Acupuncture:answer to chronic pain management - Essay Example

1 ACUPUNCTURE: ANSWER TO CHRONIC PAIN MANAGEMENT God has allowed pain to rack a human being's body for several purposes. First, it makes man remind him of his finiteness and his being a vincible and dependent creature. Without pain, man can freely assert that he is the captain of his body and soul. God has allowed pain in order to warn man of the proximate possibility of danger lurking inside his corporal system i.e. that something potentially or actually damaging has caused irregularity and imbalance in his body and might potentially cause his body to go helter-skelter resulting to the institutionalization of pain in his life, making it a chronic pain that causes him to physically, emotionally and financially suffer. Especially in cancer cases, pain becomes intractable and becomes his constant companion plunging him sometimes to the abyss of despair (Bates xv). The chronic pain sufferer's first line of defense is the gobbling of prescribed or unprescribed drugs to hopefully mitigate or vanish the suffering. Unluckily,many of these drugs have adverse side-effects and worse there is also the possibility that such drugs may not work for him, reducing them to mere placebos (Mumenthaler et al ix). The worse thing is that because of the use of these drugs, the patient becomes addicted to them. It was reported by Marks and Sacher in their 1973 research that 1% of chronic pain sufferers who were inpatients and who were prescribed demerol or meperidine became addicted to that drug (Lubkin and Larson 82). Another unpleasant side-effects of drug taking are drug tolerance and physical dependence. It is widely observed that after repeated administration of drugs, several patients develop a tolerance of such drugs, meaning that these drugs have lost efficacy forcing the taking 2 of increased dosage or more amount of such drug to achieve relief from pain. Physical dependence, another unpleasant consequence from drug taking, results to withdrawal symptoms which may manifest in such signs as anorexia, high blood pressure, vomiting, shaking chills among others (Lubkin & Larsen 83). The chronic pain sufferer especially one who suffers from intractable pain due to cancer has to go through constant hospitalization thereby hampering the family's financial status. In such modern US hospitals, the sufferer has to be closely monitored and in order to hold in check the pain, several drug adjustments have to be made. The sufferer has also to be monitored for chronic toxicities because most medications may be attended by immense levels of toxicities which if adjustment or dosage of medication is neglected, life-threatening consequences may ensue (DiPiro 106,107). One unpleaseant condition that coexists with chronic pain is depression. Most studies point to the fact that depression almost always accompanies chronic pain. One study (by Ruoff) even asserted that of all chronic pain sufferers, 50% also agonize from depression. And the sources of it is not only physical pain but also the financial straits, the sense of morbidity, career and domestic strains, loss of self-esteem and a compromised sexual potency (Roy 107,109). One jolting effect of chronic pain is its dire financial impact. It was reported that in USA alone, "the financial cost of chronic pain is estimated to be as high as $90 billion a year" (Philips 3). This statistic even reaches a staggering amount when the chronic pain sufferer has to undergo the knife. Not only then has he to contend with the possibility of risks including the peril of dying on the operating table but also the chances of the malady recurring forcing more surgeries. The recovery time is another factor that he has to take into consideration, other than the high cost of surgery. 3 Because of the abovementioned disadvantages of chronic pain management through the use of drugs, opiates and other ingested substances, American scientists have turned to search for alternative medical methods to the Orient specifically the Oriental method of acupuncture. The impetus for the American interest in this 'novel method' of diagnosis and treatment was generated when during the 1972 visit of President Richard Nixon in Shanghai, China, one of his retinue journalists, James Reston, A New York Times political commentator, suddenly had an attack of appendicitis and acupuncture was used in the emergency appendectomy that ensued (Inglis & West 121). This correspondent cannot be restrained from spreading to the whole of