Acupuncture for Pain
Pain teaches us how to navigate this world safely. Without it, we would not survive. Once we bang a shin on a coffee table or stub our toe on a box, we’re not likely to do it again any time soon. Acute pain teaches us to avoid anything that may cause further damage to our body. But what could possibly be the benefit, or the advantage, of chronic pain?
The Anatomy of Pain.
Nociceptors are the specialized nerve cells that deliver the message of pain from the site of origin to the brain. When the shin meets the edge of the coffee table or the toe meets the box, it’s the nociceptors that carry the urgent message to the brain. The message travels in the form of a neurochemical impulse to the thalamus, in the center of the brain, where input from all of our senses is gathered and processed. That is where we organize what happens to us and how we respond, as a result.
When people say, of pain, “it’s all in your head”, that’s absolutely not true. The head processes what the body experiences. It’s the stored information from the somatosensory cortex of our brain that is constantly accumulating and organizing that helps us make sense of an event and respond appropriately. Location, timing, severity, intensity and especially memories may all factor into the process and contribute to our reaction. But there is another part of the brain involved in the pain process, and that is the limbic system, which is associated with emotion. This explains why stubbing a big toe on a box that someone else thoughtlessly left in your path can illicit an emotional reaction.
The list of things that can cause pain is endless and includes dysfunction in the internal organs and in the neurons themselves. The list of possible treatments for pain is short. Most pain drugs are designed to imitate the pain control mechanisms of the body. Chronic pain is exhausting. It can deplete hormones in the endocrine system and other internal resources, resulting in fatigue and depression. Endorphins are part of the chemistry that lifts us above depression and keeps us feeling positive, capable of getting up in the morning and facing a new day.
Pain treatment may involve balancing neural chemistry to increase endorphins and retraining the brain to process stimulus in a different manner. It often involves moving blood, as with aspirin and anti-inflammatory medications.
Aspirin, which is made from a compound found in the bark of a willow tree, also works on the neural chemistry by inhibiting the synthesis of prostaglandin, a chemical that increases pain. Ibuprophen, the other popular NSAID (non steroidal anti inflammatory), like aspirin, decreases sensitivity to pain and will bring down a fever.
Acetaminophen (Tylenol) decreases pain, potentially by the same or similar mechanism as aspirin (prostaglandin inhibition). Like the above NSAIDs, it will also reduce fever but it will not decrease inflammation or thin the blood (reduce platelet coagulation). Though it may be easy to acquire, acetaminophen is designed for short term use only. Long term use, or over use, will harm the liver.
The rest of the painkillers, opioid agonists, which include codeine, hydrocodone, oxycodone, morphine and tramadol are designed for very short term use and will require increased dosage to experience the same effect. Even short term, these drugs harm the liver and, become less effective and more harmful as dependency progresses. This makes this class of drugs very dangerous for persons who suffer from chronic pain.
None of these medications are designed to be a long-term solution for pain. As with many treatment interventions, including acupuncture, the exact mechanisms for these drugs are unknown.
Acupuncture and herbs can offer a gentle approach with a longer lasting result. Eastern medicine recognizes that many things, viruses, bacteria, weather, even emotion, have the power to disturb our internal balance. The approach of eastern medicine is to regain balance. Often, the treatment is to build what is weak to counter the effect of pathogens that have become too strong. Instead of introducing more chemistry into the body, acupuncture identifies the existing internal imbalance and selects points along the body’s meridian system to release the heat, warm the cold, clear the excess and tonify the deficient. It supports the body to rebalance, clear and protect itself.
There is a large body of evidence from major national and international health organizations supporting acupuncture as an effective treatment for pain as an alternative to pharmaceuticals. Importantly, studies show that the effects of acupuncture treatment last. All of the following studies – and more – can be accessed online:
The AAFP (American Academy of Family Physicians) is one of the largest medical associations in the country. An article in the July, 2019 issue of their journal, American Family Physician, sites the evidence supporting acupuncture and recommends it as safe and effective treatment, particularly for chronic low back pain, tension headaches and episodic migraines.
The US Military utilizes acupuncture treatment. In 2014, 15,761 US military personnel received acupuncture through the Military healthcare system, most commonly for pain management. A report prepared for the Veteran’s administration, indicates that acupuncture has a positive effect when treating chronic pain and headache, including migraines, back and neck pain and osteoarthritis. https://www.hsrd.research.va.gov/publications/esp/acupuncture.cfm
The National Institute of Health HEAL initiative (Helping to End Addiction Long-term) is planning a large study of acupuncture for chronic low back pain in older adults to begin some time in 2020.
In the UK, A National Institute of Health Research Study published in 2017, analyzed data from almost 18,000 patients, and found acupuncture to be clinically effective and cost effective for osteoarthritis pain and possibly for treating depression.
The largest study of emergency room acupuncture for pain in Australia found that acupuncture provided effective pain relief, even in an emergency room setting. https://www.sciencedaily.com/releases/2017/06/170618103517.htm