Managing Pain with Acupuncture
Living with pain is debilitating. Regardless of whether the pain is chronic or acute, having physical discomfort drastically affects a person’s quality of life. Understanding the causes and symptoms of different types of pain can help you get the best treatments to find relief. You don’t have to live with your discomfort forever.
Pain is generally described by its location. Acupuncture treats all types of pain – from muscle pain to golfer’s and tennis elbow, from back to shoulder pain to sciatica to fibromyalgia. Acupuncture can help.
Acupuncture treats symptoms associated with joint pain
Joint pain is a condition that many people experience at some point. Joints are where two bones intersect, and are supported by other types of tissues — tendons, ligaments, cartilage. All of these together allow movement and flexibility. Painful joints can result when direct injury, inflammation, infection, or degeneration (as in arthritis) affects any of these components.
Some causes of joint pain can affect any or all joints — the elbow, hip, knee, or shoulder. These causes include arthritis, tendinitis, and bursitis. Other diagnoses are specific to certain joints but may have counterparts in the others. For example, Jumper’s Knee is a form of tendinitis, which can occur in any joint.
It’s important to note that Lyme disease, which is caused by a bacteria carried by ticks, can cause joint pain. If the discomfort moves from one joint to another or is accompanied by rash or flu-like symptoms, then you should be tested for Lyme disease and not just treat the pain symptoms.
Acupuncture treats symptoms associated with muscle pain, too
Muscle pain often follows strenuous exercise, or muscle pain can be a result of stress, poor posture or ergonomics (the way you move). At some point in their life, everyone has had a stressful day, followed by a night of restless sleep, and then woke up with a crick in their neck. Neck tension and pain in your neck is one of the most common conditions treated by Chinese medicine. In fact, I usually give all of my patients some tui na massage on their neck because everyone has neck tension from the busy lives we lead. In general, tui na massage is an important part of any muscle pain acupuncture treatment.
How does acupuncture treat symptoms associated with pain?
The body is covered by a network of acupuncture meridians like the highways that criss-cross the country. In fact, there are five levels of meridians covering the body, ranging from superficial to deep. When the Qi circulating in the meridians at any level becomes blocked, pain is created.
Chinese medicine treats symptoms associated with pain by removing these blockages to allow the Qi to move freely. Acupuncture is said to course the Qi through the meridians. I also use herbal medicine to encourage the free movement of Qi in the body to stop discomfort. In fact, we have a number of herbs that stop pain as a primary function. Tui na massage works to stop pain by relaxing muscles, encouraging the flow of blood and lymph, and calming the mind (pain also affects one’s mental state). Using adjunct therapies like moxibustion, cupping and gua sha to help treat aches and other discomfort can be helpful in certain instances.
What kinds of pain can acupuncture help with?
Acupuncture treats symptoms associated with a wide range of pain conditions, like:
Fibromyalgia and chronic fatigue syndrome
BACK AND NECK PAIN
No Drugs Required
The phrase “a pain in the neck” became popular for a reason. Like back pain, neck pain is a very common complaint. And no one likes having either kind of pain. My dad had chronic back pain while I was growing up, and I can say as an eyewitness, it drastically affected his quality of life. My dad isn’t alone. According to published research, back pain is one of the most common reasons to miss work, experienced by 50% of Americans & costs about $50 billion a year to treat.
Back and neck pain are tricky maladies despite being so common. There is a large postural component affected by the way we move, sit and lie down. There is a structural component when the bones of the spine and supporting musculature are affected. There is even an emotional component. Chronic stress can cause neck pain and chronic pain can cause stress and even depression.
Acupuncture can help treat signs and symptoms associated with back pain and neck pain on all three of these levels. When herbal medicine is incorporated in the treatment plan, pain relief is often increased and the treatment’s effects on the bone-level is improved too. Also, acupuncture works on both chronic and acute types of pain.
What causes pain in the back or neck?
The most common cause of acute pain is muscle spasm and strain. Ligament strain is another possibility. Strains and muscle spasm are often related to physical activity, like heavy lifting. Stiff neck (as in torticollis) is caused by sleeping in an odd position or straining the muscles of the neck in other ways.
Another common cause of back and neck pain, but of the chronic sort, is bulging or ruptured disks. Disks are like cushions in the spine to help reduce shockwaves from impacts like your foot striking the ground while walking. When a disk bulges out of its usual space, it can compress nerves. Nerve compression causes discomfort.
Arthritis and osteoporosis are also causes of back and neck pain, although the do so in different ways. Arthritis often leads to spinal stenosis, a narrowing of the spaces your nerves travel within on their way out of the spine. Instead of a disk pressing on the nerve like in bulging disk problems, bony overgrowth can press on the nerves. Osteoporosis creates discomfort as a result of compression fractures in the spine.