America his unique, almost surrealistic encounter with the ancient science of acupuncture (Eliopoulos 355). Soon Western physicians took the cue and travelled to China to learn about this esoteric method of medicine, where they saw with their own eyes acupuncture needles being employed as sole anaesthetic in surgery cases (Ernst 3). The World Health Organization stoked the fires of interest and awareness in US minds when in its publication it cited more than 40 instances that acupuncture therapy may be applied. Some of these are asthma, stroke paralysis, osteoarthritis, migraines, the common cold, addictions, tennis elbow, tonsillitis, myopia, sinusitis, duodenal ulcer, illness due to poisoning, neuralgia and Meniere's disease or the ringing in the ears with vertigo (Goldberg et al 63). Thus, interest in the new medical system took shape and then orchestrated to fever pitch. Definition of Acupuncture Soon, the questions on everybody's lips are what is thing called acupuncture, where did it originate, how does it work, does it hurt Acupuncture is defined as an ancient Chinese therapeutic technique wherein fine needles are inserted under the skin at specified points, called chi points, for the purpose of relieving pain and for treating physical illness (Verrillo 255). 4 The Theory of Acupuncture This technique is based on the belief that in the human body, there are some 600 points that are evenly spaced all over it and most of these are directly correlated with fixed points on the spinal cord of the body (Sinett 186). All of these points are connected by 14 major channels or meridians, which serve as some sort of primitive communication system based on electronic transmission and running freely throughout these meridians is Qi, which is the vital energy or life force or the force that sustains every function of each organ and thus maintains life processes. If Qi ceases, blood ceases and life ceases. If the circulation of Qi is impeded, insufficient or interrupted, there ensues an imbalance of the Yin and the Yang, which are the opposing forces within all objects of the universe. Because of such imbalance, disease and pain are engendered in the body and acupuncture steps in to restore the devastated balance. In the body, there are 12 organ pathways or meridians in each half of the body that flows vertically up and down throughout the body. There are also 2 unpaired midline meridians. The 12 organ meridians are equated to 12 body organs i.e. heart, lungs, stomach, liver, kidney, large and small intestines, bladder, gallbladder, spleen, pericardium and triple enrgizer. When the Qi is blocked or inadequate in any of these 12 organs, that organ suffers infirmity (Gellman 5). When the Qi in the heart meridian is blocked, then the acupuncture points, the extraordinary points and the Ashi or tender spot points related to the heart meridian are punctured and stimulated through rotation, thrusting or vibration. These acupoints had been mapped out and identified since ancient times and these are the specific locations where the meridians may be accessed by puncturing with needles, by acupressure and Moxibustion (Filshie & White 393-404). It must be mentioned that the practice of acupuncture also embraces a wide-ranging biophysical means of stimulating the various 'acupoints'. This includes accupressure, where 5 pressure is employed to the acupoints with the use of fingers, palms or feet; Moxibustion,where tiny, densely rolled dried cones of mugwort are burned and the heat produced is applied to the acupoints (Lee 63); electro-acupuncture or the application of low-voltage electric current to acupuncture needles to produce relief from pain (Hochschuler & Regnit 81); auricular acupuncture, where any of the 120 acupoints on the body's external ear lobes are needle stimulated to treat drug addiction, allergies, asthma and hosts of other diseases; laser acupuncture which is similar to electro-acupuncture but instead of electricity, laser is used; and herbal dietary supplements. The Physiological Theory of Acupuncture By stimulating the acupoints, the Qi is conveyed to the organ where it is most needed, thus restoring balance of yin and yang. Where the Qi has been concentrated in one organ as in hematoma, acupuncture causes the dispersion of Qi from that area. But acupuncture's analgesic effect is mainly explained by the stimulation of the spinal cord, the midbrain, the hypothalamus-pituitary to produce chemicals which inhibit pain transmissions. These chemicals are enkephalin, dynorphin and B-endorphins, the latter being particularly effective in causing analgesia. Released by hypothalamus, it is discharged into the bloodstream together with ACTH to activate the descending pain inhibition (Stux & Pomeranz 12). The secreted enkephalin and dynorphin, produced in the spinal cord, cause the activation of the ascending pain inhibition system, where serotonin and norepinephrine act as intermediaries. In the midbrain, the acupuncture stimulus causes the production of enkephalin which activates a descending pain inhibition system. All of these chemical secretions explain the analgesic and anti-inflammatory consequences of acupuncture (Davis 310,311). 