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Understanding Pain: Exploring Its Complexity and the Role of Acupuncture for Pain Management

Updated: Jul 12, 2023

Pain is a complex phenomenon and cannot always be explained by our current anatomical and physiological understanding of the body.


chronic pain

Pain is the most common ailment for which acupuncture is used


Introduction


Pain, a multifaceted and subjective experience, has captured the attention of philosophers and scientists throughout history. The understanding and definition of pain have evolved over time, reflecting the contemporary spirit and scientific advancements in the field (Gebhart, 2018). This blog post aims to delve into the concept of pain, its classification from a mechanistic perspective, and the intricate factors that contribute to its complexity. Moreover, the potential role of acupuncture in pain modulation will also be explored



What is this thing called pain?


Physicians' approach to pain management often depends on their philosophical background. Those with a mechanistic view focus on identifying the anatomical cause of pain, while those with a holistic perspective consider stress, emotions, and lifestyle as important factors for adaptive responses to pain (Gebhart, 2018). The definition of pain has undergone revisions to accommodate patient experiences and advancements in pain research (Raja et al., 2020)


Historical Perspectives of Pain


Initially, pain was attributed to lesions or dysfunction of the nervous system, termed neuropathic pain, until the International Association for the Study of Pain (IASP) recognized the stimulation of nociceptors as a cause of pain, known as nociceptive pain, in 2005 (Gebhart, 2018). More recently, the concept of nociplastic pain has emerged, challenging the traditional dualistic classification. Conditions such as fibromyalgia or irritable bowel syndrome exhibit nociplastic pain, which does not fit neatly into the dichotomy of tissue injury (Kosek et al., 2016)..


The Complex Nature of Pain


Pain defies simple categorization due to its intricate nature. The latest IASP definition characterizes pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage" (IASP, 2017). This definition acknowledges pain's complexity, considering the physical, psychological, and social components inherent to the individual's experience. Such a perspective aligns with the biopsychosocial model of pain (Van Griensven et al., 2013).


Sensory Receptors and Interactions with the Environment:

Sensory receptors, also known as afferent neurons, play a crucial role in enabling humans to perceive and interact with their environment. These specialized nerve cells exist in various parts of the body, such as the eyes, ears, tongue, nose, and skin. Through these receptors, the brain receives and processes information about light, sound, taste, smell, and tactile sensations (Betts et al., 2018).


Nociceptors and Pain Transmission:

Within the skin and other tissues, somatosensory receptors detect different types of stimuli, including pressure, temperature, chemicals, proprioception (body position and movement), and nociception (detection of potentially damaging stimuli) (IASP, 2017; Betts et al., 2018). Nociceptors serve as the body's warning system, alerting it to potential dangers or harm (IASP, 2017).


The Modulation of Pain


Interestingly, the perception of pain varies even when individuals experience the same noxious stimulus. This variation arises from a complex modulation process that occurs within the brain and spinal cord (Picture 1), influenced by cognitive, emotional, spiritual, and environmental factors (Arntz and Claassens, 2004; Moseley and Arntz, 2007; Dubin and Patapoutian, 2010; Woo, 2010; Kirkpatrick et al., 2015; Siddall et al., 2015; McCance and Huether, 2019). Factors such as mood, psychological distress, or depression can amplify or diminish the intensity of pain perception (Pincus et al., 2002).


Pain modulation



How Acupuncturists Understand Pain


From the acupuncture point of view, pain is seen as an indication of an imbalance or disruption in the flow of Qi (pronounced "chee"), which is the vital energy that circulates through the body along specific pathways called meridians.

According to acupuncture theory, when there is an obstruction or stagnation of Qi in the meridians, it can lead to pain or other health issues. The goal of acupuncture treatment is to stimulate specific acupuncture points to remove these blockages, regulate the flow of Qi, and restore harmony in the body.

Acupuncturists believe that pain arises when there is an excess or deficiency of Qi, or when the Qi is not flowing smoothly. The specific location and nature of the pain provide clues about the underlying imbalance. For example, sharp and stabbing pain may indicate an excess condition, while dull and achy pain may suggest a deficiency or stagnation.