How will my doctor diagnose and treat back pain or neck pain?
Your doctor will likely use orthopaedic and neurological tests, X-rays, MRI or CT scans, and/or electromyography (EMG) to diagnose your pain. These tests will help your doctor rule out other causes of discomfort.
Your doctor will likely prescribe acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs; ibuprofen, naproxen). Stronger medications like muscle relaxants or narcotics may be prescribed in cases of severe discomfort. Unfortunately these therapies are symptom-oriented and often just mask the pain without resolving the cause. Some doctors will suggest physical therapy, movement re-education and even surgery depending on the cause of the discomfort.
How does acupuncture evaluate and treat the signs & symptoms associated with back pain and neck pain?
The first thing we do when you come for an appointment in my clinic is sit down (or walk around) for a long talk. The initial intake for acupuncture treatment is going to cover both your pain symptoms and your overall health. The location, quality, severity, and duration of your pain, as well as the health of your other organ systems, are all very significant and influence your Chinese medicine diagnosis and treatment.
We will use the location of your pain to determine the affected acupuncture meridians, and then follow those meridians down their pathways to powerful points in the extremities. In the case of acute spasm, I often do not immediately apply acupuncture to muscles in spasm, choosing to treat adjacent and distal points first. For chronic pain, we are more likely to apply treatment at the affected areas.
In addition to acupuncture, we use Cupping, Guasha and Tuina medical massage to support treatments done in the clinic.
For treatment after you leave the clinic, I may suggest internal or topical herbal medicine or nutritional supplements. we will likely also give you some exercises or qigong to do at home for stretching, pain relief and even prevention of future injury. Back to Pain Types Menu
No Drugs Required
Acupuncture addresses hip pain and sciatica
Hip pain, hip arthritis and sciatica are some of the most common kinds of pain I see in the acupuncture clinic. Since any kind of hip pain adversely affects walking, people don’t hesitate to seek acupuncture pain treatment. Hip pain has many causes – sometimes it’s the hip joint (as in arthritis), sometimes it’s neurological (like sciatica), sometimes muscular (as in piriformis syndrome), and sometimes it’s referred pain from somewhere else (like the sacroiliac joint). Regardless of the source, acupuncture help with the signs and symptoms of hip pain successfully.
When we first start seeing a patient for any kind of pain, I encourage twice weekly treatments until acupuncture pain relief is achieved. After there’s relief in pain symptoms, weekly treatments can help consolidate the pain relief we achieved with the initial intensive course of acupuncture pain treatments. After about 6 or 8 weeks, maintenance acupuncture treatments are generally sufficient.
It’s important to keep in mind that acupuncture works cumulatively. Treatments build on one to the next. Likewise, relief of pain increases cumulatively. It’s important to invest in your health by sticking with treatments for at least 3 or 4 weeks.
What are the different types of hip pain acupuncture treats?
The sciatic nerve runs from the spinal cord to the hips and buttocks and down the back of each leg. So, sciatica may manifest as lower back, hip, or leg pain along the sciatic nerve pathway. Sciatica is a symptom of an underlying nerve abnormality, perhaps due to a herniated disk or other factor that puts pressure on the sciatic nerve. It is common to have referred pain with sciatica, or pain that is felt in places away from where the nerve is being impinged. The symptoms of sciatica include pain along the sciatic nerve’s pathway, numbness and tingling (even shooting pains into the leg or back), and weakness in the leg. The causes of sciatica are usually related to the spine rather than the hip join. Sciatica causes include herniated disks, narrowing of the spine (spinal stenosis), displaced vertebrae (spondylolisthesis), tightening of the piriformis muscle (this muscle connects the lower spine to the thighbones), spinal or nerve tumors, and direct injury.
The ends of the bones of a joint are protected by cartilage to prevent the bones from rubbing against each other. Pain due to hip osteoarthritis occurs when the cartilage breaks down. This allows the bones to rub together. Another type of hip arthritis, rheumatoid arthritis, is a chronic, inflammatory autoimmune disease caused by immune cells acting on the body’s own tissues. Pain due to rheumatoid hip arthritis occurs from when the immune system attacks the hip joints and their component parts. The cause of rheumatoid arthritis is unknown. The other causes of hip arthritis include advanced age, injury, and overuse. The symptoms of hip arthritis are pain, tingling, tenderness, stiffness, loss of flexibility, grating sound or sensation in the joint, and bone spurs.
