Treating Pain With Chinese Medicine

^{image source}

Did you know Traditional Chinese Medicine is really really good at treating pain, both acute and chronic? Effective, natural, and without horrible side-effects or addiction!

不通則痛，痛則不通
Bù tōng zé tòng, tòng zé bù tōng
When there is no free-flow there is pain, when there is free-flow there is no pain.
— The Yellow Emperor’s Inner Classic: Basic Questions (my translation)

So goes the old Chinese Medicine saying regarding the cause of pain in the body.

Western perspectives on pain

In Western Medical Science, there are three models that explain the cause and nature of pain. They are:

• Linear causality model — developed by Renee Descartes in 17 Century, where a pain stimulus triggers a nerve impulse which is transmitted to the brain. The level of pain experienced is directly proportional with the pain stimulus; thus it is posited that if the pain stimulus cannot be identified or is not present, there cannot be any pain.
• Gate Control/Neuromatrix — only appeared in 1965 when Melzack & Wall proposed that the passive Cartesian model did not reflect normal daily life or clinical experience; injury does not necessarily lead to pain, and pain can persist even after the original injury has long passed. Their theory is that there is a 'gate' in the spinal column that can inhibit pain signals and modulate them, either shutting the gate or opening the gate. In 1999, Melzack further developed the idea to include additional stress-associated changes in pathogenesis.
• Systems theory — further developed by many scientists influenced by 'systems theory' which evolved during the 1980's. The individual is considered a primary active system, and the development of pain is dependent on the functional status of this system. There is also a hierarchical network of different systems which are connected to each other in the body. Humans possess regulatory mechanisms (homoeostasis) that compensate for internal or external destabilising factors; adaptation is a modification of the system in response to pain and can alter homoeostasis, thus allowing life to continue despite the presence of pain. In this system, chronic pain is recognised as a disruption to the system, or maladaptation.

TCM perspective on pain

Chinese Medicine considers pain as a disruption to the maintenance of equilibrium of yīn and yáng.

Pain can be caused by a number of factors. Like disease, it is represented as a struggle between the the natural Qì of the body that protects it, and the external pathogens that attack it. These pathogenic factors are:

• Attack by the “six external evils” – Wind, Cold, Summer-heat, Dampness, Dryness, Fire
• Internal damage by the “seven affects” – Anger, Mania/Desire, Sorrow, Fear, Fright, excessive Thought, and Anxiety.
• Excessive taxation of the body.
• Blood-stasis
• Phlegm-rheum
• Dietary irregularities

In Chinese Medicine there are a variety of pain types, which all indicate something different. They categorise how the pain feels to the patient:

• Aching Pain: This is a sign of deficiency, Damp, or Cold. It is not severe, usually considered uncomfortable and associated with feelings of weakness and tiredness. This is what is normally found in some cases of chronic lower back pain.
• Distending Pain: Also called 'distension', this is a sign of Qi Constraint, due to a number of internal pathologies in Chinese Medicine. Can be felt in cases such as menstrual pain, some headaches, and the pain associated with severe bloating after meals.
• Dull Pain: This is a sign of deficiency, especially if relieved by pressure and massage. This can be found in some headaches and muscular aches.
• Empty Pain: Often seen in deficiency patterns, such as some presentations of headache, especially those accompanied by dizziness.
• Cold Pain: This is a sign of pathogenic Cold obstructing the channel system or by a deficiency of yáng-qì. It is characterised by being relieved by the application of warmth/heat. Some lower back pain syndromes are associated with this type of pain.
• Gripping Pain: This is a sign of Cold attacking the interior or of obstruction by pathologies such as gallstones. This is a severe pain, such as is experienced in heart attacks, and severe pre-menstrual pain cramping.
• Heavy Pain: This is pain with a simultaneous feeling of heaviness. It is a sign of Damp, and can be experienced in some cases of headache, some types of arthritic pain or sciatica.
• Pulling Pain: This is the sensation where the pain feels like it stretches from one point to another. It can indicate that the sinews are not being nourished properly, or that there is some sort of obstruction in the sinew channels. This is usually felt in strains and sprains.
• Scorching Pain: This pain elicits a sensation of heat, and thus indicates a pattern of pathogenic Heat (of either deficiency or excess type). This can be experienced in conditions such as trigeminal neuralgia, or GORD.
• Scurrying Pain: This is the sensation where the pain feels as if it is moving about or has no fixed location. It indicates either a disrupted Qì dynamic (Qì constraint), 'moving'-type obstruction, or the presence of pathogenic Wind.
• Stabbing Pain: This is a very focal, sharp shooting pain, usually intense, and signifies the pathology of Blood Stasis. This is experienced in conditions such as heel spurs or menstrual pain with severe clotting.

