Neck
pain? Back pain? Knee pain?
Sciatica? Headaches? Carpal Tunnel?
The list is endless. Pain is the #1 reason most
patients come to see me. Acupuncture is widely
recognized as being effective in treating pain
and many insurance companies are moving quickly
to cover acupuncture for the treatment of pain.
Acute Pain
To suffer an injury, you have asked your body
to do something that it is not designed or prepared
to do. The possibilities are endless-- sports
injuries, repetitive use injuries, trauma, and
injuries that “come out of nowhere.”
Your body initially responds by sending a great
deal of blood into the area to clean it, repair
it and ultimately restore the area to its normal
functioning. In this initial acute stage, the
area swells with heat and fluid, splinting the
area, which hopefully conveys the message to you
not to move it.
Patients often ask me to clarify for them when
to use ice vs. heat. Use ice with acute inflammation
for generally up to 36-72 hours after an injury.
Ideally, you can freeze a Dixie cup of water and
perform ice massage for 5 minutes 3x/day. This
can be accompanied by rest, compression (wrapping
the area in an Ace bandage), and elevation for
a limb injury in particular. Once the inflammation
decreases to the touch and feels less “irritated”
within, you can begin alternating ice with heat.
Where ever ice goes, blood moves away, hence ice’s
ability to decrease inflammation. Where ever heat
goes, blood follows. It is through the infusion
of fresh blood that healing can begin. But as
you still may have minor levels of inflammation
you start and end with ice. This may be used for
3-7 days depending on your response. From there
you begin to move away from ice by beginning and
ending with heat for another 7 days, again depending
on your response. From here, you may fall into
the chronic stage where heat can provide the greatest
relief and ice is only used on the occasion where
you may have aggravated the injury through overuse.
One of the ways to identify whether the “stiffness”
you feel is inflammation or simply tight muscles,
is if the area feels worse with heat. You will
usually know within moments. If so, you are inflamed
and should stop using heat immediately and begin
using ice.
The sooner you get treatment, the quicker your
results are likely to be. Acupuncture and Chinese
herbs are excellent for all acute injuries, especially
in conjunction with Western medicine and its ability
to properly diagnose the severity of the injury—sprains,
strains, breaks, etc. Even if you have broken
your ankle and are in a cast, the beauty of the
way I treat is that I never place needles at the
sight of the acute injury. More often than not,
I needle the opposite foot and opposite hand with
great affect. And herbs can be a tremendous help
in repairing tissue and bone. Through 4000 years
of use, the Chinese have figured out which herbs
go to which part of the body. When you take an
aspirin, it works systemically as it searches
for areas of pain. With Chinese herbs, I can,
in effect, give you an aspirin that is specific
to your foot. How amazing is that?
Chronic Pain
The transition from the acute stage to the sub-acute
stage can take sometimes just a few days if treated
properly. It is often signaled by a marked decrease
in inflammation—though there could remain
a low-grade chronic inflammation that is more
of a systemic imbalance and should be diagnosed
by your physician-- and a reduction in swelling
with a commensurate increase in range of motion
and a more comfortable resumption of daily activities.
From the sub-acute to the chronic stage can take
anywhere from a week to a few months. It is in
this time that pain can still linger. Why?
There are 3 aspects of chronic pain to consider:
1. There may still be physiological
reasons for the pain.
a. There may be trigger points—adhesions
in the local tissue, called fascia, that are painful
and can refer pain to other areas in your body.
Let’s say you have suffered from “tennis
elbow.” Even after the acute inflammatory
tendonitis is gone, we would still need to work
out the soft tissue in the forearm to clear out
any irritating knots. As long as they continue
to be present, the proper functioning of your
local muscles will be compromised creating a greater
chance of the tennis elbow to return.
b. There could be vertebral disc issues, like
a bulge or herniation, that need to be managed
and supported through proper treatment like acupuncture
and chiropractic care. This is most commonly seen
in neck and low back injuries.
c. There could be postural imbalances that contributed
to your injury in the first place and continue
to support the presence of pain even long after
the injury has occurred. The knee is the most
obvious example here. Uneven gait patterns can
translate up the knee contributing to pain, which
can further translate into the hip and low back
contributing to pain there, too. The body desires
balance and will find it one way or another. It
does so through compensation patterns than, in
and of themselves, need to be unwound and eventually
corrected if new areas of pain are to be prevented
form occurring.
d. There may be ergonomic issues at play. What
movements in your daily life are contributing
to the imbalance and the resulting pain? Is it
the way you sit at your computer, the clutch you
use in your car, or picking up your 35lb baby
everyday that is constantly aggravating your condition?