6 Origins of Acupuncture There is no doubt that this esoteric technique has so much potential in bringing resolution to chronic pain and analgesic problems in USA. But where and when did it emanate from Most point to China as its birthplace. But there are others who claim that it originated from the Ayurvedas in India and in Egypt and even in Japan. But solid evidence places ancient China as the cradle of acupuncture. Acupuncture was treated in Nei Ching, which is the oldest known book on Chinese medicine and written between 200BC and 100AD. Here it tells about how physician Pien Chueh brought acceptability of acupuncture to Chinese society. Story had it that during the 4th century BC in the province of Kuo, Pien Chueh revived the king's son who lapsed into coma and appeared moribund. He inserted acupuncture needles in the prince's head, arms, legs and chest and applied moxibustion heat and herbal treatments. When the prince regained normalcy, the King made acupuncture an important Chinese institution (Kidson 5,6). It is part of Chinese tradition that acupuncture originated during the Stone Age, where sharp tools made of stone were used to perforate and drain wound abscesses. It strengthened during the Han Dynasty and with the advent of Confucianism, came also the enthronement of acupuncture as the way to control pain and to combat diseases. This was because Confucianism held that the human body was sacred and should not be allowed to be cut and sliced apart. The identification of acupoints was the end-product of centuries of analytical observations by Chinese medical pundits and these are detailed in Nei Ching. With the invention of the stainless steel 'nine needles' and the establishment of the Imperial Medical College during the Sui Dynasty, which incorporated acupuncture and moxibustion in its curriculum, and the promotion of Sun Szu-Miao's text Thousand Golden Remedies and the printing of Yang Chi-Chou's Compendium of Acupuncture and Moxibustion, acupuncture had been implanted as 7 an essential part of Chinese traditional medicine. But it suffered decline in the 1900's with the rise of Western medicine in China. It was even outlawed in China in 1929. But the march to power by the Mao Tse Tung -led Communists revived acupuncture and since then China experienced a renaissance of acupuncture. It had been mainly used in postoperative pain control and as anesthesia in surgeries. Today, scalp and laser acupuncture are now widely used in Chinese hospitals (Lewith 1-10). The Introduction of Acupuncture in USA Dr. Franklin Bache was reputed to be the first person to introduce acupuncture in US shores. In 1826, he experimented 'acupuncturation' on prisoners at the Penn State prisons. But the idea of acupuncture did not catch fire because of its lack of scientific understanding. Instead it became a fad so much so that a journalist blurted out, "Acupuncture in America has become transformed into quackupuncture" (Sherk 125) with many of its practitioners medically unqualified. Skeptics claimed that the practice is unscientific. The few US practitioners like Bache and Lee used it mainly on experimental basis (Saks 113). But that has soon changed after that Nixon visit to China and the Reston appendectomy experience. Reston wrote about his experience and Henry Kissinger in an article in Parade Magazine recounted about witnessing a 28-year old woman undergoing open-heart surgery with nary anesthesia. Only acupuncture injected in her right ear lobe served as her anesthesia. While cut open by her doctor, she was smiling straight in the camera wide awake, with no oxygen masks nor intravenous needles protruding from her arms (Yuan & Bieber 115). Such first-hand experiences impelled eminent US doctors to travel to China and see for themselves with their own eyes the esoteric technique. There soon followed a flurry of acupuncture