Pain

The most common symptom which will bring patients into a medical office is pain. It is often easy to ignore a disease process until it becomes painful, and if left unchecked, most disease patterns will progress to exhibit pain as one of the symptoms. It is important to realize that pain is never the primary disease, but always a secondary symptom of a disease pattern. Both allopathic and holistic medicine excel in the treatment of pain, but the approaches are different. An allopath utilizes a number of approaches to very quickly and efficiently eradicate pain from the body. These include anti-inflammatory medications such as corticosteroids and NSAIDs, pain receptor blockers such as opioids and cannabinoids more recently, and in some cases medications which regulate the nervous system such as anti-depressants and anti-convulsants. All of these methods can be very effective at pain relief, some have side effects which are worse than others. The primary difference between this and the holistic approach is that a physician practicing holistic medicine will identify and treat an underlying cause for the pain rather than attempting to treat the pain itself.

Within the context of Chinese medicine, pain can be caused by many different factors including heat (inflammation), cold (constriction), blood stagnation, or qi stagnation, but any progression leading to pain has in common that it causes a stagnation of proper circulation locally, which causes the pain.

Heat leading to pain can be seen in a condition such as rheumatoid arthritis, where inflammation in the joints causes pressure. It is characterized by the classic symptoms of inflammation: Red coloration, swelling, hot to the touch, and with distending, throbbing pain. Heat type patterns also tend to present acutely and aggressively, and they often manifest in the upper body or the exterior of the body. If true heat is at the root of the disease pattern, clearing heat is the most appropriate method. This is achieved with bitter and salty flavored herbs, or with pharmaceuticals such as steroids, nsaids, and tylenol. Heat may present though without being at the root of the disorder. For example, chronic stagnation locally in the body will often cause the build up of heat. In this case the root is the stagnation and inflammation is the expression. Clearing heat in this pattern will ease the pain but not heal the condition.

Pain cause by cold can still present with inflammation (since cold causes stagnation), but pain can stem from a purely cold pattern as well. This will more often be a chronic pain pattern (though it can also be acute), and it is characterized by constriction, tight muscles, and a deep ache. Cold type pain more commonly manifests in the interior of the body and the lower body, especially affecting the low back and hips. This type of pain pattern is most effectively resolve with pungent, spicy herbs which are warming, and it is ill suited to be treated with the standard pharmaceutical regimen.

Blood stagnation is another common cause of pain. This type of pattern is vividly illustrated in the aftermath of acute contusion. Following a direct local trauma the body often quickly presents with swelling, bruising, and pain. This is pain caused by blood stagnation. The trauma causes the rupture of local capillaries, which spill blood out into the surrounding tissues; this is the bruise, we can see the degree of bleeding by the severity of bruising. As a result of the broken capillaries, local stagnation arises. Capillaries normally function to perfuse tissues, providing a route for waste to be eliminated and for new resources to be brought into the area. If these pathways are disrupted, waste material will build up and new resources (like oxygen etc) cannot come into the tissues. Lactic and carbonic acid are byproducts of cellular metabolism/respiration, and these are often the biggest culprits of pain in an acute bloods stagnation pattern since they are not quickly being eliminated from the local area. In order to accommodate this challenge, the body will flood the region with interstitial fluid to facilitate circulation while the blood vessels are compromised. This swelling is an important part of the healing process, but often another contributor to the pain. Although acute blood stagnation is the easiest to visualize, chronic blood stagnation disorders are also common causes of pain. This can come secondary to one or several traumatic injuries which are not properly treated and which have left old, stagnant blood in a muscle or joint. Remember that internal bleeding is a very common aspect of trauma. Anytime bruising occurs there is bleeding. If this is met with ice, for instance, chronic pain may develop. This is because the ice introduces cold to the bruised region. This cold encourages coagulation of the blood and fluids, it decreases the swelling, and it can prevent the elimination of that blood, instead encouraging it to stagnate. Another common mixed pattern which is a cause of blood stagnation is underlying local cold which constrict the muscles and prevent proper flow. Blood stagnation patterns are generally met with herbs which work to invigorate blood flow and break up blood stasis, warming the local area, and physically facilitating increased circulation with mechanical stimulation or by adding heat or topical liniments.

All types of pain benefit from improving circulation, it is important to not use too many warming substances when the primary issue is heat and not too many cooling substances when the primary issue is cold. An acupuncturist or herbalist can help you determine what is the most appropriate course of treatment.