How might we modify these activities?
e. There could be neuro-chemical imbalances in
our brains, like being low in endorphins, which
is our main endogenous analgesic.
f. Lastly, there could be organ imbalances that
can be affecting channel flow. In Chinese Medicine,
there are energy channels called meridians that
flow through the body and connect to their respective
organs. Imbalance in the organ can lead to imbalance
in the meridian and vice versa. Consider chronic
shoulder pain. You suffer from shoulder pain due
to a car accident 5 years ago and have tried everything
to treat it with little lasting result. How are
your bowel movements? Are you constipated? Both
the Large and Small Intestine Channel flow through
the shoulder. Long-term constipation can most
definitely affect circulation in the shoulder.
2. There is your perception
and experience of the pain.
Pain, in and of itself, is something we need to
treat. This is why Pain Management is such a huge
field of medicine. Acupuncture can be very helpful
in this area. I expect to find the precise acupuncture
point that can change your experience of your
pain within seconds. That is how immediate this
medicine can work. This may not immediately affect
structure or the other reasons mentioned above
for pain, but if your perception of the pain is
lessened, then, for as long as it lasts, you have
found relief. From there, your activities of daily
living can resume, you can sleep more restfully,
and we can even work on the local soft tissue
with less irritation.
3. There is your attachment
to the pain.
There is a fine balance between embracing your
pain as part of you rather than something you
must fight against, while at the same time not
being consumed by it or identifying with it too
much. Much of the dynamic in Western medicine
is about fighting disease. Drugs are often prefixed
with “anti”: anti-hypertensive, anti-cholesterol,
etc. When we have chronic pain or any chronic
condition, can we address the issue while at the
same time not being at war with our own body?
Can we welcome the messages the pain may be giving
us? We may need pain medication, but do we rely
on it too much in an effort to numb ourselves
because we can’t deal with the real changes
we must make?
The other side of this reveals itself in the
language patients use. My red flags go up when
I hear them say, “I have a bad back.”
To me, it reveals how much they have identified
with their pain, how attached to it they are and
how much subsequent fear they may have of letting
it go. Who would they be if they were not “Joe
with the bad back?” What would they talk
about instead? How else might they limit their
involvement in their own life? What if they don’t
have any more pain? What then?
The other type of statement I may hear is “I
can’t stand the pain,” or if severe
enough “I can’t live with this pain.”
How disrupted is their spirit? Do they feel defeated
by their pain? Do I need to refer them to a Psychotherapist
or their Family Doctor for a different type of
care? Should I be concerned for their safety?
When I feel a patient’s spirit is affected
by their chronic pain, not only do I treat the
pain, but I must also address the spirit. Each
time I place a needle into a point and ask the
patient to move their neck, for example, and the
pain changes, I am introducing Possibility. I
am introducing space for change, an opportunity
for the patient to see that there is another way
of experiencing their body that is not about their
pain, but rather relief and pleasure. And when
that patient drops into a deep restful state during
the treatment, we are beginning to disentangle
and re-wire their attachment to their pain. And
if we can couple this profound kinesthetic shift
with an understanding of their attachment to their
former state, then we can begin to see longer-lasting
change. And for the latter type of work, I encourage
them to see a Psychotherapist to work out those
issues. My role is to connect those troubled aspects
of their spiritual body with their physical experience.
Working from both angles yields the best results
when it comes to this kind of chronic pain.
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Pain is a gift; it is a messenger. It says, “Pay
attention to this area. Something is wrong and
we need to fix it.” Not feeling pain is
a problem. Yet it is simply easier for most of
us to numb ourselves out of feeling it, repress
it, or live in denial of it. For to do otherwise,
necessitates action. When you are ready to act
and to address your pain, acupuncture and I can
help.
We are fortunate to be living in a time where
the choices for treatment are abundant. Where
we can utilize all the diagnostic gifts that Western
Medicine offers to tell us what exactly is causing
us pain. Yet, with or without that knowledge,
there are choices like Chinese Medicine that can
help you deal with all kinds of pain, no matter
acute or chronic, structural or internal, physical
or emotional. Your choices are many, and I am
honored to be one of them.
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