Treating Pain with TCM - Part 1 : Acupuncture theory

We all experience pain.  It's how our bodies let us know something is wrong.  Whether from overuse or injury, pain is there to remind us we're mortal.  Many people have heard that acupuncture helps treat pain and it's true to a certain extent.  Many people have also heard that acupuncture has no effect at all.  This is also true to a certain extent.  Let's discuss a little about why that is.

acupuncture and pain

I've had a lot of people ask me about pain in their shoulder, knees, back, legs, hands, and a lot of other places. What can they do to lessen the pain and will acupuncture help?  Depending on the severity, I give them several options.  This could be using a heat pad, putting ice on it (don't flip out I said ice ...), pain patches, die da jiu, massage, visiting an chiropractor, physical therapy, and even using an herbal formula.  

However, after all those ideas, they still say, "But what about acupuncture?".

Acupuncture is a tool for the TCM practitioner and sometimes that tool isn't needed.  Sure, you could use a knife to remove a splinter, but a tweezer might work better.  I could put an expensive antibiotic on the cut once I'm done, but some rubbing alcohol and a band-aid will suffice. When you understand how your tools work, you understand how to better fix a problem.

Now, acupuncture does work well with external pain, even if it's not on the TCM Meridians.  From the Huang Di Nei Jing (黃帝內經), it states that putting the needle where it hurts or it's sore is Ashii (or more commonly known as the ashi point).  The instruction for using the needle is as follows:

You should put the needle in the muscle for muscle pain, the tendon for tendon pain, and (next to*) the bone for bone pain.

It seems too simple, doesn't it?  That's because the acupuncture needle helps to relax the offending muscle/tendon causing the pain.  TCM always states that pain is from some type of stagnation or stasis and a tight muscle/tendon is usually the culprit. Technically, there is no pain when a bone breaks, as there are no nerves on bones.  The surrounding tissue, on the other hand, knows something's wrong and it's letting you know about it. Once the blood starts flowing in the area again, it will relieve the pain.  

When we talk about internal pain though, things change a bit.  Here, acupuncture is better with pain from meridian problems.  Sure, it can help with headaches, diarrhea, constipation, eye pain, stomach aches, and such.  However, you need to have a good understanding of the theory to know which points will work, which points to avoid, and which meridian has the problem.  Generally, using herbs and herbal formulas for conditions like these are much more effective.

Acupuncture is part of a larger "team" in treatment.

As an example, let's look at two different cases of a "headache".  One person has a headache in the back of the head, while another has pain on the top of their head with eye pain and a red face.  Both people receive acupuncture, but only the one with pain in the back of his head as any relief.  Why is that?

The cause for the headache for the one that had relief was the trapezius muscle was pulling down on the occipital bone.  That was cause of the pain and acupuncture relieved some of the tension and eased the pain.  If the practitioner also used massage, it's a good bet there would have been an even greater relief.  Depending on the cause of the tension, most likely stress, the headache would probably return after a few days.  Acupuncture, once again, would help if the patient ever came back.

The other person had headaches more common to a migraine or TCM Liver yang hyperactivity. Here, there's no muscle tension or pain from stagnation. Pain is caused by a number of reasons such as stress, ocular pressure, emotional distress, or even overwork.  This kind of condition needs more than just acupuncture to have any real lasting effect. Unfortunately, when no relief happens the first time when only acupuncture is used, people assume it doesn't work and dismiss it as a sham/quackery.

This is one of the reasons why it's difficult to "scientifically prove" that acupuncture works.  Everyone's cause for the pain is different, it manifests differently, and treating something like a "headache" is just too broad.  Also, we're not only using acupuncture to help, but herbs, (Tui Na) massage, gua sha, cupping, moxa, and other treatments as well.  Lastly, if people believe they're finally getting some type of treatment, they naturally relax, as do the muscles, and the pain is lessened by itself.  This is really what happens when there's a positive reaction to a  "placebo" and what equates to the Mind/Body connection.

I hope this article gives you a better idea how acupuncture is used in treatment and how it's not the only tool we use to help patients.  In the next few weeks, I'll be talking about pain in different areas of the body and the different ways TCM treats it.

* - Don't try to put acupuncture needles "in" the bone.  It won't work and it sounds silly.