Acupuncture for Chronic, Neuropathic & Post-Operative Pain
If you are suffering from long term, chronic pain – acupuncture may help
Chronic pain is persistent pain that extends beyond the expected period of healing. It may be associated with arthritis, low back pain, shoulder and neck pain, migraines and headaches, cancer, fibromyalgia, neuropathic pain, repetitive strain injuries and visceral pain conditions, such as IBS.
In many cases, chronic pain may lead to depression.
ABOUT NEUROPATHIC PAIN
Neuropathic pain is typically described as burning, stinging, shooting, stabbing or ‘electric-shock like’ in nature.
Types of neuropathic pain include:
Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy (RSD), is a chronic systemic disease characterised by severe pain and sensitivity, swelling, and changes in the colour and texture of the skin. Usually triggered by an injury or surgery, the body responds with an amplified and disproportionate pain response. It may initially affect an arm or leg and spread throughout the body. Some cases of CRPS gradually improve over time, other cases of CRPS show no improvement, and the affected person will experience pain for many years. The constant pain and reduced quality of life with CRPS has been known to cause psychological problems, such as depression and anxiety. Conventional treatment includes pain relief medication, physical rehabilitation and psychological support.
Central Pain is a neurological condition caused by damage or malfunction in the central nervous system (CNS) which causes a sensitisation of the pain system. The extent of pain and the areas affected relate to the cause and location of the injury. Damage to the CNS may be caused by car accidents, trauma, amputations, spinal cord injury, stroke, tumours, Multiple sclerosis, Parkinson’s disease, Rheumatoid arthritis, and epilepsy. Central pain may develop months or years after injury or damage to the CNS. Conventional treatment involves a range of medications. Reducing stress and applying hot or cold can help.
Meralgia Paraesthetica is a condition where pain, burning, numbness or tingling in the outer thigh is caused by injury and/or compression to the cutaneous femoral nerve that extends from the thigh to the spine. Compression may be caused by long term sitting, wearing tight trousers, carrying an object, such as keys or a mobile phone in the anterior trouser pocket. Alternatively the nerve may be damaged by diabetic neuropathy or trauma such as a seat belt injury in an accident. Treatment includes changes in lifestyle and behaviour, to limit or remove any sources of compression, and medication.
Diabetic Neuropathy is a common complication of both type 1 diabetes and type 2 diabetes and leads to serious foot ulcers which can lead to limb amputations. Risk factors include age, smoking, poor blood sugar control, long term diabetes, high blood pressure. The condition affects all body organs and systems and thus the range of symptoms is extensive. Musculoskeletal symptoms include numbness and tingling of extremities, altered sensation, muscle weakness, burning or ‘electric’ pain. Treatment involves tight glucose control and a range of medications to reduce pain.
Trigeminal neuralgia (TN or TGN) is characterised by intermittent episodes of very severe shooting, burning or shock-like facial pain. It is caused by irritation of the trigeminal nerve, usually due to compression by adjacent blood vessels in the face. Less commonly it may be due to multiple sclerosis or a tumour. The trigeminal nerve has three branches which originate from in front of the ear and travel to the eye, the upper jaw and the lower jaw respectively. One, two or all three branches may be affected. Pain may be felt in the ear, eye, scalp, forehead, cheeks, nose, teeth, lips or jaw. In around 10% of cases the condition occurs on both sides of the face. The pain is usually triggered by activities which involve light touching of the face including eating, washing or brushing the teeth. It may also be triggered by moving the head or by the wind (breeze or air conditioning).TGN has been described as one of the most painful and distressing conditions. In severe cases, attacks may occur hundreds of times a day adversely affecting quality of life and resulting in depression.TGN is not easy to treat, but can be controlled to some degree with medication and, in severe cases, with surgery.
Vulvodynia is a chronic pain syndrome that affects around one in six women. It is characterised by a burning, stinging or sharp pain that occurs in the vulva and the entrance to the vagina. The condition is called vulvar vestibulitis syndrome (VVS) or vestibulodynia if the pain is localised to the vestibular area. VVS is the most common type of vulvodynia affecting pre-menopausal women. Vulvodynia may occur without a clear identifiable cause. Possible causes include autoimmune responses, allergy, infections, nerve damage following surgery, carcinoma, pelvic floor dysfunction and use of some contraceptive pills before the age of 16. Symptoms may be triggered by sexual activity, use of tampons or prolonged sitting or riding. In severe cases it may be constant. The effectiveness of conventional treatment varies from case to case and includes vulvar care, medication, counselling and dietary changes. If you have vaginal pain it is important to seek medical advice to get a clear diagnosis.
