Whilst I spend a lot of time talking about the wide spectrum of holistic clinical applications for acupuncture, it is still the case that the majority of patients I see, and indeed who present to acupuncturists around the country, are seeking help with some type of pain. The treatment of pain is probably what acupuncture is best known for. Indeed it is also pain treatments for which the best scientific evidence of efficacy exists (Lower back pain and migraine/cluster type headaches, NICE recommendations) In this blog we are looking in a little more detail at the subject of pain and how acupuncture may help.
What is Pain?
The widely accepted definition of pain was developed by a taxonomy task force of the International Association for the Study of Pain: “Pain is an unpleasant sensory and emotional experience that is associated with actual or potential tissue damage or described in such terms.” Importantly, this definition highlights the fact that pain is a subjective sensation. In other words expressions such as “it can’t be that bad” say more about the frustration of the person saying it than the person suffering pain. One persons unbearable pain may be very different to the next, indeed it may be very different according to a number of external factors like temperature, time of day, mood etc. In my work, pain is whatever the patient says it is.
There are a number of ways in which to classify pain but I particularly like those described by Professor G. F. Gebhart who separates pain into protective and non protective of acute or chronic duration.
Protective pain could be likened to my old career as a police officer. Nobody likes it much but actually its doing an essential job. In this simplest form, pain is a protective response from our body to prevent more serious injury. For example, the pain one experiences when touching something hot is a warning shot that prevents a more serious burn. Without pain we’d be in big trouble. A very small number of people in the world are born with a condition called congenital analgesia, no sense of pain, and it is a serious life threatening condition. So when we injure ourselves and it hurts when we move in a particular way, we can normally accept from this that our body, at least for that moment in time, doesn’t want us to move in that way through fear of making the injury worse.
Non protective pain by comparison serves no obvious protective function, such as the the pain experienced after a nerve injury.
The terms chronic and acute can be ascribed to either of the above classifications and describe the duration of the pain. The NHS consider pain to be chronic or persistent if it has been suffered for 3 months or more and has failed to respond to standard medical treatment. Persistent pain is a poorly understood condition but it is believed that in at least some cases, there has been a breakdown in the way in which the body processes information from our highly complex nervous system. Alarmingly its not an unusual condition. The Chronic Pain Policy Coalition in a recent publication reported around 14 million people in the UK alone living with persistent pain, 25% of whom have lost their jobs. In other words, if you suffer from chronic pain, you are far from being alone.
So how does acupuncture work?
Scientific research for acupuncture is very complex and is much debated (a subject better covered in my talks). A number of theories are suggested for the mechanism behind acupuncture treatment. Some studies have found that certain hormones released by the body for anaglesia in response to pain are released in greater quantities during electro-acupucture treatment. Another explanation is the micro trauma theory which suggests that causing a very small injury in the region of existing trauma re-activates the bodies healing mechanism, “waking it up” so to speak. All of the current theories/explanations are interesting and plausible but it is fair to say that the exact science is not fully understood and needs more investigation. Never the less, in certain pain conditions such as migraine and lower back pain the results of using even very basic acupuncture treatment is so positive that it is recommended by the National Institute for Clinical Excellence.
Where pain is chronic it may be more useful to consider the problem in the Traditional Chinese Medicine paradigm. In basic terms this holds that the usual smooth flow of the bodies energy force, Qi, is disrupted which causes a blockage or stagnation. This in turn causes pain. Acupuncture at certain points on the body can get the energy moving in the right way again. Of course moving Qi is just one part of the problem. The challenge, and what makes acupuncture a holistic therapy, is to work out why the energy is stagnating in the first place. In a post trauma injury this may be easy to work out but in long term chronic issues any number of physical and emotional factors could be at work in isolation, or in collusion with one another. Looking at the wider aspects of your health and well being both physically and mentally helps me to get a clearer picture of whats going on and to then tailor the treatment to your specific needs.
If you suffer from pain and would like more information about how acupuncture could help please contact me to discuss – Contact Details
For more information on managing pain follow this link to the NHS pain management self help leaflet – Pain Toolkit