Acupuncture for Pain Relief
Acute pain is short-lived, and what we experience when we’ve had an accident or injury. Once this has healed, our pain disappears. Chronic pain however, defined as any persistent pain lasting more than three months, can be life changing. This is the reality for the 28 million UK adults living day in day out with chronic pain (Fayaz et al, 2016).
There are many reasons why so many of us live a life in pain. It may be from an old musculoskeletal injury, post-surgery; from degenerative diseases such as osteoarthritis; autoimmune diseases; neuropathic pain; chronic visceral pain; or even cancer. Regardless of the cause or label, the impact on our mental health is often similar, as everyday becomes a struggle.
Pain restricts normal everyday routines – it can prevent us from sleeping and resting, exercising, work and earn a living, be social, play with our children and grandchildren, and partake in the recreational activities which bring us pleasure and a sense of purpose. It is easy to understand therefore why 85% of patients with pain conditions also suffer from depression (Bair et al, 2003) and how it can leave us feeling isolated, pessimistic, irritable and worthless.
How can acupuncture help pain relief?
The focus of an acupuncture treatment is to treat the root cause of the pain, not just the pain itself. From a conventional medical point of view, acupuncture is thought to provide pain relief in several ways:
- by stimulating nerves to release endorphins which alter the pain processing in the brain and spinal cord (Pomeranz 1987; Zhao et al, 2008);
- reducing inflammation – by promoting release of vascular and immunomodulatory factors (Kim et al, 2008, Kavoussi 2007; Zijlstra 2003);
- improving muscle stiffness and joint mobility – by increasing local microcirculation (Komori et al, 2009), which aids dispersal of swelling and bruising;
- reducing the use of medication for back complaints (Thomas et al, 2006); and
- improving the outcome when added to conventional treatments such as rehabilitation exercises (Ammendolia et al, 2008; Yuan et al, 2008).
The path of pain in the body and conventional treatment (read more)
Although unpleasant to experience, pain is part of our body’s sophisticated protective mechanism. Nociceptors, sensory neurons found throughout the body, detect any potentially dangerous changes in temperature, chemical balance or pressure in our system. When nociceptors are stimulated, they send electrical signals to the brain. The brain evaluates the information and produces pain causing us to stop and change our behaviour e.g. removing our hand from the hot plate.
With chronic pain however, we feel and process pain messages differently because our nervous system has been altered – our nerve cells may become so sensitive that even a light touch can cause the brain to interpret the pressure as painful (Koestler & Myers, 2002).
Conventional medical treatment aims to reduce pain and improve function so we may resume our daily activities. The goal of the treatment is to manage the pain because it can’t usually be cured (National Institute of Health, 2011).
Doctors often treat pain by prescribing medication such as analgesics (paracetamol) or non-steroidal anti-inflammatory drugs (NSAIDs) or opioids (morphine), but long-term use of these medications can cause side effects such as toxicity to the kidneys (NSAIDS) and liver (paracetamol); gastritis (aspirin) and nausea, vomiting and constipation (opioids) (Stephenson, 2011).
The NHS also recommends physical therapy delivered by an osteopath, chiropractor or a physiotherapist; meditation; hypnotherapy and acupuncture (NHS Choices, 2017) through NHS pain clinics.
Research
For further information on research that has been carried out with regards to acupuncture and pain relating to endometriosis, fibromyalgia, frozen shoulder, neck and back pain, neuropathic, post-operative pain, rheumatoid arthritis and chronic pain please see specific research fact sheets on the British Acupuncture website (https://www.acupuncture.org.uk/category/a-to-z-of-conditions/a-to-z-of-conditions.html)
Arch Intern Med. 2006 Feb 27;166(4):450-7.
Acupuncture in patients with chronic low back pain: a randomized controlled trial.
Brinkhaus B1, Witt CM, Jena S, Linde K, Streng A, Wagenpfeil S, Irnich D, Walther HU, Melchart D, Willich SN.
Ammendolia C et al. (2008) Evidence-informed management of chronic low back pain with needle acupuncture. Spine Journal, Jan-Feb; 8(1): 160-72.
Bair, MJ; Robinson, R. L; Katon W, et al. (2003). Depression and Pain Comorbidity. Archives of Internal Medicine. 163 (20), 2433-2445.
Fayaz A, Croft P, Langford RM, et al (2016) Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies BMJ June 2016;6:e010364. doi: 10.1136/bmjopen-2015-010364
Kavoussi B, Ross BE. (2007) The neuroimmune basis of anti-inflammatory acupuncture. Integrated Cancer Therapy; 6: 251-7.
Koestler, A. & Myers, A. (2002). Understanding Chronic Pain. Mississippi: University of Mississippi.
Komori M et al. (2009) Microcirculatory responses to acupuncture stimulation and phototherapy. Anaesthesia & Analgesia; 108: 635-40.
Kim HW, Uh DK, Yoon SY, Roh DH et al. (2008) Low-frequency electroacupuncture suppresses carrageenan-induced paw inflammation in mice via sympathetic post-ganglionic neurons, while high-frequency EA suppression is mediated by the sympathoadrenal medullary axis. Brain Research Bulletin. Mar 28;75(5):698-705.
NHS Choices. (2017). How to get NHS help for your pain. Available: http://www.nhs.uk/Livewell/Pain/Pages/Longtermpain.aspx. Last accessed 23 Aug 2017.
National Institute of Health. (2011). Chronic Pain: Symptoms, Diagnosis, & Treatment. National Institute of Health. 1 (1), 5-6.
Pomeranz B. (1987) Scientific basis of acupuncture. Stux G, Pomeranz B, eds. Acupuncture Textbook and Atlas. Heidelberg: Springer-Verlag; 1987: 1-18.
Stephenson, C. (2011) The Complementary Therapists Guide to Conventional Medicine. Elsevier pp333
Thomas KJ, MacPherson H, Thorpe L, Brazier J et al. (2006) Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain. BMJ. Sep 23;333(7569):623.
Yuan J et al. (2008) Effectiveness of acupuncture for low back pain: a systematic review. Spine; 33(23): E887-900.
Zhou Q et al. (2008) The effect of electro-acupuncture on the imbalance between monoamine neurotransmitters and GABA in the CNS of rats with chronic emotional stress-induced anxiety. International Journal of Clinical Acupuncture;17: 79-84.
Zijlstra FJ et al. (2003) Anti-inflammatory actions of acupuncture. Mediators Inflammatory; 12: 59-69.
Further Reading:
‘Does acupuncture work for chronic pain? Here’s what the science says.’ Article by Washington Post, 24th July 2023
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