Chronic Pain - types, treatments and self care

WHAT IS CHRONIC PAIN?

• pain continuous for more than 3 months
• pain has persisted after a condition or injury has healed
• pain frequently recurs 

WHAT ARE SOME COMMON TYPES OF CHRONIC PAIN?

• low back pain
• headaches/migraines
• arthritis
• nerve pain
• pain associated with long term illness such as cancer

How pain becomes chronic varies depending on the condition.  In the case of low back pain it may have started out as an injury which may have never completely healed.  Osteoarthritis on the other hand is a condition that progresses over time due to deterioration of the cartilage which provides cushioning for the joint.  Nerve pain may develop from a long term condition such as diabetes whereas headaches may be due to long standing stress or tension.

HOW DOES CHRONIC PAIN IMPACT THE BODY?

• loss of appetite
• sleep disturbances
• depression
• decreased energy

WHAT ALTERNATIVE TREATMENTS ARE AVAILABLE FOR CHRONIC PAIN?

• acupuncture
• herbal remedies or supplements
• massage/tui-na
• tai chi
• qi gong
• meditation

HOW DOES ACUPUNCTURE TREAT CHRONIC PAIN?

Acupuncture needles are inserted into specific areas of the body to regulate the flow of Qi.  When Qi is blocked there will be pain.  Qi can become blocked through various mechanisms such as trauma or injury to the body, long term emotional distress, internal imbalances such as digestive, circulatory, respiratory and gynecological disorders will all disrupt the flow of energy or Qi in the body.  Specific points are chosen for their pain relieving quality as well as to balance the body.  

From a more Western perspective acupuncture has been shown to affect areas in the brain that are related to pain control.  As well acupuncture has been shown reduce pain transmission by overloading nerve gates with impulses.  Acupuncture also affects blood vessels by causing constriction or dilation through the release of vasodilators.  Endorphins, serotonin and noradrenaline are also released during acupuncture.  Although they may not directly affect pain they do have the affect of promoting a sense of well being.

Several studies on acupuncture and different types of pain have been done.  Below are links to a few.
Osteoarthritis of the knee
Headaches/Migraines
Low back pain
As well studies have been done on pain and other complementary therapies
Tai chi and osteoarthritis
Yoga and back pain
Meditation and pain

Please check with your health care provider to ensure a particular therapy is appropriate for your condition

Rheumatoid Arthritis

Arthritis, Acupuncture and Traditional Chinese Medicine - Part Two

Rheumatoid arthritis (RA) occurs when the immune system attacks the lining of the joints causing inflammation. This inflammation may involve other organs and tissues often the heart, lungs, eyes, and in about 20% lumps may form under the skin.

Rheumatoid arthritis commonly affects people between the ages of 25 and 50, although it can occur at any age. In RA joints affected are symmetrical with the most common being the wrist and hand except the most distal finger joints although elbows, shoulders, neck, jaw, feet, ankles, knees, and hips can also be affected.

Studies on using acupuncture to help RA symptoms show that electro acupuncture has the best results with a significant reduction in the number of tender joints and measurable reduction on pain, swelling and mobility. The traditional acupuncture group experienced benefits but at a slower rate. To read the evaluation click here

Arthritis in general falls into the category of Bi syndrome which translates to joint pain due to wind, cold, heat and damp. The pain characteristics will vary according to the cause

• Wind causes pain to come on suddenly and move around

• Cold will cause local or general pain and stiffness which improves with warmth

• Heat will result is hot, inflamed joints with local redness, swelling, excruciating pain and limited movement

• Dampness leads to heavy sensations with swelling, numbness and is often worse in damp weather

With regards to RA, as in OA an assessment is done to determine which joints are involved, severity of pain, quality of pain, duration of condition, changes in condition, as well as general body condition.

For dietary guidelines for RA can be found here

May is Arthritis Awareness Month

Looking at Arthritis, Acupuncture & Traditional Chinese Medicine - Part One
Arthritis comes in several forms, the most prevalent being osteoarthritis (OA), affecting approximately 10% of the adult population. Below are some quick facts on OA plus links to well known studies. The traditional Chinese medicine viewpoint will be discussed along with the benefits of acupuncture and herbal therapy.

Osteoarthritis

• symptoms include pain and stiffness of the joint with the possibility of locking
• due to degeneration of the joint cartilage, frequently in hands, feet, knees, hips and spine
• risk factors include old age, previous injury, obesity and hereditary factors
• treatment includes medications, physiotherapy, exercise and weight loss
• acupuncture may be used to reduce pain and increase mobility

One well known study looked at the effect of acupuncture on osteoarthritis of the knee and found that by the end of the study those that received acupuncture had a 40% reduction in pain and almost a 40% improvement in function compared to baseline levels. The course of treatment consisted of 24 sessions during a 26 week period. By the 8th week there was a marked improvement in pain. Read the press release for more details.

In TCM assessment of the joint function and pain is important including which factors aggravate or improve the condition. The overall body condition including sleep patterns, energy, digestion and mood will also be taken into consideration when developing a treatment strategy.

In OA age is often a factor and as we age our kidney qi starts to decline, the kidney energy is also related to the back and the knees, therefore acupuncture points or herbs to strengthen this energy may be used.

If a previous injury has predisposed a person to arthritis there may be residual blood stasis or swelling. Acupuncture or herbs may be used to reduce swelling, reduce pain and heal injuries by improving blood circulation in the body.

Often a person is limited in the amount and type of exercise due to pain and mobility of the joint either from the arthritis or a prior injury. Exercise can be beneficial to maintain range of motion, joint stability through strengthen the surrounding muscles. Physical activity has the added benefit of keeping weight at a healthy level thereby taking pressure off of joints especially knees and hips.