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Acupuncture for Pain Control

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Category: Chronic Pain Articles Published on Wednesday, 25 June 2008 Written by Yong Tsai, MD
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Pain, an unpleasant sensation that occurs in response to tissue injury, is a normal protective process that lets us know when something is wrong.

Our nervous system is made up of the central (brain and spinal cord) and peripheral (nerve fibers, nerve endings, receptors) nervous systems, which work together, transmitting signals to and from the brain, spinal cord and other parts of the body via nerve fibers. There are three categories of nerve fibers, each responsible for different sensation: A-delta fiber (sharp localized pain), B fiber and C fiber (generalized aching).

GATE CONTROL AND ENDORPHINS

If the spinal cord is overloaded with various signals transmitted by A-delta fibers, areas of our spinal cord can act as a gate, blocking the transmission of pain signals via C-fibers, thus diminishing or eliminating pain. Furthermore, our brain and spinal cord is capable of producing endorphins, a morphine-like substance, or other neurotransmitters, which can further block pain signals to the brain.

ACUPUNCTURE AND PAIN RELIEF

Acupuncture, which originated in China nearly five thousand years ago, is a treatment for pain and illness in which thin needles are positioned under the surface of the skin at specific points on the body. It spiked interest in the United States in the 1970s following reports of the use of acupuncture as the sole analgesia during major surgeries.

Many studies have suggested that the majority of acupoints are located over the peripheral nerves, near nerve endings or tender points. Due to our better understanding of pain, we realize that needle stimulation via acupuncture can close the gate and block the stimulation of pain signal within A-delta fibers located in or just under the skin or muscle. Acupuncture can also activate the release of endorphins within our central nervous system to further reduce the transmission of pain signals. However, at present, there are still some elements of acupuncture that cannot be satisfactorily explained.

ITS LIMITATIONS

There is no doubt that some musculoskeletal pain can be effectively treated with acupuncture. However, because pain is our body’s alarm signal, it is crucial to understand and find the root of the problem. Camouflaging pain is like switching off a fire alarm and letting the fire burn, which can create a false sense of security to both physician and patient that the “fire” is under control. At times, pain can be caused by a severe underlying disease, such as inflammatory muscle disease or rheumatoid arthritis, severe disc herniation or spinal stenosis, which cannot be treated with acupuncture alone.

In conjunction with modern medicine, soft tissue manipulation, and therapeutic massage, acupuncture can be a powerful tool to manage musculoskeletal pain and disorders. However, it is clear that acupuncture should be used as a tool to support conventional pain management, not as a substitute.

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