March 2, 2019 Cathryn

Pain and Acupuncture

What is Pain?

Pain is often complex and debilitating affecting jobs, relationships, mental and emotional wellbeing, sleep, ability to exercise and overall health. Managing ongoing chronic pain often involves taking a multidisciplinary approach. Here we provide a guide on the types of pain and some simple ways you can manage pain.

How is Pain Classified?

Pain is defined by the International Association for the Study of Pain (IASP) as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage (1)

Pain can be classified in a number of different ways with some of them overlapping such as

  • Physiological pain due to nociceptive, neuropathic and/or inflammatory response
  • Mild, moderate or severe
  • Acute, Chronic or acute on chronic
  • Type of tissue involved  such as skin, muscles, viscera, joints, tendons, bones
  • Syndromes or disease such as endometriosis, fibromyalgia, cancer, migraine etc.

Pain the signs and symptoms

  • Stinging
  • Burning
  • Ache
  • Sore
  • Stiffness
  • Throbbing
  • Anxiety
  • Depression
  • Moodiness
  • Sleep problems
  • Fatigue and weakness
  • High blood pressure
  • sweating
  • change in skin and body temperature
  • inflammation
  • joint deformity
  • change in body posture

How Pain is assessed?

Physical examination is only one aspect of pain assessment. Self-reports are the most reliable indicators of pain and no one tool should be used as an absolute measure of an individual’s experience. There are, however, various assessment tools such as the visual analogue scale, abbey pain scale for people whom are unable to verbalise and the Wong-Baker faces tool (often used in children over three years of age (2)

 

The Wong baker faces scale

 

 

 

 

 

 

How many Australians suffer with Pain?

  • In 2007-2008 approximately 67% or 11.1 million people in Australia aged 15 years and over reported experiencing bodily pain. (3)
  • More Australian adults experienced chronic pain in 2007–08 than in 1995. Rates of overall body pain has increased from 57% to 68%, whilst severe/very severe pain increased from 7% to 10%. (3)
  • The average cost of chronic pain is estimated at $34 billion dollars
  • Arthritis and back problems are the most common reason people drop out of the work force
  • More than 700,000 women suffer from crippling symptoms of pelvic pain and conditions such as endometriosis including severe period pain at a cost of $6 billion per year in Australia (3)

Common Pain conditions we treat?

  • Back pain
  • Shoulder pain
  • Hip pain
  • Headache
  • Migraine
  • Plantar fasciitis
  • Knee pain
  • Fibromyalgia
  • Arthritic pain
  • Sciatica
  • Digestive Pain
  • Pelvic Girdle pain in pregnancy
  • Symphysis pubis dysfunction
  • Painful Periods
  • Endometriosis

Treatment Options for Pain?

Alongside conventional treatment there are also a number of complementary treatment options to consider for managing pain such as diet, relaxation and acupuncture.

Diet

A well balanced diet with plenty of fresh fruit and vegetables is important for general health and wellbeing. However for pain it is important to take a more targeted individualised approach to efficiently manage inflammation. Here is what some recent research provides to efficiently manage inflammation

  1. Support Gut Health with the correct prebiotic and probiotic’s to modulate immune function, support digestion and reduce intestinal hyperpermeabiilty (leaky gut) as it is noted as a contributor to inflammation. One reason is due to the passage of lipopolysaccharides (LPS). LPS are endotoxins (present on the cell wall of gram-negative bacteria) that may elicit an immune/inflammatory response. Consuming soaked then cooked legumes, fruits, and vegetables such as chicory and Jerusalem artichoke are good sources of prebiotic fibres (4)
  1. Proteolytic enzymes, such as bromelain, papain and trypsin assist in the breakdown of numerous inflammatory by-products such as bradykinin, making them useful in addressing the symptoms of inflammation and injury. Proteolytic enzymes can be used for swelling, pain, redness and recovery during intense training and exercise. It is important to ensure you are taking the correct enzymes for your condition, dosing correctly and taking at the correct time for pain management.  (5,6)
  1. Anti-inflammatory diets inclusive of foods such as fish for their omega-3 fatty acid content and herbs such as curcumin/turmeric. Research has shown that curcumin blocks inflammatory cytokines and enzymes, including cyclooxygenase-2 (COX-2), the target that the pharmaceutical medication Celebrex targets, without the side effects (7). However turmeric contains only 2-6% of curcumin so check the standardised amount of curcumin.
  1. Magnesium reduces pain and is necessary to breakdown substance P (a compound responsible for the sensation of pain) (9). Foods containing magnesium include legumes, nuts and seeds, green leafy vegetables such as kale and spinach.