Small fluid-filled bursae pad the space between bone, tendons, and muscles of joints. Hip bursitis occurs when these bursae become inflamed. The causes of hip bursitis include repetitive motion in sports or manual labor and prolonged kneeling. The symptoms of hip bursitis include aching pain in the hips, stiff hips, hip pain from movement or pressure, and swelling and redness of the hip.
How is hip pain diagnosed by my doctor?
The location of pain can hint as to the type and cause of hip injury. The diagnosis of hip pain involves:
Complete medical history
Physical exam, including specific tests for pain in the hip area
Imaging, such as X-ray, MRI, or computerized tomography (CT)
How is hip pain treated by my doctor?
Treatments for hip pain include:
Pain and/or anti-inflammatory medications
How is hip pain diagnosed by an acupuncturist?
When evaluating a patient with a pain condition, we perform orthopaedic tests, including range of motion tests and other tests to differentiate different syndromes from one another. For example, hip pain has many causes, and the root of the pain must be determined in order to achieve the best results of pain reduction.
That being said, acupuncture has been addressing pain conditions since a time well before the creation of orthopaedic tests and diagnostic imagining. I use the information I gather from a physical exam as part of my treatment strategy, but the theory behind treating hip pain still comes back to an acupuncture theory called channel theory (also known as meridian theory). By determining the affected acupuncture meridians, I can effectively give acupuncture pain relief treatments to my patients. Determining the affected meridians also informs any herbal medicine treatments we may use.
How is hip pain addressed by an acupuncturist?
Acupuncture can help wioth the signs and symptoms of hip pain by regulating the acupuncture meridians of the body. Acupuncture has been shown, from a Western biological perspective, to improve circulation, move blood and lymph and stimulate the nervous system. This in turn can help with the signs and symptoms of hip pain.
Acupuncture can be applied at the site of pain and in places related to that site in other parts of the body (e.g., in a different place along the same affected acupuncture meridian or in a mirror to the site). Herbal medicine does the same thing, but works from the inside out. We use tui na massage, cupping and gua sha to support these main modalities of treating hip pain. Back to Pain Types Menu
No Drugs Required
Acupuncture helps to treat knee pain
I am no stranger to the treatment of knee pain. I often see patients in the clinic for treatment of knee pain. From a Chinese medicine perspective, there are a number of causes, so as always an accurate diagnosis is key to getting pain relief. In addition to acupuncture, I often use tuina massage as part of my treatments because this kind of massage can help reset muscle imbalances to support the work of the acupuncture. In some cases, herbal medicine is beneficial, too.
What are different types of knee pain do you treat with acupuncture?
Knee ligament injuries
The knee contains several pairs of ligaments that are classified by their location, either intra-capsular or extra-capsular. These ligaments help stabilize the knee. The major intra-capsular ligaments are the cruciate ligaments (anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL)). The major extra-capsular ligaments are the collateral ligaments (medial collateral ligament (MCL) and lateral collateral ligament (LCL)). Tears or sprains of the ACL, PCL, LCL, and/or MCL are common in athletes that play sports that involve sudden changes in direction, such as soccer or basketball.
There are two main types of knee arthritis. Osteoarthritis is caused when the cartilage that prevents the ends of bones from rubbing together degrades over time. Rheumatoid arthritis is caused by a chronic immune system disease in which the immune system attacks the body’s own tissues, causing joint swelling and bone deformation. The causes of knee arthritis are age, injury, obesity, inactivity and overuse. The symptoms of knee arthritis are pain, tenderness, stiffness, loss of flexibility, a grating sound in the joint and possibly bone spurs.
Fluid-containing sacs, called bursae, cushion the joint. The bursa absorbs the shock of impact from walking, running and the like. Bursitis is caused when these sacs become inflamed. Common causes of bursitis include repetitive motion (athletics or manual labor) and prolonged kneeling. Some of the symptoms of knee bursitis pain include joint stiffness, pain upon movement or pressure, swelling and redness.
Patellofemoral pain syndrome
Patellofemoral pain syndrome is the result of the back of the knee cap (patella) rubbing on the thigh bone (femur). Patellofemoral pain syndrome is statistically more likely to occur in women than men and younger people rather than older ones. It is very common among athletes, too. Eventually, cartilage under the kneecap breaks down (chondramalacia), making the knee pain worse. The cause of patellofemoral syndrome is not exactly known, but we can say that it is the result of uneven strain on the knee cap during moving or resting. Some of the causes of this strain are unbalanced muscle pulling, misalignment of the joint surfaces, genu valgus (i.e., “knock knees”), and quadriceps contractures (tightening of the thigh muscles). The symptoms of patellofemoral syndrome include pain behind the knee cap (retropatellar pain), and is worse during bending the knee, contracting the thigh muscles, rapidly going from rest to movement, and after keeping the knee bent for long periods of time (AKA “movie-goer’s knee”). Pain in the knee typically appears after 30 minutes of activity or up to a few hours after stopping activity.
