Pain Relief

Presented by:Dr Katalin Csoka L.Ac., Diplomate in Acupuncture, Ph.D., M.D. (Hungary)

Website: www.biorient.com

Integrative Approach:Biomedicine/Western Medicine Chinese Medicine Science

Contents:I. Facts What is Pain? Clarification on pain-related terms Characteristics of pain Pain management/Facts Treatment of pain (East-West) Traditional Chinese Medicine-TCM TCM Treatment Modalities Auricular Pain Management Integration of TCM with Western Medicine Advantages of TCM

II. Summary

What is Pain? Pain is a feeling triggered in the nervous system.

Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body.

Pain can be helpful. Without pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment. Once you take care of the problem, pain usually goes away. However, sometimes pain goes on for weeks, months or even years. This is called chronic pain. Sometimes chronic pain is due to an ongoing cause, such as cancer or arthritis. Sometimes the cause is unknown.

Clarification on pain-related terms

The word pain used without a modifier usually refers to physical pain, but it may also refer to pain in the broad sense, i.e. suffering

Nociception, the unconscious activity induced by a harmful stimulus in sense receptors, peripheral nerves, spinal column and brain

Qualifiers, such as mental, emotional, psychological, and spiritual, are often used for referring to more specific types of pain or suffering

The term unpleasant or unpleasantness commonly means painful or painfulness in a broad sense

Certain characteristics of the pain

Quality Intensity Localization Radiation Frequency and Duration Onset and Offset Exacerbating Factors Ameliorating Factors

Cont….Certain characteristics of the pain Localization of pain

Referred pain

Pain threshold

Pain tolerance hyperalgesia hypoalgesia pain scale

Pain management Multidisciplinary approach

Pharmacologic measures-analgesics/anesthesia Physical exercise, Psychological measures

Medical specialties Anesthesiologist, Neurologist, Physiatrists or Psychiatrists Physiotherapists, Chiropractors, and Occupational Therapists

Complementary and Alternative Medicine (CAM) Traditional Chinese Medicine, herbal medicine, acupuncture Nutritional Supplements Hypnosis

Fact #1

*Sources:Pain – 76.2 million people, National Centers for Health StatisticsDiabetes – 20.8 million people (diagnosed and estimated undiagnosed), American Diabetes AssociationCoronary Heart Disease (including heart attack and chest pain) and Stroke – 18.7 million people, American Heart AssociationCancer – 1.4 million people, American Cancer Society 

Highlights from the National Center for Health Statistics Report: Health, United States, 2006, Special Feature on Pain1

Fact #2

The annual cost of chronic pain in the United States, including healthcare expenses, lost income, and lost productivity, is estimated to be $100 billion.

When asked about four common types of pain,

respondents of a National Institute of Health Statistics survey indicated that low back pain was the most common (27%), followed by severe headache or migraine pain (15%), neck pain (15%) and facial ache or pain (4%).

Treatment of Pain

Fortunately, there are many ways to treat pain.

Treatment varies depending on the cause of pain.

Pain Relievers

TCM, Acupuncture

Surgery

1. Pain Relievers The major classes

Paracetamol and NSAIDs COX-2 inhibitors Opiates and morphinomimetics Specific agents

Combinations Topical or systemic Psychotropic agents Atypical and/or adjuvant analgesics

ADDICTION! ADVERSE EFFECTS! INTERACTIONS!

2. TCM, Acupuncture

Zhou dynasty (1128-220 BC) for orthopedic pain conditions

Ming/Qing dynasties (1368-1644)

Diagnostic techniques + physical rehab + physical modalities: Heat Therapy Moxibustion Massage and Manipulation of tissues and joints

New Millennium: Transdisciplinary Assessment

What is Traditional Chinese Medicine (TCM)?

TCM is defined as a medical science governing the theory and practice of traditional Chinese medicine. It includes: Chinese medication, pharmacology/herbalogy, acupuncture, Massage, Qigong.

There are fundamental differences in TCM and the western medical system. With some understanding of Chinese culture and philosophies, it may help one to see through and start to appreciate the value of TCM.

Colleges of traditional Chinese medicine and acupuncture have been founded in France, US, Italy and Australia.

Cooperation in TCM has been established between China and Japan, the United State and Germany.

Traditional Chinese Medicine Traditional Chinese medicine is a range of traditional medical

practices used in China that developed during several thousand years. It is a form of Oriental medicine, which includes other traditional East Asian medical systems such as Japanese and Korean medicine.

TCM says processes of the human body are interrelated and constantly interact with the environment. Therefore the theory looks for the signs of disharmony in the external and internal environment of a person in order to understand, treat and prevent illness and disease. TCM theory is based on a number of philosophical frameworks including the Theory of Yin-Yang, the Five Elements, the human body Meridian system, Zang Fu theory, and others.

Diagnosis and treatment are conducted with reference to these

concepts. TCM does not usually operate within a scientific paradigm but some practitioners make efforts to bring practices into an evidence-based medicine framework. (From Wikipedia, the free encyclopedia)

What is PAIN by Traditional Chinese Medicine (TCM)?

Qi and Blood stagnation!

Qi stagnation - distension

Blood stagnation - PAIN

Cont…. TCM, Acupuncture New Studies Confirm Acupuncture Relieves

PainMRI Scans Provide Objective Evidence that Treatment Works

"It is important for Western medicine to recognize that these acupoints really mean something in regard to pain relief,"

"So many people with pain, whether from cancer, headache or a chronic, unexplained condition, rely on medications such as morphine, which can become addicting. Acupuncture as no side effects, and other studies have shown the pain relief it provides can last for months."

Cont…. TCM, Acupuncture Pain related conditions commonly treated by licensed

acupuncturist: Anxiety/Depression Arthritis/Joint problems (TMJ, etc) Back and Neck pain Colds/Influenza Cough/bronchitis Effects of chemotherapy Fibromyalgia GI problems (IBS, Crohn’s disease, etc) Headache/Migraine Muscolosceletal injuries PMS Paralysis/Numbness Sciatica Skin problems Tendonitis

…..many MORE

TCM treatment modalities in Pain Management

Auricular Pain Management

Integration of TCM with Western Medicine

Western biomedicine emphasizes: Analgesics (pain relievers)

TCM aims: Overall condition of patient Regulating Yin and Yang Treating the disease by pattern identification Side effects are minor Less invasive Generally more acceptable to patients

cont. Advantages of TCM

TCM has certain advantages: Enhancing the immune system Reinforcing the body’s Vital Qi Cultivating the Root Preventing, correcting, reducing iatrogen pain

due to surgery, radio-and chemotherapy

cont. Advantages of TCM The combined approach shows significant improvement

in the efficacy of Western medicine:

Reduces symptoms associated with pain Treats the side-effects of Western interventions Enhances recovery time Raising Quality of life Reducing recurrence Alleviating sufferings (pain)

Q & A

Is pain preventable? Examples from my practice

Q & A

Summary

Chinese medicine can be used as part of an overall treatment strategy to bring new hope to patients with PAIN.