Pain Managements
The most common pain conditions we treat in our office are list below:
Headaches/Migraine, Frozen shoulder, Back pain/Sciatica, Arthritis/joints pain, Trigeminal neuralgia, Endometriosis, Fibro-myalgia pain,
muscular pain, Pain post-operation
Acupuncture is a complementary therapy that is being increasingly used in the day-to-day management of pain.
Over the years there has been substantial debate about whether acupuncture really works for chronic pain. Research from an international team of experts adds to the evidence that it does provide real relief from common forms of pain. The team pooled the results of 29 studies involving nearly 18,000 participants. Some had acupuncture, some had “sham” acupuncture, and some didn’t have acupuncture at all. Overall, acupuncture relieved pain by about 50%. The results were published in Archives of Internal Medicine.
The study isn’t the last word on the issue, but it is one of the best quality studies to date and has made an impression. “I think the benefit of acupuncture is clear, and the complications and potential adverse effects of acupuncture are low compared with medication,” says Dr.Lucy Chen, a board-certified anesthesiologist, specialist in pain medicine, and practicing acupuncturist at Harvard-affiliated Massachusetts General Hospital.(Acupuncture is worth a try for chronic pain--Harvard health publications)
TCM theory about pain:
About 2000 years ago, The Huang Di Nei Jing (The Yellow Emperor's Classic of internal Medicine) states, "The Meridians move the Qi and Blood. As a result, Yin and Yang get regulated. Tendons and bones get nourished. Joints get facilitated."
The principles believe that there is a continuum of vital energy (Qi) that circulates and carry by 14 main Meridians throughout the body to maintain the balance between two opposites called the Yin and the Yang. Those two poles are related and inseparable from each other despite being opposites and also interdependent and interchangeable as well. The balance between them in our body is crucial to have our body healthy and functional maintained. Any disturbance in the balance of the Yin and the Yang in the body, which leads to an unbalanced, stagnation, obstructed and irregular flow of Qi, will result in illness, infections, injury etc.
The role of acupuncture treatment plays is to regulate the balance of YIN and YANG through acupuncture points on 14 main Meridians by nourishing or dumping accordingly based on the balance of YIN and YANG.
From modern point of the view, Meridians work like a network system, transporting and distributing Qi and blood. They link up organs, limbs, joints, bones, tendons, tissues and skin, and provide communication between the body's interior and exterior. Through a healthy Meridian System, Qi and Blood successfully warm and nourish different organs and tissues, and maintain normal metabolic activities and functions. Meridians are essential in supporting the flow of nutritive Qi inside the blood vessels and the flow of protective Qi around them. In addition, they strengthen the body's immunity, protect against external pernicious influences (anything evil that causes disease) and assist in regulating yin and yang.
Understanding the Meridian System and its relationship with the body's organs is essential in guiding acupuncture therapy. Chinese medicine always aims to resume the harmony of yin and yang and maintain the flow of Qi and blood. Acupuncture exerts its therapeutic effects by replenishing, balancing and moving the flow of Qi throughout the body so normal organ functions and harmony can be resumed.
Meridian differential diagnosis is essential for both herbal treatment and acupuncture therapy. In TCM, herbal medicines are chosen specifically for treating certain meridians and their corresponding organs. Moreover, some herbs have meridian guiding properties, which help potentiate the therapeutic effects of specific organs and meridians. In this way, meridians allow for an individually tailor-made herbal treatment plan according to a patient's disharmony pattern.
Similarly, understanding meridian selectivity is important for optimal therapeutic outcomes with acupuncture. For example, a headache in the forehead region is diagnosed as Yang Ming Meridian disharmony.
Acupuncture points in Arm Yang Ming Meridian such as Hegu (the depression on the dorsum of the hand between the first and second metacarpal bones, at the level of the middle of the second metacarpal bone) can be selected to treat this type of headache. Another common example is a stomach ache (indigestion, dyspepsia). Since the stomach belongs to the Leg Yang Ming Meridian, the corresponding acupuncture point of Zusanli (located: one finger-breadth lateral to the anterior crest of tibia) can be chosen to relieve this pain.
The effectiveness of acupuncture-The Science behind Acupuncture
The effectiveness of acupuncture for pain is well known and evidenced. But the mechanism on how exactly acupuncture works, there are no clear theories. According to Chinese traditional medicine, acupuncture affects the vital energy called "Qi." More than 2000 acupuncture points in the body are connected by meridians or pathways, through which energy must pass freely for optimal wellness. Disturbances in this flow result in illness or dysfunction.
The Two-Gate Control Theory
Man and Chen in 1972(Dis Nerv Syst. 1972;33:730) came up with another theory to explain the effectiveness of acupuncture. This was called the Two-Gate Control Theory. In this theory, there exist two main nerve fibers: A-beta
and C nerve fibers. The A-beta nerve fibers are large, fast conducting, and have a low volt threshold while the C nerve fibers are small, slow conducting, and have a high volt threshold.
Intricate networks of connective tissue -- which extend throughout the body -- may be at the crux of acupuncture, according to other studies. It's evident when an acupuncture needle is inserted into the body. Like a fork in a plate of spaghetti, the needle grabs up tiny bits of connective tissue and nerve bundles between muscles.
Over the years, research has shown that acupuncture affects a variety of biological systems---releasing hormones, disabling receptors, and activating anti-inflammatory chemicals (Endorphins, Nitric oxide). It has been suggested that the healing power of acupuncture comes from its effect on the nervous system. It might aid the pain-killing effect of chemicals called endorphins or help cells from the immune system fight infection, according to the NIH.
The turning and manipulation of that needle instantly affects the connective tissue in its plane -- including more distant points in the plane. "All this has been documented using high resolution ultrasound" expert says. More studies have been carried out and some theories that acupuncture could work as the pain-reliever have be proposed as follows:
The Gate Theory of Pain
One of the theories is the Gate Theory of Pain. This was introduced in 1965 and it explains that acupuncture works through the nervous system to alleviate pain. The theory states that in the nervous system, there are nerves that both transmit and inhibit pain. These fibers come together in the substantia gelatinosa of the spinal cord. The substantia gelatinosa then sends pain signals to the brain, depending on the amount of pain input.
Acupuncture helps in pain relief by stimulating the pain inhibitory nerve fibers, which lowers the pain input and therefore, relieves the pain. This can explain the effectiveness of acupuncture in short term and acute pain conditions.
The body's pull on that tissue is intense, which both the practitioner and the patient can feel, the feeling of "sore, numbness and pinching", at this point, the needle is being held by the body and gets sucked in. If the needle is turning a little bit, it is grasped by the body and been hold on.
The two-gate theory states that when high amount of impulses coming from A-beta fibers closes the gate in the substantia gelatinosa there is prevention of passage of painful impulses from the C fibers. While Acupuncture acts as a pain-reliever by stimulating the acupuncture points, on one hand, which affect the A-beta nerve fibers and the needles move to create a steady stream of non-pain impulses transmitted to the substantia gelatinosa causing the gate to close. Once the gate is closed the pain impulses are stopped. Thus, no pain is felt.
On other hand,The impulses from the A-beta fibers can transmit to the thalamus, which serves as the final gate. This gate is closed to produce pain relief in the entire body. Therefore, tailored acupuncture can reduce pain intensity; improve quality of life in people with fibro-myalgia.
Counter-pain treatment
Yet another theory is the counter-pain treatment. This theory states that when pain comes
to one part of the body, pain on another part of the body will be less noticeable. This is also applicable for short term pain control rather than long term pain control.
(sources from WHRIA how does acupuncture works and internet)