Chondromalacia patellae (CMP) is characterized by pain at the front and inner side of the knee. CMP often affects the adolescents who are otherwise healthy. In fact, CMP is most common in athletes. Chondromalacia patellae is caused by the irritation of the cartilage of the knee cap that allows for smooth knee bending. Chondromalacia patellae is an extension of patellofemoral pain syndrome. The causes are the same as above.
Jumper’s knee (patellar tendinitis)
The patellar tendon connects the knee cap to the shin bone. When this tendon becomes inflamed and irritated, pain can result. The term jumper’s knee implies a functional stress overload due to jumping, and so I often see this condition in basketball and volleyball players. Patients report aching pain in the front of the knee. Onset of pain is typically slow, and rarely related to a specific injury or trauma to the knee. Jumper’s knee can progress to tendon tear if left untreated.
Osgood-Schlatter disease occurs in growing children, especially those participating in sports. It affects the growth plate at the end of the leg bone. The cause of Osgood-Schlatter disease is stress on the tendon connected to the lower leg bone (tibia), which pulls on the soft growth plate. This pulling causes inflammation and pain. The symptoms of Osgood-Schlatter disease include pain below the kneecap, tightness of the thigh muscles, and pain worse with activity and better with rest.
Iliotibial band syndrome (ITBS)
The iliotibial band (ITB) extends from the hip (pelvic bone) to the larger bone of the lower leg (tibia). ITBS is the most common cause of lateral knee pain in athletes (pain on the outside of the knee). Iliotibial band syndrome is caused by inflammation of the fibers surrounding the ITB or the ITB itself. Iliotibial band syndrome usually affects athletes involved in sports that require continuous running or repetitive knee flexion and extension, like long distance running and cycling. ITBS presents as lateral knee pain worse with activities, like running, and pain going down stairs or walking/running downhill. Pain at rest is a sign of severe tendinitis, bruising of the cartilage or meniscus tear.
How is knee pain diagnosed by my doctor?
Your doctor will diagnose knee pain by:
Taking a medical history
Performing a physical exam, concentrating on knee and its function
X-ray, MRI, ultrasound, or computerized tomography (CT) imaging
How is knee pain treated by my doctor?
Your doctor may prescribe the following treatments for knee pain include:
Self-care by icing and resting
Orthotics, braces, or taping
Surgery and/or joint replacement
How does an acupuncturist diagnose knee pain?
As an acupuncturist, I was trained to evaluate pain conditions, perform physical exams and use orthopedic tests according the Western medical model. These evaluations are an important part of my practice, but when someone comes into my clinic with pain somewhere, my first step is to evaluate that pain from the perspective of an acupuncturist.
Acupuncture theory says that the meridians of the body must be unobstructed. When there is obstruction there is pain. Obstruction can be caused by injury, emotional stress and other factors. So, I evaluate each patient based on which meridian and part of the body is effected. I also do what we call a constitutional diagnosis, in which I take into account the whole body, or overall, wellness of the patient.
By putting the acupuncture diagnosis together with the Western medical diagnosis that your doctor might do, I am able to create a treatment plan.
How does acupuncture help to treat knee pain?
I address knee pain with acupuncture and tuina massage for the most part. Acupuncture and massage can help correct the obstructions and imbalances I mentioned above. When using acupuncture to treat knee pain, I use a combination of local and distal points to remove obstruction, relax muscles and improve circulation in the affected area. In other words, I apply acupuncture near or on the knee and also in other places on the leg along the affected meridians. I will often use tuina massage, moxibustion and possibly cupping to treat the pain. In some instances, I will use herbal medicine, but it is entirely dependent on the acupuncture theory diagnosis of the pain and the patient’s interest in herbal medicine. Back to Pain Types Menu
ANKLE & FOOT PAIN
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Acupuncture can address ankle and foot pain
With 26 bones, 33 joints, and over 100 tendons, your foot is a complex piece of machinery. At any place in that mix, it’s possible for a problem in the foot to cause pain. It’s also hard for the foot to heal if we’re walking around on it all day.
Enter acupuncture. Recent research shows that acupuncture treats pain better than non-acupuncture treatments. In fact, acupuncture has been shown to bring fresh blood and oxygen – the necessary components for healing – to tissues where acupuncture is applied. All of that together spells foot and ankle pain relief for you.
