- Dr Samantha Law
Acupuncture for Chronic Pain
1 in 5 Australians live with Chronic pain. That is nearly 5 million people!
According to the Australian Pain Management Association (APMA), pain is said to be chronic if it persists beyond the normal healing time of about three months. 'Chronic' simply means ongoing and doesn't tell us much about the severity or quality of the pain.
Many people are new to the notion of chronic pain because they are taught that pain goes away when tissues heal after an injury or illness. However, this is not the case for 1 in 5 Australians and pain may not lessen when the healing process is complete.
Sometimes, it is not possible for doctors to pin point the cause of the pain and it can be frustrating not to have a diagnosis. Chronic pain is complex because it involves the nerves and nervous systems, including the central nervous system made up of the brain and spinal cord.
Chronic pain occurs because of changes to the nerves or nervous system which keeps the nerves firing and signalling pain. However, there are likely to be other precipitating factors with chronic pain including genetics, gender and previous episodes of acute pain. Chronic pain can be intense and unrelenting, and lead to various degrees of disability if it is not managed well.
Chronic pain is a condition in its own right because of the changes in the nervous system unrelated to the original diagnosis or injury, if there was one. Medical scientists are able to map pain centres in the brain using brain imaging, bringing hope to the many Australians who have not had their pain properly believed, assessed or treated in the past(1).
Misdiagnosis of Chronic Pain
A lot of the time, people associate chronic pain with structural damage that irritates the nerve (by pushing on it). Most doctors tend to believe that bone, soft tissue, disc or other structural abnormalities causes physical nerve irritation, leading to pain. However, most of the time, no structural abnormalities are detected, yet you still have pain. Although pain killers mask the unpleasant sensation, it never fixes the root of the pain itself.
Why Does The Body Produce Chronic Pain?
When an area of the body becomes injured or infected, the body “guards” itself. Movement is limited, muscles maintain high levels of resting tension and blood circulation is restricted to the area as a survival mechanism. A cycle of swelling, impaired circulation, inflammation, fatigue, and soreness ensues because of this(2). Unfortunately, due to incorrect neural signalling, the body may perceive that the area requires more guarding when it doesn’t. Blood flow continues to be restricted to the area, limiting the body’s ability to heal.
Additionally, people with pain, in particularly chronic pain, do not have proper release of pain relieving chemicals like enkephalins and endorphins. The weak signal strengths of the proprioceptive pathways result in the body not knowing where these pain relievers need to be released to. As other swollen nerve fibres continue to fire incorrect signals to the brain, little to no pain relief occurs.
Drugs and Chronic Pain
Drugs such as NSAIDs, local anaesthetics and mostly opioids are often prescribed to deal with a patient’s pain as a first line treatment. Yet, Cochrane UK estimates that 5-10% of people who are given opioids will benefit from the treatment(3). Long-term use of opioids can potentially lead to gastrointestinal, respiratory, cardiovascular, musculoskeletal, endocrine and immune effects. It can also lead to opioid addiction which can be fatal to one’s health. These drugs “may” help with masking the chronic pain but doesn’t address and treat the underlying root that causes the pain. This means that you are required to have a dependency on the drugs to live a pain-free and manageable life.
What Can Acupuncture Do To Help With Chronic pain?
Endogenous opiates are neurotransmitters released in the body which provide analgesic effects (block effects of pain signals). Some are short-acting (enkephalins) and others are longer acting (endorphins)(2). The aim of acupuncture with pain management is to improve nerve signalling, promote blood flow and increase the concentration of the endogenous opiates to the affected area. This promotes local healing and resets the brain’s proprioceptive neural threshold and ultimately stops the signals that cause chronic pain.
Pain relief from acupuncture can be felt quite quickly and can possibly occur within your first session. However, it is common for the pain to come back within 1-2 days of treatment as your body has developed a bad habit of firing pain signals to the area. It is recommended that you receive treatment twice a week for the first few weeks to re-establish the body to a normal state and the treatment holds itself. This allows the body to realise that the pain is unnecessary and that it can function without it. Once this occurs, treatment is weaned from weekly, fortnightly, monthly to either coming in once every while for maintenance or not coming back at all. If you are interested in understanding how acupuncture can help a specific pain you’re experiencing, read more about acupuncture here, send a message through the website or call 0435 526 178 to discuss how acupuncture may benefit you.
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