operating in their daily life. Sometimes the pain is due to a compressed nerve or blood vessel, sometimes it is due to knotted, tense muscles or rigid scar tissue.
More and more often in this era, it tends to be of genetic or autoimmune origin, rather than direct trauma. The varied etiology of pain is so riddled with complexity and mystery. Treatments born of recent times have centered around pharmaceutical opiates that have ultimately proven to be deleterious and somewhat dubious in their ubiquitous application. An important note is that many over-the-counter drugs actually are chemical analogues of what were once popularly used anti-inflammatory, anti-febrile herbs.
Salicylic acid, a major component of many anti-inflammatory drugs such as Aspirin, derives from the bark of the White Willow Tree.
It is the nature of many pain medications to merely short-circuit the body’s ability to feel, while never actually addressing the root cause. Acute relief from prescription medicine often leads to overdependent behaviors, and many persons must adopt additional drugs to combat the side effects of the original prescription. Liver issues often arise as the chemicals tax it by overstimulating its metabolic processes (a reason why overuse of Aspirin is discouraged).
Detoxifying the Blood with Acupuncture
As a person ages, the notion of bodily interconnectivity tend to become more steeply pronounced. The hunches and limps seen in old age often develop alongside poor posture, arthritis, osteoporosis and other diseases that afflict the musculoskeletal system. These disorders can induce systemic inflammation, and this build-up of cellular products, like platelets & cytokines, can intensify or prolong the pain of an individual.
The perpetual accumulation of inflammatory by-products in the blood can instigate what is known as Blood Heat or Blood Stasis. These conditions can exhaust the adrenal system, overstimulate cortisol production and lead to general destabilization of the hormonal system. It is not unusual to see pain patients that present with insomnia, fatigue, anxiety and depression. These symptoms tend to improve as the pain does; a notion that is acknowledged but not understood by Western medicine. Treatment of anxiety is sometimes done with Beta Blockers—a well known blood-pressure medication. This correspondence between the vascular system and the mental state has been anticipated and explored for aeons.
Acupuncture techniques like guasha help to comb coagulations in the muscle fibers out. This reinforces the motive behind local acupuncture, which is to break up stasis and move qi and blood. The result is often ecchymosis of varying hues, typically pink or purple, and it is visual evidence of the internal blockages and inflammation. Cupping, performed with a different apparatus, relies on similar therapeutic functions, but can also be employed to blood-let. This method is excellent for reducing local stasis, while encouraging hematopoiesis by the body.
Though many modern methods of treatment are making positive waves in pain management, few have managed to alleviate these conditions without inducing unwanted side-effects or exorbitantly expensive procedures. Often times people will pursue surgical intervention, and this can be necessary. In such circumstances, acupuncture offers an invaluable means of supporting the body through an otherwise intense recovery process.
Many persons are turning to acupuncture and are getting improved quality of life due to its ability to treat the entire body in tandem with local therapies. The mechanisms explained in this article are merely a superficial exploration, and there are more and more scientific studies being released that reinforce these therapies with clinical evidence. Time itself is a testament to its efficacy, and with 2000 years behind it, acupuncture is set to maintain as an unmatched pain management therapy.