Chinese Medicine Demystified

(Part V): A Closer Look At How
Acupuncture Relieves Pain
on MARCH 14, 2010 by CHRIS KRESSER 71 comments
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Note: This is the fifth article in an ongoing series. If you
haven’t read the first four, I recommend doing that before
continuing:

 Chinese Medicine Demystified (Part I): A Case of
Mistaken Identity

 Chinese Medicine Demystified (Part II): Origins of
the Energy Meridian Myth

 Chinese Medicine Demystified (Part III): The “Energy
Meridian” Model Debunked

 Chinese Medicine Demystified (Part IV): How
Acupuncture Works

 Chinese Medicine Demystified (Part V): A Closer
Look At How Acupuncture Relieves Pain

 Chinese Medicine Demystified (Part VI): 5 Ways
Acupuncture Can Help You Where Drugs and Surgery
Can’t

I’m going to break it down in plain language for my readers who don’t have a scientific background. The sensory nerves register pain. I have to give you a little background on the physiology and neurology involved. So the . The position nerves tell the brain where that pain is coming from. There are two types of nerves involved in our perception of pain: sensory (nocioceptive) and position (proprioceptive) nerves. and more is being learned each year about the mechanisms of pain relief via acupuncture. we know little about the mechanisms of most anesthetic gases but still use them regularly. according to Professor Bruce Pomeranz of the University of Toronto. Both of these nerve types are firing at the same time in an area where we’re experiencing pain. (Although as an interesting side note.In this article we’re going to take a closer look at one of the latest theories on how acupuncture relieves pain. Keep in mind that pain research is a constantly evolving topic. These nerves travel to the spine and pass their information on to neurons in the spinothalamic tract. For example. but I’ll also provide references at the end of the article for those of you that want the nitty-gritty detail. we know more about acupuncture analgesia than many chemical drugs in routine use. The physiology of pain Before I explain the mechanism. 1) What I’m going to share with you here represents the latest information from the American Academy of Pain Management and papers published in major peer- reviewed journals. This tract travels up the lateral dorsal horn of the spinal cord to the mid-brain.

When things go wrong Unfortunately. There are two different types of sensory nerves involved in the acupuncture response. A-Delta fibers are surrounded by a fatty. and fire over an extended period of time. this is not what happens in people with chronic pain. Now. Why? The current explanation is that the . which transmit sharp. throbbing pain messages. so C-fiber signals don’t travel quite this quickly. C-fibers are unmyelinated and their signals travel at 20 ft/second. The enkephalins then plug up pain receptor sites in the brain. The A-Delta fibers mediate what is known as the “gamma loop”. There are A-Delta fibers. They fire for a while and then the signals die off. This stops the pain in its tracks. The gamma loop is what gets activated when you stick your hand in a fire and your hand jumps back. which transmit dull. These nerve fibers respond so quickly that your hand is immediately pulled back out of the fire. Chronic pain is a C-fiber problem. the brain will release powerful natural pain relieving substances called enkephalins when it starts to receive those C-fiber messages.sensory nerves say “ouch!” and the position nerves say “my knee!”. C-fibers are responsible for chronic pain. myelin sheath and the signals they send travel at 60 ft/second (that’s fast!). and the signals they send are short-lived. if the signal strength of the position nerves (the ones that register the location of pain) is what it’s supposed to be. And there are C-fibers. burning pain messages. A-Delta fibers are responsible for acute pain. spine and capillary beds where the pain is located.

And keep firing. What the brain does in this situation is restrict the blood supply going into the knee and the blood return coming out of the knee. The brain doesn’t know what happened to the knee. The nerve signals are too weak and aren’t stimulating the brain to release the natural painkillers. but it assumes a worst-case scenario. reducing blood flow around the knee will lessen the chance that the poison will spread. Because the brain isn’t getting the message. This phenomenon is known as “guarding”. When we bang our knee into something.position nerve signal going up to the brain is too weak. so these people aren’t getting a clear signal where the pain is emanating from. One of the results of reducing blood flow to the knee is that it . The second problem involves a survival mechanism that the brain evolved a very long time ago. or perhaps you seriously cut your knee and are losing a lot of blood. Maybe you were bitten by a poisonous snake. So that’s the first problem. After a while the nerves become inflamed. which in turn further weakens the signal’s ability to jump the threshold and get the message to the brain. the brain immediately takes measures to protect it. This is why people in chronic pain often have trouble identifying exactly were the pain is. The mid-brain can’t figure out where the pain is coming from. the nerves keep firing. Let’s take a knee injury as an example. And if you were cut badly. reducing the blood flow will lessen your chances of bleeding to death. If you were bitten by a venomous snake. The neural threshold of the position nerve pathway is too low. This is actually a very intelligent choice. so the enkephalins don’t get released.