This information is incredibly useful to your Acupuncturist or Herbalist, as the type of pain you are able to describe gives very clear clues as to the possible cause of pain, and thus enable the practitioner to develop the appropriate treatment principle.

The location of pain is also a vital piece of information for a Chinese Medicine practitioner. This will indicate which muscles and/or channels are involved, and also potentially which organs are involved (if the pain is presenting as an internal problem, such as with heart conditions, and so on).

Treating pain

The practitioner's primary goal in treating pain is to find the disruption of the free-flow of pain, and to clear this disruption. For musculoskeletal conditions, the primary treatments will inevitably involve the use of acupuncture, moxibustion, and massage/physiotherapy; it may involve the use of liniments, oils, and medicated patches/salves.

There are some herbal prescriptions that are also very good, especially for treating the pain. For internal pain conditions, the combination of acupuncture with herbal medicine is vital.

The first step in treatment is to address the immediate (and acute) matter of the pain. If the pain has been caused by chronic conditions, this needs to be addressed over time, and most likely will involve changes to diet and lifestyle as well as regular acupuncture treatments and herbal prescriptions.

In a recent meta-analysis of Randomised Controlled Trials of acupuncture treatments for pain, acupuncture for chronic pain management was found to be effective.

In 80 percent of the RCTs, patients underwent between six and 15 acupuncture sessions. Most patients received acupuncture one to two times per week. In slightly more than half of the RCTs, the typical acupuncture session lasted less than 30 minutes.

Chinese Medicine is certainly good for both, but whilst acute symptoms will take relatively few treatments concentrated over a short span of time, chronic conditions will need continued treatments over an extended period of time. Pain itself is seen as an 'acute episode', and can be addressed rather quickly.

Simple pain remedies

In any situation where pain is present, especially acute pain, it is always best to seek treatment from a professional. Acupuncture is in my opinion by far the best form of acute treatment.

Understanding that pain is the “lack of free-flow” of Qì allows us to find simple ways to manage it until such times as we can consult with our practitioner. Here are a couple of things you can do yourself:

• Self-massage above and below the local site of pain — you want to encourage circulation and flow to and from the local area.
• Breathing — especially useful combining the massage synchronised with the breath. Ideally, breathing out as you approach the pain. Even making a sound or vocalising helps.
• Warmth — this really depends on the nature of the pain, but generally speaking, applying moderate amounts of warmth, particularly with massage will also encourage free-flow. And by moderate I mean very slightly. It’s not about applying heat, but by preventing the area to cool. Placing a hand and allowing body-heat can sometimes be enough. Under no circumstances do you apply ice or cold packs, as this will hamper circulation.
• Movement — again, this depends on the type and location of pain, but moderate amount of movement (combined with breathwork) can help ease pain. Yoga, Tai Chi, or Qigong have postures and forms good for pain treatment and management.
• Ginger & Mint tea — these two herbs are easily found, and combined they help “warm the middle” and encourage free-flow of Qì in the channel system. This isn’t going to act as an analgesic, but helps the physiology internally to get things moving enough until you get to see your Acupuncturist. Ideally you want these fresh, as the scent also stimulates certain areas of the brain.
• Turmeric is also good, and a major ingredient in many pain formulas in Chinese Herbal Medicine; however you need significant amounts for it to work. It’s better for chronic inflammation than it is for acute pain.

Bibliography

• Drs Bäcker, M. & Hammes, M.G., (2010), Acupuncture in the Treatment of Pain: an Integrative Approach, Churchill Livingstone Elsevier, Sydney.
• Riley, Dagmar, (2003), Treating Pain with Traditional Chinese Medicine, Paradigm Publications, Brookline MS.
• Vickers, Andrew J., et al, (2017), ‘Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis’, The Journal of Pain, https://doi.org/10.1016/j.jpain.2017.11.005, sourced 17/09/2019.

Posted using Partiko iOS