By inserting needles at acupuncture points along the meridians, acupuncturists aim to correct the imbalances and restore the proper flow of Qi.

Acupuncture for Pain Management


While acupuncture's efficacy has been observed for thousands of years, recent scientific studies have shed light on its mechanisms and effects. Although the exact mechanisms of acupuncture's effects on pain modulation are still being explored, the following scientific studies contribute to our understanding of acupuncture's neural mechanisms and its potential in healthcare.


1. The Neural Acupuncture Unit:

In their publication titled "Neural Acupuncture Unit: A New Concept for Interpreting Effects and Mechanisms of Acupuncture," Zhang, Wang, and McAlonan propose a novel concept that aids in understanding acupuncture's effects. They suggest that acupuncture modulates neurovascular responses, involving the activation of various neural structures. By examining functional MRI scans, they identify brain regions associated with acupuncture and how they influence pain perception, immune responses, and emotional well-being. This concept helps bridge the gap between traditional acupuncture theory and modern scientific understanding.


2. Unraveling Acupuncture Analgesia:

Zhao (2008) focuses on the neural mechanisms underlying acupuncture analgesia, providing valuable insights into pain management. Through extensive research, it is revealed that acupuncture stimulates the release of endogenous opioids, such as endorphins, enkephalins, and dynorphins. These naturally occurring pain-relieving substances bind to opioid receptors in the central nervous system, thereby diminishing pain signals and promoting a sense of well-being. This understanding deepens our appreciation for acupuncture as a viable alternative or complementary therapy for pain management.


3. Acupuncture in Western Medicine:

While acupuncture's integration into Western medicine has faced skepticism, researchers like Longhurst, Chee-Yee, and Li (2017) emphasize its potential and advocate for its inclusion in mainstream medical practices. They highlight acupuncture's efficacy in treating conditions such as chronic pain, nausea, and migraines. By acknowledging the neural mechanisms underlying acupuncture and its ability to regulate various physiological processes, Western medicine can embrace this ancient therapy as a valuable addition to conventional treatments..

Conclusion


Pain, a complex phenomenon, defies a single comprehensive definition due to its multidimensional nature. It encompasses sensory, emotional, and social components that contribute to individual experiences. The understanding of pain has evolved, embracing a biopsychosocial model that considers the interplay of physical, psychological, and social factors. The modulation of pain involves intricate processes influenced by various variables.

It's important to note that while acupuncture has been used for thousands of years and is still practiced today, the scientific understanding of acupuncture's mechanisms of action is still evolving. While some acupuncture studies have shown promising results in pain management and relief, more research is needed to fully understand the effects of acupuncture and its role in pain management.




References:


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-Arntz, A. and Claassens, L., 2004. The meaning of pain influences its experienced intensity. Pain, 109(1-2), pp.20-25.


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-International Association for the Study of Pain. 2017. IASP Terminology [online]. Available at: https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698


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-Longhurst, J., Chee-Yee, S. and Li, P., 2017. Defining Acupuncture’s Place in Western Medicine. Scientia, 1(5).


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evokes. PAIN, 133(1-3), pp.64-71.

-Pincus, T., Burton, A.K., Vogel, S. and Field, A.P., 2002. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine, 27(5), pp.E109-E120.


-Raja, S.N., Carr, D.B., Cohen, M., Finnerup, N.B., Flor, H., Gibson, S., Keefe, F.J., Mogil, J.S., Ringkamp, M., Sluka, K.A. and Song, X.J., 2020. The revised International Associ- ation for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain, 161(9), pp.1976-1982.

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-Zhang, Z.J., Wang, X.M. and McAlonan, G.M., 2012. Neural acupuncture unit: a new concept for interpreting effects and mechanisms of acupuncture. Evidence-based complementary and alternative medicine.

-Zhao, Z.Q., 2008. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol, 85, pp.355-75.


 

Acupuncture Clinic in North West London

If you have been suffering from pain for a long time, don't suffer any longer! It's time to get in touch with a professional Acupuncturist who can help you. If you live in the North West London area and seeking pain relief, contact Nazan at Virtue Acupuncture. Discover the beneficial effects of acupuncture treatment in a clean and hygienic Clinic near you.


Living in London? Book your Acupuncture appointment today!







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