Inserting needles into the skin at peripheral sites “jumps” the neural threshold on the position nerve pathway. no healing. but when I’ve explained it to a couple of doctors they both said something to the effect of. It’s not taught in such a direct way in medical school. Once the signal reaches the brain. hormones and immune substances to fight infection. Almost everyone would prefer to lose function in their knee to death.becomes stiff and weak (sound familiar?). but it makes perfect sense. anti- inflammatories. The brain doesn’t want whatever happened to the knee to threaten your chances for survival. so that the signal can reach the brain. now we’re finally coming to the part where I explain how acupuncture fits into this picture. because when we cut our knee or get bitten by a snake we can go to the hospital and they can save our lives. “Huh. No blood flow. This was a great strategy before the advent of western emergency medicine. So the brain sacrifices the health of the knee in order to keep you alive. nutrients absorbed from food. I never thought of it that way. If the blood flow is restricted to a particular area. It’s such an obvious fact that it’s often overlooked in medicine. healing won’t occur. oxygen. And the problem is that cutting off blood flow to the knee – while it may have saved our lives in times past – dramatically limits the knee’s ability to heal.” How acupuncture helps Okay. the whole series of events I described in the . But this isn’t a choice most of us have to make anymore. Stop and think about this for a minute. The blood contains analgesics (painkillers). Why? Because everything we need to heal is in the blood. The brain wants it to feel weak because it is attempting to protect the knee.

There are millions of immune cells called mast cells in the dermis of the skin. There’s another pain relief mechanism that involves activating the immune system. But if the patient returns in a couple of days to get another treatment. just like the mind. But after the needling therapy the patient goes home and the pain comes back. Acupuncture needles are seen as foreign invaders to our body. Inserting a needle into the skin creates a micro-trauma that in turn stimulates the activity of immune cells that control inflammation. the brain does the opposite. And if you keep jumping the neural threshold. These cells are like water . It no longer thinks the knee is injured or threatening the survival of the body. What I’ve described above is how acupuncture relieves pain via the peripheral and central nervous system. The body. eventually the central and peripheral nervous system figure out that it’s better to operate in the non-pain state than in the pain state. It immediately vasodilates the capillaries and venules around the knee. Once this happens. This initial response is very fast. Now. the neural threshold will be jumped again. which increases blood flow and begins the healing process. the brain is no longer receiving pain signals from the knee. The brain recognizes there is pain and where it’s coming from and releases enkephalins (painkillers). has a hard time breaking bad habits. It should be perceived as almost instantaneous by the patient.paragraphs above kicks in. The old bad habit of the nerve chronically firing below the threshold re-establishes itself. The technical term for this is re- establishment of neurological homeostasis. instead of restricting blood flow to the knee.

If there is other damage in the area from previous traumas or injuries. Leukotrienes are the strongest anti-inflammatory substance the body can produce. the micro-trauma caused by the needle starts a systemic immune response. and helps its powerful inbuilt pain relieving mechanisms kick into gear. that will also be addressed by the immune chemicals released by the needle insertion. It’s a bit like jump starting a car. it pops the mast cells and releases the leukotrienes and prostaglandins. What’s more. When a needle is inserted into the skin. or even . It will do everything it can to get us out of pain. the healing caused by the needle insertion isn’t limited to the damage caused by the needle.balloons full of fatty molecules called leukotrienes and prostaglandins A & B. After the needles are removed. Summary Genetically the body is not designed to be in chronic pain. However. the needle-induced lesions continue to stimulate the body until the lesions heal. This means that the anti- inflammatory effect of acupuncture persists for 2-3 days (and sometimes as long as a week) after the needle is withdrawn. Acupuncture “reminds” the body how it should be functioning. Prostaglandins cause the cutaneous nerve in the area to fire (which activates the process described in the previous paragraphs). This promotes healing of the soft tissue throughout the body – not just at the needling site. You’re not changing how the car works. White blood cells called macrophages leak out through the capillaries and immediately begin to heal the damage caused by the needle stick. Leukotrienes cause local capillaries to vasodilate and become permeable.

. high blood pressure. cardiovascular and digestive systems. such as asthma. but also promotes homeostasis and tissue healing and regulates the immune. In the next and final article of this series. irritable bowel. anxiety and insomnia. This explains why getting acupuncture treatment for your knee pain also addresses other problems you might have. endocrine. You’re just giving the battery a little jolt so the car can run how it’s supposed to.adding anything to the engine. I’ll explain the advantages of Chinese medicine over western medicine for the prevention and treatment of most common health conditions. It’s important to understand that this neurochemical mechanism not only provides pain relief.