Have you Tried Acupuncture for Managing Chronic Pain?

Acupuncture is the gentle insertion of thin needles into specifically targeted areas of the body. Its origin extends 2500 years as an integral tenant of Traditional Chinese Medicine (TCM). Today, however, its theory and practice have evolved beyond classical application towards effective pain management.

So how does it work? The theory behind acupuncture is extremely complex and multifaceted. Basically, it works via two main systems; the release of natural pain relieving chemicals (called endogenous opiates) and sensory nerve interactions signaling pain inhibition from the brain to the affected area.  

Natural, endogenous opiates are chemicals produced in the body that have a potent analgesic effect (reduce pain perception). They include endorphins, serotonin and epinephrine. Acupuncture insertion stimulates the release of these chemicals in the central nervous system, which results in a decreased perception of pain. Similarly, endogenous opiates have anti-inflammatory effects. Electroacupuncture elicits immediate pain relief by acting on sensory nerve pathways. Vibration information stimulates nociceptors (specialized pain receptors), which initiates an inhibitory pathway from the brain to the affected area. 

Needling technique is important for effective pain relief results. There are two main acupuncture techniques:

1.       Rapid Needling: Involves insertion of a needle into an identified trigger point (area of intense pain within a band of muscle) with manipulation (in and out motion) of the needle at a quick pace. This is the best technique for dissolving trigger points and relieving muscle pain.

2.       Electroacupuncture: Involves the connection of a mild electric current to the Acupuncture waterloo. It feels like a vibration in your muscle and may cause a slight muscle contraction response. This is the best technique to use for inflammation, chronic muscle pain and joint pain.

Acupuncture can help you with…

  

•          Myofascial Pain Syndrome (chronic muscle pain from trigger points) 
•          Chronic neck and back pain
•          Fibromyalgia
•          Osteoarthritis
•          Joint Pain
•          Tension headaches
•          Sciatica
•          Plantar Fasciitis
•          Post-operative pain
•          Diabetes related peripheral-neuropathy

Other pain treatments include pharmaceutical opioid management (e.g. Percocet, Naproxen, Ibuprofen, etc.), injectable opioids (e.g. morphine) and corrective surgery. As a minimally invasive technique, acupuncture should be considered as first-line treatment prior to implementing higher risk procedures. Furthermore, if extensive therapy is indicated (e.g. surgery), acupuncture should be used to compliment recovery. Additional benefits include decreased cost, avoidance of opiate-induced side effects and avoidance of analgesic tolerance (when the same dose of a medication is no longer effective).

Practitioners qualified to practice acupuncture include Naturopathic Doctors, TCM certified practitioners and some Chiropractors and Physiotherapists. However, Naturopathic Doctors uniquely receive 4 years of intense training in the practice itself. Furthermore, they have the anatomy and clinical background to couple traditional acupuncture with more advanced and current theories.

There’s another component to the efficacy of this treatment…it forces you to relax for 30-60 min while the needles are doing their work. When dealing with pain, stress management and self-care are key. Therefore, having time devoted to healing, and having a skilled practitioner take care of you will help. 

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How to Relieve Pain from Fibromyalgia

Fibromyalgia (FM) is a functional somatic disorder, characterized by the insidious onset of chronic pain (Kim et al, 2015). FM generally presents with widespread musculoskeletal pain, causing debilitation and severe impacts on health-related quality of life (Rusu et al, 2015). In addition to muscle pain, fibromyalgia is characterized by a low overall pain threshold, muscle stiffness, chronic fatigue, headaches, sleep disturbances and memory loss (Cerda-Olmedo et al, 2015). Many people suffering from this condition have difficulty working and carrying out activities of daily living (Rusu et al, 2015). The global prevalence is estimated to be between 2-8%, with a greater proportion of females to males affected (Cera-Olmedo et al, 2015).

The cause of Fibromyalgia is still not fully understood, although many theories have been proposed. For example, altered cytokine (immune marker) profiles and autoantibodies have been shown in FM patients (Cera-Olmedo et al, 2015). There is also evidence of anatomical changes in the brain of those experiencing chronic pain. Specifically, reduced gray matter has been noted in certain areas including the basal ganglia and thalamus (Kim et al, 2015). Furthermore, increased gray matter has been reported in the cerebellum (Kim et al, 2015). Other theories focus on mitochondrial dysfunction and increased oxidative stress (Sanchez-Dominguez et al, 2015). Specifically, disruptions in the mitochondrial chain activities and increased levels of oxidation are suggested to play a role in peripheral nerve damage, leading to diffuse pain (Sanchez-Dominguez et al, 2015). Whatever the cause, the abnormalities in FM patients may be a product of genetic make-up, aging or environmental factors (or a combination of all) (Kim et al, 2015).  Furthermore, a link has been suggested between chronic infection and fibromyalgia (Cera-Olmedo et al, 2015).  The diagnosis of FM is purely clinical, meaning it is based on presenting symptoms and health history (Cera-Olmedo et al, 2015).

Fibromyalgia treatments are difficult to implement for a number of reasons, but mostly because the etiology is not yet understood. Short-term benefits have been found with pharmacological interventions, but long-term resolution has not been demonstrated (Wang et al, 2015). First-line medications include analgesics and antidepressants, which are associated with risk of adverse events with chronic use (Wang et al, 2015). Furthermore analgesic tolerance is a real concern whereby long-term ingestion of the same dose of medication is no longer effective.

Natural fibromyalgia treatments are important to implement because they are safe and free of adverse effects. Specifically, a combination of pharmaceutical and natural therapies is an ideal approach to the management of this condition.

Natural fibromyalgia treatments include lifestyle modifications, exercise, mind-body work, acupuncture and nutraceutical supplementation. Lifestyle risk factors for chronic disease, including smoking, obesity, poor diet, high blood pressure and unregulated blood sugar are commonly associated with fibromyalgia (Rusu et al, 2015). Therefore, treatments should begin with nutritional counselling, smoking cessation and healthy weight management to minimize these risks.

Exercise has been shown to be an effective tool for relieving symptoms of pain and stiffness. Mild-moderate aerobic exercise at 30-45 min, 4 days per week is a suggested guideline (Wang et al, 2015). Walking is a great way to implement a consistent exercise routine. Thai Chi is also beneficial in the treatment of FM (Wang et al, 2015). Not only does it help to alleviate physical pain, but it also benefits mental-emotional wellness through a heavy meditative component.  

Regular meditation sessions help manage the emotional pain associated with fibromyalgia (Porter et al, 2010). Daily breathing exercises are an easy way to begin the process, and can benefit feelings of depression and sadness.

Acupuncture is useful in providing immediate pain relief (Porter et al, 2010). It works by stimulating a release of natural endorphins and opiate chemicals that decrease the perception of pain in the central nervous system. Acupuncture also works by triggering sensory pathways to the brain that inhibit pain through neural transmission along the spinal cord. If needling is too aggravating, acupressure (which is the application of local pressure where an acupuncture needle would be inserted) is a gentler alternative.

Other fibromyalgia treatments include supplementation with magnesium, L-carnitine and S-Adenosylmethionine (SAMe) (Porter et al, 2010). Magnesium is important in relieving muscle hypertonicity, while L-carnitine and SAMe target mitochondrial functioning and cellular methylation pathways.

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