By Jamie Starkey, LAc Lead Acupuncturist, Center for Integrative Medicine Wellness Institute, Cleveland Clinic
“So, can you help me with my pain?" It’s the first question I’m asked when someone discovers I’m an acupuncturist.
There is not one person I’ve met who has not experienced pain to some degree. It can be temporary pain from a skinned knee or from slamming a thumb in the door to more chronic pain, such as low back pain, neck pain, migraines, or pain associated with serious diseases.
What happens when acute pain begins to linger and then transforms into a chronic condition? What happens when you’ve exhausted all conventional treatment options, you’ve undergone surgery, you’re on pain medication, and you’re STILL in pain?
Emotionally, you may begin to feel depressed or frustrated. The pain may prevent you from getting a full night’s sleep, so now you’re sleep-deprived and irritable. Your relationships may suffer. You may not be able to think clearly and you may experience memory loss. Chronic pain is ultimately exhausting and negatively impacts your quality of life. If severe enough, it also can negatively affect your spirit and sense of self worth.
Acupuncture is a branch of Traditional Chinese Medicine (TCM) with a rich history and lineage dating back thousands of years to ancient China. Acupuncture is truly a medical art, as each clinician uses various approaches, techniques and styles to address their patients’ conditions; no two patients are treated the same.
TCM is complex and abstract as we think in terms of the universal principles of Yin and Yang. We discuss theoretical concepts such as “Qi” (pronounced “chee”). Qi is incredibly challenging to translate, but can loosely be described as “life energy.” Qi is a fundamental concept in Eastern ideology and TCM. In China, it is referred to as “Qi.” In Japan, it is called “Ki”. Koreans refer to it as “Gi,” and in India, ayurvedic practitioners refer to this life energy as “Prana.”
Qi takes on various roles in our body. For example, it is the energy that keeps us from falling ill, the energy that forces our heart to beat, or cells to divide. In TCM, Qi is a moving force that travels along pathways in the body noted as meridians. When Qi is flowing without obstruction or without deficiency, we are in a perfect state of health and wellness. It is the moment an imbalance occurs, that we begin to fall ill and manifest in various symptoms of disharmony.
Acupuncturists have a unique and keen ability to address the patient as a whole. We take a tremendous amount of time assembling a complex jigsaw puzzle; each piece of the puzzle comprises details such as stress levels, bowel movements, response to changes in season, aversion or preference to cold or hot temperatures, menstrual cycle, etc. Our main goal is to treat the root cause of a patient’s condition. It is not uncommon for my chronic pain patients to notice improvement in pain, but they also begin noticing side benefits, such as improvement in sleep, mood, mental clarity, and overall improvement in quality of life.
Conventional medicine has begun paying closer attention to acupuncture. It is no longer looked upon as a fad, exotic, or as folk medicine. TCM is rooted in empirical evidence. Our model of medicine was shaped by thousands of years of clinical experience by ancient Chinese physicians who did not have the technology we have today. Scientists are now working backward to determine exactly why you feel better when I stick small needles into your body! A tremendous amount of data is accumulating to support acupuncture’s complex influence over the body, especially the nervous system.
Acupuncture is now available in many US hospitals and private practices. It’s even being used by the Department of Defense to treat our soldiers who are dealing with acute and chronic pain in war-torn areas such as Iraq and Afghanistan.
Your initial appointment with an acupuncturist will usually be the longest visit. You’ll undergo a detailed assessment from which a TCM diagnosis is made and appropriate treatment plan is developed. Acupuncturists are trained in various techniques and styles and use these techniques on a patient-by-patient basis.
You may experience any one or a combination of TCM techniques for pain management. Traditional acupuncture is the most commonly used and the following techniques are often added to enhance a traditional treatment.
An acupuncturist will pick a combination of points on the body called acupoints. These are regions that, when stimulated by hair-thin needles, will induce various therapeutic effects in the body, one of which is a pain-relieving effect. Once the needles are in the body, the acupuncturist will apply specific subtle and purposeful manipulations to the needles, such as twirling the needle clockwise, or counterclockwise, varying the depth of insertion, etc.
This is a technique involving moxa, the herb mugwort (Artemisia vulgaris). In TCM, this herb is used to invigorate the flow of Qi and blood, promote a pain-relieving effect, and deeply penetrate the area of discomfort with soothing warmth. The moxa herb is lit on fire and can either be placed on top of the needle (Needle Moxa); applied without the use of needles, as it can be burned in stick form as the acupuncturist hovers and swirls the stick of burning moxa above various acupuncture points; or the moxa can be indirectly placed on various acupoints on the body using a thin slice of ginger or other barrier to shield the skin. Moxibustion is particularly effective for cases like tight muscle spasms, low back pain, frozen shoulder, or various osteoarthritic joint pains, especially when pain is worsened by damp and cold weather.
This involves the placement of needles as is performed in traditional acupuncture needling, but rather than applying manual manipulation to the needles, an acupuncturist will attach electrodes from an electrical device to specific needles placed in the body. Once the electrodes are placed, the acupuncturist will adjust the frequency and wave pattern of electricity according to the patient’s condition. The device is turned on, and the patient will feel a small current of electricity move through the needles and into the soft tissue. This sensation should be comfortable as the intensity is adjusted to fit the patient’s tolerance. I will often use this technique not only for various pain conditions, but also for numbness or neuropathy.
This is a procedure involving the placement of needles solely in the ear to treat your pain condition. The auricular model is a microsystem, meaning the entire body is mapped on the ear. For pain, we tediously palpate areas of the ear for tender points that correlate to areas of pain felt in the body. Needles are placed in points that promote pain relief and sedation. All pain-related conditions can be effectively addressed using this technique.
In TCM, many pain conditions are due, in part, to stagnation of Qi and blood in the area of discomfort. Cupping is a technique in which a suction-like force holds cups against the skin for several minutes. This treatment promotes increased blood flow to the area of pain and can be quite effective for lingering pain conditions from old injuries such as whiplash, low back pain or shoulder pain.
This is another way an acupuncturist can resolve any stagnation of Qi and blood in the body that may be an attributing factor to pain. In this technique, a medium is placed on the skin, such as massage oil, which has a lubricating and protective function. The acupuncturist will then use a tool with a smooth surface – my preference is a device made of jade. The guasha tool is held in the acupuncturist’s hand and, using moderate force, the acupuncturist will rub the tool on the patient’s skin in long smooth strokes. This technique will create redness to the area as we work to break up the area of stagnation and pain.
Unlike acupuncture, this is a non-invasive technique in which an object is used to apply mild to moderate pressure to acupoints rather than puncturing the skin with needles. This object can be in the form of your fingers or other devices that can apply long-term pressure. For my patients who are migraine and headache sufferers, I will often demonstrate acupressure techniques to several acupoints, which could potentially abort the onset of a migraine or reduce its severity. Because acupressure is non-invasive, this is a technique that, when properly taught, can be used by the patient to self-treat.
The beauty of acupuncture is it can be easily incorporated into any pain management program without interfering with conventional treatment protocols, and with little to no side effects.
My personal preference is to use a multidisciplinary approach to managing pain.
At the hospital, I am fortunate enough to have the opportunity to collaborate with many specialists, inclusive of physicians, physical therapists, pain psychologists and chiropractors, among other clinical specialists. Through a team approach, each specialist brings an area of clinical expertise to the table with the ultimate goal of addressing your pain and improving your quality of life. If you are suffering from pain, speak with your provider about complementary treatments like acupuncture, and you may just find relief.