Acupuncture and Chronic Pain
Scientific validation of acupuncture's most wide application


Michael Domeny DNP-c, FNP, MS, L.Ac, CD/N,

Licensed Nutritionist, Licensed Acupuncturist

Board certified Herbalist,

Family Nurse Practitioner

 

 

     Pain is a serious public health issue with more than 50 million people in the US living with chronic pain.  In fact, chronic pain is the third most common health-care problem in our country, behind heart disease and cancer, with the combined annual costs of lost work days, doctor visits, hospital stays, pain medication, and disability totaling an estimated $100 billion.

“Uncontrolled pain is associated with adverse consequences in terms of daily functioning, mood, sleep, overall quality of life, energy level, the ability to work and marital relationships,” says Russell Portenoy, Chair of Pain Medicine and Palliative Care at Beth Israel Medical Center in New York City.  However, pain is not simply an uncomfortable sensation. According to Dr. Richard Payne,  Professor of Medicine and Divinty at Duke University: “Newer studies actually show that persistent pain causes changes in the brain and spinal cord that begets more pain.” Some animal studies suggest that controlling pain could help prevent these changes in the brain. Unfortunately current medication is not capable of arresting this process.  There is evidence, however, that acupuncture has the potential to stop or even reverse chemical changes in the brain and nervous system resulting from chronic pain. 

 

     What Is Acupuncture?
     Acupuncture can be described as an ancient Chinese system of health care that involves the insertion of very fine, stainless steel disposable needles into certain points of the body for the purpose of stimulating the body's ability to resist or overcome illnesses and conditions by correcting energy imbalances.

 The World Health Organization recognizes acupuncture for treatment of  over forty-three conditions. Many people think of acupuncture as a treatment modality that is particularly effective for conditions that do not respond well to conventional modern biomedicine.This is especially true in the field of pain management. The Chinese have an old saying that nine out of ten diseases produce pain, and according to statistics, 85% of the pain in our daily lives is soft tissue pain. This is why in Western societies acupuncture is used primarily for pain management. It is safe, compared to Western treatments, low cost, and has no side effects if performed by a qualified practitioner. It can be very effective by itself or as a complement to other medical procedures. 

     History of Acupuncture  

     Acupuncture has a recorded history of 2000 years, and some believe it may have been practiced as early as the Stone Age. It developed alongside other modalities, including herbal medicine, diet therapy, massage, and qigong (therapeutic exercise). The core principles of Chinese medicine are based on the theory of yin and yang and the flow of energy known as “qi” In today’s practice, most practitioners of Traditional Chinese Medicine still make their diagnosis based on signs and symptoms rather than chemical and microbiological laboratory tests.  Because traditional Chinese tongue and pulse diagnosis are difficult to standardize and verify, efforts have been made to integrate Western diagnosis with acupuncture treatment, especially in the area of pain management.

     Modern Understanding of Acupuncture
    Western medicine views acupuncture as a physiological therapy coordinated by the brain which responds to needling of peripheral sensory nerves. Thus we can look at acupuncture as a modality that does not treat specific pathological symptoms, but normalizes physiological homeostasis and promotes self-healing of the whole body.  

    In China alone there are more then 80 different styles of acupuncture, in addition to many Japanese, Vietnamese, Korean, American, and European styles. The common denominator shared by all of them is using needles to make tiny lesions in the soft tissue (acu-puncture). Lesions that result form needle insertion  activate the intrinsic survival mechanism that normalizes homeostasis and stimulates self-healing.

 Acupuncture analgesia
       To date, acupuncture analgesia is one of the most thoroughly researched physical modalities in medicine. More is known about its mechanism of action than many pharmaceutical agents in routine use.

       When we treat soft tissue pain, needles are inserted directly in the affected area. This triggers neuro-endocrine, immune, and cardiovascular reactions around the needling site with the consequent desensitization of the painful nerves and repair of the damaged soft tissue. The process of tissue repair and desensitization is often activated immediately after needle insertion.

Clinical evidence shows that acupuncture can be effective for both peripheral soft tissue pain and internal disorders.  When we treat internal disorders such as stomachache, we cannot directly create the “needle reaction“ in the stomach. Therefore the segmental nerves that transmit messages between certain parts of the body and internal organs are stimulated. This creates balance between sympathetic and parasympathetic nerves to promote self-healing of the stomach. We refer to this as “indirect” treatment by acupuncture. 

Effectiveness of Acupuncture
      The response to acupuncture treatment varies from person to person. In general, injuries of recent onset respond to treatment faster than long term chronic cases. Overall state of health is also a factor, and patients in good health can achieve complete or longer remission with just a few sessions.

      One of the biggest problems faced by acupuncturists in the United States is that, for the most part, people do not seek acupuncture treatment until Western medical approaches have failed. Then they come to the acupuncture clinic with the expectation of resolving a longstanding problem in the course of one or two visits.   Although seemingly miraculous cures are not uncommon, it is better to approach acupuncture with realistic expectations.  It requires time to take its full effect, like any other medical modality. The full benefit may take longer to manifest if the condition is very severe and advanced. Some very chronic cases may not be cured completely. In these situations acupuncture helps patients to prevent further deterioration of their health and allows them to live their life to the maximum potential that their condition allows. Therefore it is imperative for anybody suffering with chronic pain to start acting early. Persistent pain will continue to get worse as time passes and the aging factor sets in.  If patients have the attitude that acupuncture activates the body's natural healing power, they are more likely to cultivate the patience for a successful outcome.         

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