31 Dec Pain & Acupuncture

The last 40 years have witnessed a phenomenal growth in interest in Traditional Chinese Medicine and Acupuncture. Although many factors have played a part in this, a single event may be seen to encapsulate the moment when acupuncture in particular was brought into the spotlight. The journalist, James Reston, accompanying President Nixon to China in 1972 wrote a front page article in the New York Times, telling of his emergency appendectomy. Chinese doctors used acupuncture to control Reston’s post-surgical pain and his recovery was swift. Intrigued by Reston’s report, doctors began visiting Chinese hospitals to observe acupuncture being practised.

Not surprisingly, acupuncture’s role in the treatment of pain has probably aroused more interest within the orthodox medical community and the general public than any other aspect of Traditional Chinese Medicine. Even newly trained acupuncturists (like myself 30 years ago) have observed significant results in the clinic, since at the most basic level the local insertion of a needle into a site of pain can offer relief. Perhaps unsurprisingly, these factors have contributed to the erroneous idea that the treatment of pain is relatively simple and empirical, and that the basic practice of needling local and adjacent sites, whether chosen on the basis of traditional acupuncture points or modern trigger points theory, is all that Chinese Medicine usefully has to offer. 

It is exactly because of this over-simplification that we see a lot of people who have no in depth medical training, like physiotherapists, osteopaths, chiropractors and even massage therapists, offering acupuncture services. These people are unaware of the true depth and richness of Traditional Chinese Medicine. The insertion of needles and the prescribing of a mixture of herbs is the final act in a refined process of analysis and discrimination, and the most effective treatment can only be determined by this process.

Central to this process is the understanding of the theory of ben (root) and biao (branch or manifestation). The same manifestation (biao) may have different roots (ben).  For example, pain in the face may be due to heat or cold, excess or deficiency, external environmental factors or internal disharmony. If treatment only focuses on treating the symptoms, the effect of the treatment will be diminished, being less effective and more temporary. By using the traditional methods of diagnosis, differentiation and treatment selection, true Traditional Chinese Medicine seeks to combine treatment of the root cause or disorder with treatment of its symptoms (manifestations).

By treating the root, any underlying disease may be helped or cured and the treatment of the symptom will be supported and amplified. Wherever possible, the aim of Chinese Medicine is to treat the disorder at all its levels and by doing so offers much more than just palliative relief. One aspect of root differentiation that has special significance in the treatment of pain, is the role of mental and psychological states. Disharmony of the emotions is one of the traditional causes of disease, and certain emotional habits, for example emotional repression, can play an important role in the development of painful disorders. At the same time, prolonged pain can itself injure a person at the psycho-emotional level. Addressing treatment at this level (for example by calming the mind) as well as by giving emotional support can play a vital role, especially in the treatment of chronic pain.

Finally, how does TCM explain the occurrence of pain? According to Traditional Chinese Medicine our body maintains a balance between the principles of yin and yang, and between the qi and blood. Qi and blood travel through the body along well-defined pathways called meridians (see KULA #13: Meridians of the Body). When there is not enough qi or blood (emptiness or deficiency), or when they are stuck in one area (fullness or excess), there is an imbalance between yin and yang, the internal organs are not functioning optimally, and illness and pain develop. Acupuncture and TCM can offer great relief or even a cure for acute as well as for chronic pain, whatever their root causes

By Dr. Thomas Sladek