Traditional Chinese Medicine and the Management of Pain
The TCM Definition of Pain
What most people want to have with pain is for it to stop in a way that means health has been restored. People today understand that while drugs can mask pain, the only thing way that will keep pain away is the body back in balance. Western medicine looks at pain as a matter of nerves and signals to the brain. Traditional Chinese Medicine (TCM) focus on the ideas of Yin, Yang, Qi, and blood. Qi is the energy force that runs through the body’s energy meridians. Yin and yang are the complementary and opposite energies. Yin contains the body’s nutritive forces, while yang is for heat and metabolism. Blood is blood. From the point of view of TCM, pain results from an imbalance of qi and blood.
This imbalance can be in different directions. There can be too little qi, or too little blood. Or, qi and blood can stagnate or be obstructed. In a small but non-trivial percentage of cases, qi and/or blood may flow too aggressively. In any of these cases, TCM believes that the body will function less than optimally, and less than optimal functioning can result in weakness or pain. That pain can manifest in different ways, and at different locations in the body.
Another tenet of TCM, which should be borne out by real life experience, is that one’s emotional and mental state has an impact on one’s pain. Think of the injured athlete who manages to muster so much on the playing field that the pain goes away, or of how it feels to be heartbroken. In both cases, positive and negative, there is a strong connection between the mind and body. TCM does not see these systems as separate. There is no barrier between emotional pain and physical aching, or vice versa. Be assured that the TCM practitioner will take care of the patient’s whole body, including the mind and spirit.
What TCM Can Do About Pain
Regardless of its source, whether the western diagnosed cause is a broken bone, cancer, a fibromyalgia, depression, colitis, rheumatoid arthritis, or another reason, TCM can brief relief in any of the following ways.
- Reduce the actual pain level as measured by a patient’s self-scoring of symptoms, and prevent the pain from recurring.
- Help the patient to respond to pain signals;, dial down physical, emotional, and mental activation caused by pain; assist the management of fear, self-loathing, frustration, and angst.
- Reduce the need for the patient to consume pharmaceutical medications, including pain medications that are either prescription or over the counter.
- Support a better quality of life, no matter the baseline condition of the patient, or his or her age.
TCM can reduce or eliminate not just pain, but restore the body to equilibrium in a way that removes the causes of pain.
How TCM Practitioners Treat Pain
Your TCM practitioner will begin with perhaps the most detailed health conversation you have ever had with a doctor. The more that she or he knows about you, the patterns of your life, and the course of your health, the easier it will be to put your present situation in context. Oftentimes in western medicine, history taking consists of filling out a form in the waiting room; the doctor may glance at the form to see whether any non-standard boxes are checked or additions made. In TCM, that is unheard of. The doctor will want to hear about the health history in the patient’s own words, in order that there may be opportunities for additional questioning. Expect inquiries about such subject as sleep patterns and habits, diet, past traumas, exercise patterns, surgeries, diseases and their treatments, allergies and their appearances, sex life, menstruation cycle (if a woman!), and emotional state. The doctor will also conduct an examination using multiple senses of the patient’s pallor, pulse, breath, hair texture and color, and urine/stool. In some cases, the doctor will ask for additional testing of blood, and especially hormones. For women, especially, understanding hormonal response can be helpful to diagnosis
In terms of modalities of treatment, your TCM practitioner will most like combine acupuncture and traditional herbal remedies. Acupuncture is by now well known in the west; it is the process of the insertion of sterile, fine-tipped needles along qi energy meridians in the body. The needles are completely painless but affect the energy flow under them. Since the meridians correspond to various organs and bodily system, restoration of proper flow can help restore the patient to health.
For the scientifically minded, there are multiple rationales advanced for the success of acupuncture in treating various medical conditions. According to neurotransmitter theory, acupuncture stimulates the hormonal release of enkaphalins and beta-endorphins in the brain, and then in the spinal cord. Once these neurotransmitters are released, the immune system is positively affected, as well as the release of antinociceptives that block nerve pain transmissions to the brain. According to autonomic nervous system theory, acupuncture makes the autonomic nervous system function at full capacity, so that blood pressure is properly regulated and breathing is full and deep. As a result, the body releases acetycholine, norepinephrine, and a number of natural opiods, which naturally reduce pain and inflammation.
Two other theories for the success of acupuncture are vascular-interstitial theory and blood chemistry theory. In the former, it is posited that acupuncture creates the milieu for better closed circuit movement of the normal electrical impulses in the body through its tissues. Better movement fosters healing and cellular repair. In the latter, acupuncture is seen as improving the level of key blood components like cholesterol, triglycerides, and phospholipids, which positively effects the quality of arterial blood flow. A final theory is gate control theory, which holds that acupuncture can active certain brain signals that block, or gate out, pain indications sent to the dorsal horn of the spinal column. Pain relief is the result.
The weight of the scientific evidence in favor of the efficacy of acupuncture for pain relief is overwhelming. Andersson and Lundeberg (1995), writing more than twenty year ago, summarize the benefits, and many hospital now offer acupuncture services as part of their departments of complementary or integrative medicine.
Acupuncture is administered most often with herbs that tonify the blood or have other positive effects on the body. Herbal medicine is complex; it should not be done with over-the-counter herbs available at a drug store, or in response to a diagnosis made with Internet sources. Herbs are almost always prescribed in combination.
TCM: Techniques for Pain Prevention
See, that was simple. Every TCM practitioner would affirm that acute pain – the kind that results from a sudden accident, like a wrenched knee – is more easily treated than chronic pain from fibromyalgia or colitis. To that end, patients should be encouraged to see their TCM practitioner at the first sign of pain that doesn’t seem to be going away quickly. Even more important is to see that doctor if pain seems to be increasing. As a general rule, TCM supports moderation in all things: eating, drinking, sex, work, and exercise. Moderation makes it less likely that the body will be wrenched out of homeostasis, or that undue stress is made normal by repetition. In any case, pain is a signal that something is wrong. TCM can help.