Pain: Chronic and Acute

Written by Scott Schauland, LAc

Father and son playing soccer in a park

The Chinese Medicine view on treating pain

The feeling of pain is most commonly associated with the disease (病 bìng) of “impediment” (痹 bì) in Chinese Medicine, which is a kind of blockage or obstruction of the normal flow of qi and blood throughout the body. When the body’s channels are blocked, not only can pain result, but also numbness and other forms of dysfunction. When treating pain, we’re treating bì-syndrome.

“Where there is pain, there is stagnation.”

– common saying in Chinese Medicine

There are a number of different reasons why things become obstructed and stagnant. For instance, pathogenic factors such as wind, cold, or damp can cause dysfunction and blockages.

These pathogenic factors manifest with different signs and symptoms of the pain. For instance, wind type pain tends to move from area to area, with the pain coming and going. Cold type pain tends to stay in the same place, be constant, sharp and tight, and improve with the introduction of warmth. Damp type pain tends to be heavy and achy, and worsen with changes in barometric pressure and humidity.

There is also pain after an injury, which tends to be qi and blood stagnation type pain. When qi stagnation is predominant, the pain will fluctuate and won’t be as sharp. When blood stasis predominates, there can be bruising and discoloration, and more constant sharp pain. The two usually happen simultaneously.

Sometimes the way in which we were injured causes other pathogenic factors to enter the injured site. For instance, if a person falls on their knee in the middle of winter while wearing shorts, they are more likely to develop cold type bi in addition to the qi and blood stagnation type.

In addition to what are classified as “excess” patterns of bi-syndrome, there are also deficient patterns. When the yang qi (basically the vitality of the body) is deficient, that allows cold and damp pathogens to increase in the body, leading to pain from the obstruction of healthy circulation.

When assessing pain due to an external injury, just like with Western Medicine, we consider the three phases of healing. There is the initial phase, during which there will be greater swelling, redness, heat, and loss of function. Instead of ice, we use topical herbal remedies to reduce the excessive heat and increase the circulation, such as “san huang san”. There are also specific acupuncture techniques that can help with the initial phase of healing.

Ice is considered very restrictive to the channels, and therefore in most cases it leads to further injury and a prolonged time of healing the injury. As a matter of fact, Gabe Mirkin (who invented the acronym RICE: rest, ice, compression, elevation) says that it’s no longer his recommendation to use ice.

In my personal view, ice should only be used in the case where the injured site is very hot to the touch, only for up to 20 minutes at a time, and only for up to 48-72 hours. After that, it’s no longer effective and actually does damage to healthy tissue.

There are better ways of dealing with the pain, reducing swelling, and improving the speed of healing.

In the second and third phases of healing, support is given to the body’s self healing process which reduces the time of being injured.

Chinese Medicine writings on this topic

Although these books are written only for practitioners who have the educational background necessary to understand them, I consider these books the most useful regarding the treatment of pain.

The Treatment of Pain with Chinese Herbs and Acupuncture, 2nd edition by Peilin Sun. I was impressed when I first saw this book, which is a comprehensive overview of treating the different types of pain from a TCM perspective.

Bodymapping Acupuncture Technique by Cole Magbanua. Having seen some of Cole’s continuing education courses, I was really impressed with how he took Dr. Tan’s Balance Method, and Master Tung’s needling, and really clarified and expanded upon it. My results in clinic, as well as just treating myself for pain, have been very impressive with his Bodymapping style.

Scientific evidence for acupuncture’s pain reducing effects

Evidence Based Acupuncture did a broad overview of the research on treating pain conditions. If you want the most up-to-date and extensive info, just check out that link.

Also, here is a research article on acupuncture for pain conditions, which was published in the American Journal of Pain in 2018. They did a meta analysis on 20,827 different patients who received acupuncture for varying pain conditions, and concluded that the modality is effective, with lasting results. They also found that the results are definitively above and beyond placebo effect.

This next research article was published in the American Journal of Emergency Medicine in 2016. They compared acupuncture against IV morphine for acute pain cases in 300 different patients. Acupuncture was 92% effective for pain relief, compared to morphine which was only 78% effective. Morphine is a very strong drug, so that’s surprising! It took roughly 16 minutes for acupuncture to be effective, compared to taking roughly 28 minutes for morphine to kick in. Also, out of both groups, 89 experienced minor adverse effects…85 of them from the morphine, and 4 of them from the acupuncture. (An example of a minor adverse effect is bruising).

Aside from scientific research, and in my personal experience, it’s only in very rare cases that pain doesn’t improve at all with acupuncture. Sometimes there is drastic improvement quickly, and sometimes it’s a gradual process of decreasing pain.

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