What are the different kinds of ankle and foot pain treated by acupuncture?
Plantar fasciitis is pain in the sole of the foot, where a thick band of tissue, the plantar fascia, runs from your heel bone to your toes. The most common cause of heel pain is plantar fasciitis. Plantar fasciitis causes a stabbing pain in the sole of the foot. The pain from plantar fasciitis is generally worst when you first get out of the bed in the morning. The pain you feel first thing in the morning likely improves after walking around a bit. This is because the plantar fascia softens up. Unfortunately, the pain usually returns after long periods of inactivity. Plantar fasciitis is common in runners, and is an unfortunate side effect of barefoot shoes. People who are overweight and pregnant women are also at risk of developing plantar fasciitis.
There are three kinds of arthritis that affects the foot and ankle: Osteoarthritis (known as “wear and tear” arthritis), rheumatoid arthritis (an autoimmune disease), and post-traumatic arthritis. The most common sites of foot and ankle arthritis are the ankle, the hindfoot, the midfoot and the joint of the first toe. Symptoms include pain, tenderness, swelling, stiffness and restricted movement, and difficulty walking.
Morton’s neuroma causes a pain in the foot, specifically the ball of the foot. Morton’s neuroma often appears between the third and fourth toes. Morton’s neuroma is a thickening of the covering around one of the nerves in the toes. Morton’s neuroma is likely caused by irritation, injury or pressure to the nerve. People describe the discomfort of Morton’s neuroma as the feeling of standing on a fold in their sock. Morton’s neuroma can also cause sharp, burning pain in the ball of the foot. In some cases, your toes may also burn or feel numb.
Gout is a kind of arthritis in which urate crystals form in your joints. This causes excruciating pain. Urate crystals form when there are high levels of uric acid in the blood. Uric acid is made from the breakdown of purines. Purines occur naturally in certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms. Gout attacks are sudden and the pain is severe. The affected joints will be red and tender. The most commonly affected joint is the one at the base of the big toe. Men develop gout more often than women, but risk of developing gout in women increases after menopause. Most patients report an acute gout attack waking them in middle of the night with a burning sensation in the big toe. During a gout attack, it is difficult to put weight on the affected foot.
An ankle sprain is a common injury. An ankle can be sprained sprained when you twist or turn your ankle in an odd way, thereby stretching the ligaments that hold your ankle together. In extreme cases, the ligaments can even be torn. Most sprained ankles are injuries to the ligaments on the outside of the ankle. Here’s a video of how a typical ankle sprain happens.
Heel spur and bone spur
A bone spur is a tiny growth of bone that grows along the edges of bones. A bone spur is also called an osteophyte. Bone spurs can occur in spine or in joints. Bone spurs are associated with wear in tear, so areas that are under a lot of stress are likely affected. For this reason, the heel is also a common site of bone spur development, called a heel spur. Most bone spurs are asymptomatic, so go unnoticed before they grow to a size that will cause pain.
Shin splints a common name for pain that occurs along the shinbone (tibia). People feel the pain of shin splints during physical activities, like running. They are caused by too much force being exerted on your shinbone and the connective tissues between the muscles and the tibia. Shin splints are common in runners and athletes playing sports that involve running, like basketball, soccer or tennis.
Achilles tendinitis is inflammation of the Achilles tendon, the tendon that attaches the calf muscles to the heel bone. Achilles tendinitis occurs in runners and other running-intensive sports. Achilles tendinitis is caused by overuse, vigorous exercise, jumping, and other movements that strain the tendon and calf muscles. Serious cases of Achilles tendinitis can end in tendon rupture, which requires surgery to be repaired.
How is ankle and foot pain diagnosed and treated by a doctor?
Your doctor will likely perform a physical exam and order imaging of the affected site (X-ray, MRI, CT scan). A doctor will suggest rest, physical therapy, anti-inflammatory medications or injections, and in some cases surgery.
How is ankle and foot pain evaluated and handled by an acupuncturist?
Regardless of the type of foot or ankle pain you are experiencing, the first thing I determine is the location of the discomfort and affected acupuncture meridians. This will allow me to select which meridians I need to use to regulate any blockages that might be causing pain.
In addition to helping with your experience of pain you are feeling in your foot or ankle, I also review a patient’s overall health. By treating a person holistically, the body becomes stronger and pain problems are less likely to return after you experience pain relief.
Because the foot and ankle are easily submerged, I often use herbal soaks to support the acupuncture treatment. Herbal soaks deliver medicine directly the site of pain. This improves circulation and encourages fresh blood and oxygen to come to the foot, speeding healing. Back to Pain Types Menu