Relaxation techniques to manage pain:

Relaxing your muscles and mind are important in managing pain this may include actives such as mindfulness, meditation, listening to music, gardening, gentle exercise, massage and acupuncture.

A recent research article showed that Acupuncture increase’s the release of endorphins, (11) he body’s own ‘feel-good’ chemicals, which play  an important role in the regulation of physical and emotional stress responses such as pain, heart rate, blood pressure and digestive function. (12, 13, 14, 15).

Acupuncture for Pain

There is substantial clinical evidence to support acupuncture for the relief of both acute and chronic pain according to a number of systematic reviews and randomised controlled trials (16,17,18,19,20,21).

In china and other countries acupuncture for pain relief is provided daily as part of the medical system to ease the symptoms of conditions such as:

  • Osteoarthritis and rheumatoid arthritis
  • low back pain
  • fibromyalgia
  • sciatica
  • Migraine
  • Painful periods

If you feel this information may help a friend or you would like more information about acupuncture, diet therapy and additional pain management strategies please Contact us or you can make an appointment on line BOOK online.

 

 

References:

  1. Pain, IASP terminology. International Association for the Study of Pain 2018, https:// www.iasp-pain.org/terminology?navItemNumber=576#Pain
  2. Garra G, Singer AJ, Taira BR, et al. Validation of the Wong-Baker FACES Pain Rating Scale in pediatric emergency department patients. Acad Emerg Med 2010;17(1):50-54.
  3. ABS, National Health Survey, Characteristics of bodily pain in Australia, 2007–2008 http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4841.0Chapter12011
  4. Rodes L, Khan A, Paul A, et al. Effect of probiotics lactobacillus and bifidobacterium on gut-derived lipopolysaccharides and inflammatory cytokines: an in vitro study using a human colonic microbiota model. J Microbiol Biotechnol 2013;23(4):518-526. 3
  5. Bucci LR. Nutrition applied to injury rehabilitation and sports medicine, CRC Press, Inc, Florida: 1995.
  6. Bromelain monograph. Altern Med Rev 1998;3(4):302-305
  7. Arthritis Foundation 2018
  8. Weglicki WB, Chmielinska JJ, Tejero-Taldo I, et al. Neutral endopeptidase inhibition enhances substance P mediated inflammation due to hypomagnesemia. Magnes Res 2009;22(3):167S-173S
  9. Lam M, Galvin R, Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2124-38.
  10. Manyanga T, Froese M, Zarychanski R, Abou-Setta A, Friesen C, Tennenhouse M, et al. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complement Altern Med. 2014;14:312.
  11. Da Silva AN. Acupuncture for migraine prevention. Headache. 2015 Mar;55(3):470-3.
  12. Qin 2015 (SR & MA of 11 RCTs; 10 acupuncture vs medications; 1 acupuncture vs sham): Acupuncture may be superior to drugs and may enhance the effect of drugs for patients with sciatica; low quality evidenc
  13. Xiang, A., Cheng, K., Shen, X., Xu, P., & Liu, S, 2017, The Immediate Analgesic Effect of Acupuncture for Pain: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM2017, 383719
  14. Liu T, Yu JN, Cao BY, Peng YY, Chen YP, Zhang L. 2017, Acupuncture for Primary Dysmenorrhea: A Meta-analysis of Randomized Controlled Trials. Altern Ther Health Med. 2017 Nov 7
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