Tags: chronic pain

Pain: Considering Complementary Approaches (eBook) | NCCAM

Check out this free e-book download from the National Institutes of Health on considering complementary approaches to pain.

PainBookCoverTo download – follow this link and pick your preferred download format: Pain: Considering Complementary Approaches (eBook) | NCCAM.

BMC Complementary and Alternative Medicine | Full text | Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis

“The use of acupuncture is associated with significant reductions in pain intensity, improvement in functional mobility and quality of life.” -via BMC Complementary and Alternative Medicine | Full text | Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis.

needling

“In this systematic review, we found acupuncture administered to adults with osteoarthritis to be associated with a statistically significant reduction in pain intensity, improved functional mobility and improved health-related quality of life. Reductions in pain were greater in trials with longer intervention periods. Though under-reported and inconsistently described, major adverse events with acupuncture were not reported. Subgroup analyses suggest that acupuncture is most effective for reducing osteoarthritic pain when administered for more than four weeks. Outcome assessment for the majority of trials occurred immediately following the intervention period and thus the durability of treatment effects are unknown.” -via BMC Complementary and Alternative Medicine | Full text | Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis.

I see and treat all sorts of pain every day in the clinic.  Time and time again people find acupuncture and TCM to be a wonderful way to manage their pain.  Some injuries and some pains completely resolve with minimal treatment (even after sticking around for years), where others don’t ever totally go away, but patients report less pain, more function and a better quality of life when they receive on-going care.  In my experience osteoarthritis falls into this category.  Generally once we bring the pain down to manageable levels, patients do well with semi-regular care – and I can’t tell you how happy it makes me to see patients who had given up on their favorite activities return to them with minimal discomfort.

 

 

Acupuncture not working for you? It could be your coffee habit.

Even though acupuncture usually works well for you – do you sometimes find that a treatment may not give you the pain relief you were hoping for?  There are lots of possible reasons why, but your caffeine intake could be part of it.

coffee

In this study Caffeine inhibits analgesic effect of acupuncture – from The Journal of Chinese Medicine, the researchers found that both acute and chronic caffeine administration could reverse acupuncture’s pain relieving effect.  In the animal model studied, a dose of caffeine immediately preceding acupuncture as well as a daily intake  of 70mg/kg/day (average daily dose in Western countries) for 8 days, both negated the acupuncture -induced analgesia.

What does this mean for you? While this was an animal study, it does raise the question of caffeine consumption and beneficial outcomes in clinical practice.

Coffee (and caffeine in general) consumption can be a touchy subject in clinic.  I often work with patients in pain or dealing with insomnia, anxiety or digestive complaints.  Caffeine can negatively affect every one of those conditions – so reducing or eliminating coffee often becomes a topic of conversation.  A difficult topic – people are really attached to their coffee.  Don’t get me wrong.  I happen to love coffee. I’m not here to demonize it (or worship it for that matter).  But, I also find it enlightening to take a little break from it every now and then and watch what changes.

From observation of patients who come having just consumed coffee, I find they generally have a less pleasant experience – they are usually a little jumpier, more sensitive to the needles and aren’t able to relax quite as well.  This isn’t surprising if you are at all familiar with the sensations that result after drinking a strong coffee, and it makes sense considering the properties of coffee from a TCM perspective.

The Institute for Traditional Medicine has an excellent article about the history and use of coffee in China and has this to say about coffee’s medicinal properties from a Traditional Chinese Medicine (TCM) paradigm:

“In sum, coffee dredges the liver to regulate the flow of liver qi, purges the gallbladder, opens the heart orifices, warms the blood circulation, detoxifies, and gently tonifies. However, while coffee dredges the liver qi, it does not necessarily smooth or soothe the liver qi. Therefore, one has to be cautious about the amount consumed and certain individuals will find the otherwise desirable effects distressing: releasing stagnated qi but not regulating its flow. As with other Chinese herbs, coffee would best be used in combination with herbs to moderate and enhance its effects. As an example, peony root (baishao) is often used to “soften” the liver, and smooth the flow of qi. Because coffee is consumed as a flavorful beverage, to pursue such an approach would best be done by having additional herbs taken in a form that wouldn’t alter the taste of the coffee, such as in pills. Excessive amounts of coffee will agitate the liver yang and even stimulate internal wind. Prolonged use of excessive amounts could thereby damage the blood, but for moderate amounts it serves as a valuable therapy for stagnated liver qi, with constricted circulation of blood, and constrained gallbladder function, with constricted elimination of damp and heat.” 
-COFFEE IN CHINA and the Analysis of Coffee According to Traditional Chinese Medicine, by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine

I’m not asking you to give up coffee forever but if you either consume caffeine on a regular basis and/or prior to treatment you may well be setting yourself up for less relief.   If you’re in pain and not getting the results you’d been hoping for, it may be worth laying off the coffee for a bit and giving acupuncture another try!

Have you taken some time off from coffee – have you noticed any changes in your health for better or worse? Share your experience in the comments!

 

Acupuncture Effective for Post-Surgical pain

While I love it when I can help patients avoid surgery (really, it happens all the time, and it’s awesome!) sometimes they can’t. Surgery is sometimes very necessary and when that’s the case, I support patients with acupuncture, bodywork, internal and external herbs so they can enter and recover from surgery as smoothly as possible.

Acupuncture and Chinese Medicine can be extremely useful tools both pre and post surgery.  Beforehand we can ready the body by helping manage pain, promote normal sleep and digestive cycles and prepare the tissue for the upcoming surgery.  After surgery we can work to reduce swelling and pain and often decrease or discontinue pain medications that have unwanted side-effects – all of this helps the surgical trauma heal quickly and appropriately.

A recent study in Regional Analgesia and Pain Medicine found that acupuncture after a total knee replacement reduced the amount of pain patients were in as well as reducing the need for and amount of pain medications required.  Those in the acupuncture group also had fewer adverse reactions (nausea and vomiting) due to anesthesia.

acupuncture for post-op TKRResults: This study comprised 60 patients (30 in the study group and 30 in the control group). The fentanyl requirement via patient-controlled analgesia in the study group was lower [mean (SD), 620.7 (258.2) vs 868.6 (319.3) [mu]g; P = 0.002). The time to first request for fentanyl was longer in the study group. Pain intensity on a 100-mm visual analog scale was lower in the study group in the first 24 hours after the operation. The incidence of analgesia-related adverse effects of nausea and vomiting was lower in the study group. The success of blinding was not significantly different between the 2 groups (P = 0.731).

Conclusions: The data obtained from this clinical trial demonstrate the potential advantages of using acupuncture for postoperative pain control after total knee arthroplasty.
Acupuncture for Pain Relief After Total Knee Arthroplasty: A Randomized Controlled Trial. Regional Anesthesia and Pain Medicine.

If you or someone you know is preparing for or recently underwent surgery – we’d love to help – Give us a call or book an appointment online!  What questions do you have about pre or post-op acupuncture?