Pain can be debilitating, interfering with the ability to sleep, work, and enjoy life. It can aggravate other health conditions and lead to depression and anxiety symptoms. Relieving it often requires a trial-and-error approach that embraces the whole person, not just the source, which can’t always be identified clearly. Many people find it useful to choose from a menu of different pain treatments and remedies, combining them in a regimen that fits their lifestyles.
In addition to the standard pain medications, and surgical repairs of specific problems, patients and their clinicians also have access to a wide range of nondrug therapies for pain. Acupuncture, biofeedback, topical treatments, assistive devices, tai chi and yoga are just a few of the many options available.
Not everyone is able or willing to take pain medication every day, and not everyone can or should have surgery for painful conditions. The good news is that mainstream medicine is embracing a wider variety of treatments than ever before. And it’s important to recognize when it’s time to see a physician for an evaluation of pain.
If a new pain develops and persists beyond a few days, check with your doctor. And see a doctor immediately if you have chest pain or anything else that could be serious. Severe pain should always be a signal that medical consultation is needed.
One ancient method of pain relief now in widespread use is acupuncture.
Acupuncture has been practiced for centuries in Asia, and has more recently spread to the United States and other Western countries. Acupuncture has been used to treat most pain conditions, including low back pain, shingles and other nerve pain, hand and knee pain, headache, fibromyalgia, and menstrual pain. For people with knee pain, for example, there’s some evidence that acupuncture may provide some pain relief, although results from different studies are mixed.
A large 2004 study published in Annals of Internal Medicine found that people with knee osteoarthritis who had acupuncture for six months reported less pain and better function than people who received sham acupuncture (no needles actually inserted) or participated in an arthritis education program.
A meta-analysis published in 2007 in Annals of Internal Medicine showed conflicting results. In this latter study, acupuncture led to significant improvements in pain and function compared with usual care or being on a waiting list for acupuncture, but it did not provide a significant advantage over a sham procedure.
Cochrane reviews of acupuncture for prevention of tension and migraine headaches have noted that trial results are difficult to interpret because of differences in study designs, but also found some potential benefits. Overall, the research in many of these conditions is suggestive but largely insufficient to draw definitive conclusions.
Traditional Chinese acupuncture involves the insertion of extremely fine needles into the skin at specific “acupoints” along the meridians (pathways along which the body’s vital energy flows, according to acupuncture theory). This action, some scientific evidence has shown, may result in pain relief by releasing endorphins, the body’s natural painkilling chemicals, and may affect the part of the brain that governs serotonin levels, the brain transmitter involved with mood.
During Chinese acupuncture, the acupuncturist may turn or twirl the needles slightly or apply heat or electrical stimulation to enhance the effects, or he or she may apply an herb called mugwort to the needle tips to further stimulate the designated acupoints; this is called moxibustion.
A Japanese form of acupuncture involves more shallow needle insertion than Chinese acupuncture and needles usually are not manipulated. Korean acupuncture focuses on needling points just in the hands and feet. Acupressure, on the other hand, does not involve the insertion of needles but substitutes deep pressure, usually with a finger or thumb, at acupressure points.
The acupuncturist typically inserts four to 10 needles and leaves them in place for 10 to 30 minutes while you rest. A usual course of treatment includes six to 12 sessions over a three-month period.
The complication rate for acupuncture appears to be quite low. A review of complications reported in medical journals found that the most common serious problem was accidental insertion of a needle into the pleural space between the lungs and the chest wall. The advent of single-use, sealed needle packages has all but eliminated the risks of blood-borne infection such as hepatitis B or HIV.
If you decide to try acupuncture, it is crucial to seek out an experienced acupuncturist. Licensing requirements vary from state to state. In states with no licensing requirements, the safest way to find a qualified acupuncturist is to seek one with certification from the National Certification Commission for Acupuncture and Oriental Medicine.
–Â Harvard Health Letters
Excerpted from the Harvard Special Health Report, “Pain Relief without Drugs or Surgery,” prepared in collaboration with the editors of Harvard Health Publications and Diana Post, M.D. assistant professor of medicine, Harvard Medical School; physician, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass.
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