Post- Herpetic Neuralgia (Shingles)
If you have severe pain or think you may have a type of neuropathy you should seek medical advice.
ABOUT POST OPERATIVE PAIN
Post operative pain is caused by injury to your skin, nerves and muscles during surgery. The intensity of pain is greatest at the onset of injury, pain intensity reduces with healing. The degree of postoperative pain you experience depends on the extent and location of your operation. Thoracic or upper abdominal surgery is more painful than procedures involving the head, neck or limbs. Postoperative pain will be greater with surgical procedures that penetrate the body cavity or the outer lining of the lungs. Recently, peripheral and central (central nervous system) sensitisation have been shown to play a part in post operative pain. More than 75% of patients undergoing surgery suffer from acute post operative pain. Acute post operative pain may transform into chronic pain. Currently, treatment of post operative pain is based mainly on medication. Being anxious can make post operative pain worse.
Acupuncture for Chronic, Neuropathic & Post-Operative pain
The World Health Organization report on acupuncture and clinical trials (2003) states that acupuncture has been proven effective for the treatment of postoperative pain and that therapeutic effect has been shown for treating reflex sympathetic dystrophy (CRPS) and post herpetic neuralgia (shingles)
Research reviews suggest that acupuncture may be a useful adjunct to conventional treatments for the management of chronic pain, including post operative pain.
Acupuncture may specifically help to treat neuropathic pain by:
- Inhibiting allodynia (pain resulting from harmless touching of the skin) and hyperalgesia (abnormally high pain sensation)
- Influencing the neurotrophic factor signalling system important in neuropathic pain. (Neurotrophic means having a selective affinity for nervous tissue)
- Reducing hypersensitivity induced by spinal nerve ligation (application of a ligature)
- Reducing muscle stiffness and improving joint mobility by improving circulation which aids reduction in swelling
- Reducing inflammation
- Acting on the areas of the brain known to reduce sensitivity to pain and stress
Acupuncture may help relieve symptoms of post operative pain by:
- Altering the brain’s chemistry,
- Increasing production of the body’s natural pain killers – endorphins
- Reducing serotonin levels
- Calming sympathetic nervous activity, to promote relaxation and reduce tension
See also:
Treating Chronic & Neuropathic Pain
“In clinic I use a range of techniques to help provide pain relief including, traditional body acupuncture, ear acupuncture, Battlefield acupuncture, moxibustion and Scenar therapy, depending on your particular needs.
Generally speaking, the earlier acupuncture can be given in cases of neuropathic pain, the better the results. Mild cases of neuropathy, such as early stage carpal tunnel syndrome respond better than more severe and chronic cases.
It is important to look at the patient and their symptoms holistically. If we can understand the patient’s underlying imbalances and why they, as an individual, developed this condition, we are better placed to help them. We don’t just treat the patient’s neurological symptoms, we treat the whole person.
In very severe cases, the effectiveness of acupuncture in giving relief from neuropathic pain may be limited, but even in these cases acupuncture can have a very significant effect. By reducing anxiety and stress and helping the patient to bear the emotional dimensions of the pain, we can help improve their quality of life.”
Treating Post-Operative Pain
“In my experience, traditional acupuncture techniques can be very effective in the treatment of post-operative pain. Ancient Chinese Medicine views pain as a ‘stagnation of blood and energy’ at the site of the surgery or scar. Using acupuncture points on the hands or feet, at the ends of the energetic pathways that pass through the area of pain can help move that stagnation, promote circulation and healing and reduce pain.
Acupuncture can also be very helpful in promoting healing of scar tissue.”
FURTHER INFORMATION
Backer, M & Hammes, M (2010). Acupuncture in the Treatment of Pain, An Integrative Approach. Elsevier
Research Fact Sheets
For more information see the British Acupuncture Council Research Fact Sheet below.
