THE ROLE OF ORIENTAL MEDICINE IN PAIN MANAGEMENT
Sven A. Andersson (Goeteborg University, Goeteborg, Sweden
Thomas Lundeberg (Karolinska Institutet, Stockholm, Sweden
During centuries diseases and pain conditions have been treated with empirical methods. The claimed curative or preventive actions were unproven scientifically and the methods were often rejected by the scientific community. Recent research suggests that somatic sensory stimulation which often is part of oriental methods, may influence endogenous control systems. In pain management acupuncture is of particular interest. Pain relief is observed in acute pain, e.g. surgery. In chronic nociceptive pain relief is reported in 40-80% of the treated patients. A rational is suggested for pain relief induced by different modes of somatic sensory stimulation. Manual stimulation or electrical stimulation with low frequency release neuropeptides, including endorphins, in a fashion similar to that during long-lasting muscle exercise. Our hypothesis is that methods in oriental medicine give pain relief due to activation of high threshold afferents, primarily A- delta fibers, from skeletal muscles which activates hypothalamic and brainstem pain inhibiting systems. These systems are physiologically activated during physical exercise resulting m an increased pain tolerance.
THE ROLE OF ORIENTAL MEDICINE IN THE MANAGEMENT OF PAIN HOW ACUPUNCTURE WORKS
Hirohisa Oda (Meiji College of Oriental Medicine, San Francisco, U.S.A.)
Acupuncture needling is considered more effective in the management of musculoskeletal pain than herbal treatment. There are three reasons explaining the effectiveness of acupuncture: increased blood circulation, modulation of perception, and general elevation of the pain threshold. Acupuncture is most effective for ischemic pain because needling causes local vasodilation of the area surrounding the needle insertion site resulting in increased blood flow, and dilution and flushing away of chemical pain substances. The effects of contra-lateral needle stimulation or stimulation in the same segmental area is classified as perception modulation. Needling for more than 15 minutes on a subject can result in stress-induced analgesia and stimulation-produced analgesia which are commonly referred to as Acupuncture anesthesia. Needling with direct current (12 volts, 200 μA) emphasizes the noxious stimulatory effects of basic acupuncture treatment. Transcutaneous electrical acupuncture-like stimulation accompanied with heat radiation is one of the most effective methods for treating general musculoskeletal pain. In summary, acupuncture influences perception and the sympathetic nervous system, which innervates the vascular system. Noxious stimulation produced by needling gives qualitative information of severe injury, but not large quantitative information. This qualitative information of the injury acts as a method of counter irritation.