Why Does Acupuncture Work for Pain?
When I was in acupuncture school, a famous put off from one of our instructors was to tell us that "why" is not a Chinese question. In truth, it was a reminder that Chinese medicine is based on thousands of years of keen observations that predictable results followed certain stimuli. Why something works isn't seen as especially relevant. So, I guess the Chinese medical answer to why acupuncture relieves pain is that it doesn't matter - it just does!
In practice, however, I have to contend with the American need to know why something works. Otherwise, we're left with blind trust, often in the wake of the western doctors giving the stink eye to any unorthodox forms of treatment. And in the spirit of true confessions, I myself wouldn't seek treatment of any kind without understanding the premise behind the healing. So, here goes . . .
- AS ALWAYS, IT'S ALL ABOUT THE QI
When it comes down to it, Chinese medicine revolves completely around the notion that we are manifestations of Qi (pronounced "chi"). An explanation of the concept of Qi could literally fill many pages. While I may write that book someday, I won't do it here! So, here's a quick and dirty explanation. Mostly, Qi is translated as "vital energy." After all, we would only be an unorganized heap of non-living matter without that spark of life. The Qi gives that matter organizational influence and governs the processes we know as life. In other words, Qi gives us both form and function. For purposes of discussing pain, we just need to know that the Qi physically travels through the body via a super highway system that we call meridians. These meridians travel to every part of the body and it is their superficial branches that come close enough to the exterior to be influenced with needles at the so-called acupuncture points.
When all is right with your internal world, the Qi flows abundantly and smoothly throughout the meridian system. When something knocks us off that point of balance, the Qi gets disturbed and no longer flows smoothly. We call this stagnant or obstructed Qi and it causes pain. An analogy I often use is to compare the Qi in the meridians to water flowing through a stream. If something obstructs the flow of the water (rocks, log jam, dams), water backs up and floods upstream, is cut off or reduced downstream, and there is a lot of pressure at the place of obstruction. Applying this idea back to the notion of Qi, there can be stagnant excess "upstream" (swelling, edema, or tenderness), Qi deficiency "downstream" (numbness, referred pain, tingling, or coldness), and acute pain at the site of obstruction. The nature of the pain indicates the severity of the obstruction. Sharp, stabbing, fixed pain sits at the most highly obstructed end of the spectrum; dull or roving pains are due to less severe obstructions.
- MOVE THE QI, MOVE THE PAIN
When it comes down to it, Chinese medicine is simplicity itself. Define the problem and the solution becomes self evident. In the case of pain, the solution is to resolve or bypass the obstruction and move the Qi. As practitioners, acupuncture is the main tool we use to achieve this, by stimulating the proper movement of Qi through the meridian system. We also have a number of adjunct practices we use in addition to acupuncture, such as electrical stimulation, gua sha (skin frictioning), cupping, topical herbals, and moxabustion (the application of heat on or above the skin with the herb "moxa" or mugwort.) Your acupuncturist will apply the best techniques suited to your particular pain.
While the principle of moving Qi is simple, the devil is in the details, as truly effective treatment also depends on understanding the cause of the obstruction. There are a number of reasons the Qi can get obstructed. For example, injuries, deep scars, surgeries, or other physical impairments like arthritis can cause sticking places for the Qi. Exposure to cold and damp external conditions, like bad weather or air conditioning after we get out of the pool, can also cause internal pain. The energy form of the cold and damp lodge in "hollow spaces" in the body, for example in the joints, the bladder, or the uterus. This cold and damp manifestation stagnates the Qi, much as extreme cold weather would freeze moving water. Yet another common source of pain occurs when, instead of completing the natural circuit throughout the body, Qi flies aggressively into the head and can't come back down. This results in headaches and migraines, which often have no known physical cause.
- HOW WELL DOES IT REALLY WORK?
Theory is great to discuss, but the proof, as they say, is in the pudding. Acupuncture for pain relief is probably the most documented and accepted use of the practice, even by western doctors. Heck, even animals get enormous pain relief with acupuncture. So, it's pretty safe to say that it works, placebo effect notwithstanding. How well and how fast relief can be expected depends on the nature and cause of the Qi obstruction. Generally, underlying physical injuries can take several weeks to a month or more to overcome, depending on their severity. Permanent impairment like arthritis puts us in perpetual pain management mode, meaning we can typically get relief but treatment is ongoing. Many patients are OK with that, as it allows them to reduce or eliminate medications. More energetic imbalances, like migraines or cold retention tend to respond very quickly. Pain relief can even occur right on the treatment table. Often that relief is temporary, but can typically completely resolve with continued treatment. How long resolution takes depends on how long the patient has suffered with the particular problem. The general rule is, the shorter time spent with the problem, the more quickly it resolves.
So, we come back to where we started. The important thing is that, for the vast majority of cases, acupuncture and all its adjunct practices work. And when you're in pain, nothing is as sweet as relief. Who really cares why?
