Chronic Pain
Persistent (chronic) pain is a widespread problem that affects around 8 million people of all ages in the UK (Chronic Pain Policy 2010). In 22% of cases, chronic pain leads to depression, and some 25% of those diagnosed with chronic pain go on to lose their jobs (Chronic Pain Policy 2010). In fact, around £3.8 billion a year is spent on incapacity benefit payments to those diagnosed with chronic pain (Chronic Pain Policy 2010)
The International Association for the Study of Pain has defined pain "as an unpleasant sensory or emotional experience resulting from actual or potential tissue damage.
Chronic pain may be defined as pain that lasts beyond the usual course of the acute disease or expected time of healing, and it may continue indefinitely.
Typical chronic pain conditions include:
- Osteoarthritis
- Rheumatoid arthritis
- Low back
- Shoulder and neck pain
- Headache and migraine
- Cancer pain
- Fibromyalgia
- Neuropathic pain (e.g. sciatica, trigeminal neuralgia, post herpetic neuralgia)
- Chronic overuse conditions (e.g. tendonitis)
- Chronic visceral pain (e.g. irritable bowel syndrome, interstitial cystitis, endometriosis) (Singh 2010).
Your treatment plan
After a thorough medical history and examination procedure treatment needs to address the underlying causes and any exacerbating factors.
Acupuncture
Acupuncture is commonly recognised as an aid to pain relief. N.I.C.E (the National Institute of Health and Clinical Excellence) concludes that acupuncture is a proven method to prevent tension-type headaches and migraine and doctors should prescribe it. Certain acupuncture points have been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety (1).
Acupuncture may help relieve chronic pain by:
- Stimulating nerves located in muscles and other tissues, which leads to release of endorphins and other neurohumoral factors (e.g. neuropeptide Y, serotonin), and changes the processing of pain in the brain and spinal cord (2-6).
- Increasing the release of adenosine, which has antinociceptive properties (8).
- Modulating the limbic-paralimbic-neocortical network (9).
- Reducing inflammation, by promoting release of vascular and immunomodulatory factors (10, 11).
- Improving muscle stiffness and joint mobility by increasing local microcirculation which aids dispersal of swelling (12).
Massage
A combination of bodywork such as tui na, acupressure, massage, reflexology, relaxation, breathing and mindful awareness exercises are also a core strategy that has proven helpful for many people.
Other Lifestyle factors - Creating restful sleep patterns, making sure you have the right diet, nutrients and nourishing eating habits are also key, as well as addressing any emotional issues that may be involved.
British Acupuncture Research Fact Sheets - For further information please take a look at the related issues section on the right hand-side of the screen.
- Wu MT et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain-- preliminary experience. Radiology 1999; 212: 133-41.
- Pomeranz B. Scientific basis of acupuncture. In: Stux G, Pomeranz B, eds. Acupuncture Textbook and Atlas. Heidelberg: Springer-Verlag; 1987: 1-18.
- Han JS. Acupuncture and endorphins. Neurosci Lett 2004; 361: 258-61.
- Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008; 85: 355-75.
- Zhou Q et al. The effect of electro- acupuncture on the imbalance between monoamine neurotransmitters and GABA in the CNS of rats with chronic emotional stress-induced anxiety. Int J Clin Acupunct 2008 ;17: 79-84.
- Lee B et al. Effects of acupuncture on chronic corticosterone-induced depression-like behavior and expression of neuropeptide Y in the rats. Neuroscience Letters 2009; 453: 151-6.
- Cheng CH et al. Endogenous Opiates in the Nucleus Tractus Solitarius Mediate Electroacupuncture-induced Sleep Activities in Rats. Evid Based Complement Alternat Med 2009 Sep 3. [Epub ahead of print]
- Goldman N et al. Adenosine A1 receptors mediate local anti- nociceptive effects of acupuncture. Nat Neurosci 2010 May 30. [Epub ahead of print]
- Hui K.K.-S. The salient characteristics of the central effects of acupuncture needling: limbic- paralimbic-neocortical network modulation. Human Brain Mapping 2009; 30: 1196-206.
- Kavoussi B, Ross BE. The neuroimmune basis of anti- inflammatory acupuncture. Integr Cancer Ther 2007; 6: 251-7.
- Zijlstra FJ et al. Anti-inflammatory actions of acupuncture. Mediators Inflamm 2003; 12: 59-69.
- Komori M et al. Microcirculatory responses to acupuncture stimulation and phototherapy. Anesth Analg 2009; 108: 635-40.