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TCM for Pain Managment

Written by Zhenni Jin

Pain, one of the leading causes of disability worldwide, has posed serious challenges for public health and healthcare systems. Including discrete pain episodes and longer durational pain, around 9 to 12 million American adults suffer from chronic pain. Many of which have high-impact chronic pain that has created profound difficulty in life and work. Not only do patients suffer from physical and psycho-emotional challenges in regard to their pain, but they also may have to bear extra medical costs and economic loss with the progress of time. As pain is an experience influenced by biological, psychological, and social factors, a more comprehensive approach to treatment is required for the Chinese medicine practitioner’s thinking towards treating pain conditions.

When Chinese medicine practitioners deal with pain and pain-related issues, we more often discuss issues related to stagnation located in channels, muscles, and sinews. From the Chinese medicine perspective, those stagnations can be made by qi, blood, dampness, phlegm, coldness, and heat toxicity. Therefore, any treatment to move qi, breakdown blood stasis, drain damp or phlegm, expel cold and clear heat toxicity, combined with open channels, can be very efficient in fixing the pain from different modalities. Moving the stagnation, warming the channels, nourishing the internal organs (like kidney and liver), boosting the immune function are critical in the treatment plan. For chronic pain and elderly patients, the body constitution is also a key point for consideration, disregarding stagnations. That is why acupuncture, one of the most popular treatments for pain management, should always be combined with a holistic and individual-designed treatment plan.

Acupuncture and Moxibustion

Acupuncture is a traditional Chinese Medicine practice that inserts needles into specific locations on the body, using hand-manipulating needling to enhance the qi sensations. Acupuncture keeps the balance between the outside environment and the body, thus allowing for the qi to flow throughout the channels, restoring health from the mind and physical body. With little risk of severe adverse effects, acupuncture has been recognized as a practical, cost-effective, and safe integrative therapy for treating pain conditions. In fact, over the past decades evidence on this ancient therapy has been accumulated by researchers of Biomedicine. In addition, the effect of acupuncture has also enabled it as a reasonable alternative to opioid abuse in the management of chronic pain conditions.

Moxibustion/moxa is a therapy that involves burning mugwort (ai ye) to facilitate healing. Burning moxa produces a lot of smoke and a pungent odor that often warm the channel, expel dampness and invigorate the blood. Usually, we place a medium-large moxa stick into a box, then put the box on the pain-related channel pathway area or place a small moxa cone on the top of needles to focus on specific points. We can also hold the large moxa stick by hand and move it along the channel to stimulate qi and dissolve stagnation. Primarily, the moxa box is used to treat pain by tonifying and boosting body deficiency. When moxibustion is combined with acupuncture, it is more efficient in healing the pain due to cold, blood stagnation, manifesting a cold-like feeling, fixing sharp pain.

Tui na and Cupping

Tui na (a combination of channel massage, acupressure, and body manipulation) is the earliest form of Asian bodywork therapy that has been used in China for centuries. In the tui na session, the patient lays on the table or sits in a chair in their most relaxed position. As the practitioner, we will ask a series of questions and then begin treatment with fingers, hands, elbows, and forearms, pressing, kneading, pushing, and tapping on the body’s surface. The type of tui na delivered by varying practitioners can be quite different and is often dependent on the patient’s needs and abilities; therefore, we always check with patients about their feelings and technique endurance. Tui na is best suited for treating muscular pain due to qi and blood stagnation, manifesting as deep aches, and poor joint range of motion; most of the time, this is combined with the cupping method. In addition, we may use herbal wine, ointments, and heat to enhance these techniques.

Cupping is a Chinese medicine hands-on modality consisting of placing several glass or plastic cups on the body. Practitioners warm the cups using a cotton ball or other flammable substance placed inside the cup to remove all the oxygen. The practitioner places the cup against the skin; the air in the cup then cools, creating lower pressure inside the cup, creating a vacuum, and allowing the cup to stick to the skin. Fleshy sites on the body, such as the back and thigh, are the preferred sites for treatment. Fire cupping brings excellent warmth to the body, warming and moving the stagnations very quickly. Therefore, for muscular pain treatment, tui na and cupping are common to move the qi and blood, opening the channels and muscles before acupuncture. It can reduce a lot of pain and muscle tension and assist in a better outcome of needling.

Herbal internal and external treatment

Chinese herbal treatment is a commonly used method combined with other hands-on treatments, like acupuncture and tui na; it can be applied internally or topically. Taken orally, herbs help the internal organs related to the pain; when placed topically, herbs work more on the muscles and ligaments. Therefore, once the patient has finished with acupuncture, we usually suggest they take some herbal medicine to enhance and prolong the effectiveness of any hands-on treatment.

The herbs for pain management that practitioners most commonly use can come from different leaves, roots, stems, flowers, and seeds of plants such as Safflower (hong hua), Szechuan Lovage Rhizome (Chuan xiong), Notopterygium Rhizome and Root (Qiang huo), pubescent angelica root (du huo), Corydalis Rhizome (yan hu suo), Eucommia Bark (du Zhong), and Achyranthes Root (Niu xi). Suppose we recommend Chinese herbs as a treatment: In that case, the herbs are combined into an individual-designed formula that is dispensed in the form of an herbal tea, capsule, liquid extract, granule, or powder. In addition, some herbs can be made into topical remedies. For example, many athletes or people who suffer from muscle pain might use a Notoginseng (san qi) ointment to treat their pain topically. This herb is usually made into creams and ointments to treat muscle soreness and aches, bleeding and bruising, joint pain, swelling, and inflammation. As well, many herbal patches and herbal foot soaks help open channels and move blood very efficiently.

Chinese medicine is used to look at the human body through the eyes of heaven, earth, and human at the same time. It is a complex being, made up of spiritual and physical properties. Pain is a complicated condition, which is the reason why Chinese medicine treatment is so expansive. It attempts to comprehend and gather as much of the universe’s themes to restore health to us, while simultaneously, trying to create as simplistic of a conclusion to understand the complexity of our health as functional human beings within the vast network of life as possible.

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