training and learning as the National Institutes of Health, provided research 8 funding and 42 exploratory grants to look into the use of acupuncture and other alternative medicine for the treatment of "AIDS, cancer, asthma, women's disorders, geriatrics, stroke and several areas of pain" (Stux & Pomeranz 2-5). There followed importation of Chinese acupuncture textbooks and training programs in acupuncture. Acupuncture practitioners soon proliferated all over USA as by 1991, 1500 doctors and 8000 non-doctors practiced acupuncture (Helms 3,4). Today, most states except three, enact laws allowing the practice of acupuncture by licensed physicians (18 states); for those who passed examinations (11 states); or those duly licensed or registered non-physicians (12 states) (Stux & Pomeranz 1,2). With the formation in 1987 of the American Academy of Medical Acupuncturists whose objective is the advancement of the practice of acupuncture by surgeons and physicians all over USA, the status of acupuncture as the first choice as alternative medicine in USA was solidified. Soon after, 3000 medical practitioners underwent acupuncture training (Freedman 94). Today, the study of acupuncture is encompassed in the curriculum of 27 US medical schools like Harvard, Yale, Stanford, UCLA etc. Simultaneously, schools accredited by the US Federal Government offer 4 year courses in acupuncture for non-physicians (Stux & Pomeranz 2-5). Conclusion There is today, no stopping the use of acupuncture in US medical practice. It is obvious that it is efficacious, economically advantageous and cures pain in the long run. Compared with medicine controlled pain management, which places the patient to so many risks and to so many side effects, addiction , drug tolerance and physical dependence and plunges him sometimes to the abyss of despair, acupuncture treatment is non-invasive, relatively painless and in line with natural therapy. Because orthodox medicine has trouble in reliably curing cancer, AIDS and other maladies and giving palliative to many of their symptoms, acupuncture has gained 9 unprecedented acceptance and in so many clinics "acupuncture has become a standard complementary form of treatment in addition to orthodox treatment methods" (Doyle et al 410). 10 REFERENCES Bates, Maryann. Biocultural Dimensions of Chronic Pain. SUNY Press, 1997. Davis, Carol. Complementary Therapies in Rehabilitation. SLACK Inc, 2004. DiPiro, Joseph and American College of Clinical Pharmacy. Encyclopedia of Cli Doyle, Derek., Hanks, Geoffrey., Cherny, Nathan., and Calman, Kenneth. nical Pharmacy. Informa Health Care, 2003. Oxford Textbook Of Palliative Medicine. Oxford University Press, 2005. Eliopoulos, Charlotte. Invitation To Holistic Health. Jones and Bartlett Publishers, 2004. Ernst, Edzard. Acupuncture. Elsevier Health Sciences, 1999. Filshie, Jacqueline and White, Adrian. Medical Acupuncture. Elsevier Health Sciences, 1998. Friedman, Mitchell and Morrison, William and Harwood, Marc. Minimally Invasive Muscoskeletal Pain Medicine. CRC Press, 2007. Gellman, Harris. Acupuncture Treatment for Musculoskeletal Pain. CRC Press, 2002. Goldberg, Burton.,Triveri, Larry., Anderson, John., Burton, Goldberg. Alternative Medicine. Celestial Arts, 2002. Helms, Mike. Acupuncture Energetics. Thieme, 1995. Hochschuler, Stephen and Teznik, Bob. Treat Your Back Without Surgery.Hunter House, 2002 Inglis, Brian and West, Ruth. The Alternative Health Guide. Knopf, 1983. Kidson, Ruth. Acupuncture For Everyone. Inner Traditions, 2001. Lee, Ilchi. Human Technology. Healing Society, 2005. Lewith, George. The History of Acupuncture in China. Thorsons Publishing Group Lubkin, Ilene and Larsen, Pamala. Chronic Illness. Jones and Bartlett Publishers, 2002. Mumenthaler, Marco., Zwieter, P.A., Farcot, Jean Marie and Council of Europe. Treatment Of Chronic Pain. Taylor and Francis, 1990. Philips, Clare. The Psychological Management of Chronic Pain. Springer Publishers,1988. Roy, Ranjan. Chronic Pain, Loss and Suffering. University of Toronto Press, 2004. Saks, Mike. Professions and The Public Interest. Routledge, 1995. Sherk, Bill. 500 Years of New Words. Dundurn Press, Ltd, 2004. Sinett, Todd and Sinett, Sheldon. The Truth About Back Pain. Perigee, 2008. Stux, Gabriel and Pomeranz, Bruce. Basics of Acupuncture. Springer, 1998. Verrillo, Erika and Gellman, Lauren. Chronic Fatigue Syndrome. St. Martin's Griffin, 1998. Yuan, Chun-Su and Bieber, Eric. Textbook of Complementary and Alternative Medicine. Taylor And Francis, 2003. Read More