Jan, late 50s, sought out acupuncture to relieve her pain three months after a dog pulled at the leash and strained her right shoulder and arm, resulting in a complex injury and a torn tendon.
"I was in extreme pain at the top of my shoulder, the back of my shoulder and my biceps muscle," she says. "Simply touching the areas was so excruciating." Jan certainly knows from experience how bad musculoskeletal pain can be.
What is musculoskeletal pain?
This type of pain affects muscles, tendons, bones, ligaments, cartilage and nerves, which means it disturbs one or more of the components of that body system―the musculoskeletal system―that provides us with structure, support and movement. This pain may be accompanied by rigidity, inflammation, difficulty in the movements and even immobility. In Jan's case there was also a burning sensation on her arm and shoulder.
Some causes of musculoskeletal pain are obvious, such as a fall or a car accident. Others are not so evident, for instance, the continuous repetition of one movement during sports or long hours of work, or the prolonged immobility when recovering from illness.
Jan, for example, had bowled for 15 years in a competitive environment. The pulling from the dog's leash was probably a definitive strain to her well-worked-out right shoulder and arm.
Acupuncture and pain
When practised by a qualified acupuncturist, acupuncture effectively and safely treats all kinds of musculoskeletal pain conditions. In fact, the World Health Organization (WHO) recommends acupuncture in the treatment of many chronic pain conditions due to the side-effects and the risks of dependence associated with long-term drug therapy for pain.
Acupuncture is a medical system that has existed for more than 2,500 years. The therapy involves the insertion of fine needles in specific points on the body's surface. These points may also be stimulated by means of pressure, heat, electro-stimulation and laser beams, all of which are modalities related with acupuncture. This medicine achieves its therapeutic goals by stimulating the body's own potential, therefore it is non-toxic.
Effects and applications
The effects of acupuncture in the treatment of musculoskeletal pain are pain relief, reduction of muscular spasms, stiffness and swelling, and recovery of a normal range of movement.
Acupuncture benefits all kinds of conditions of musculoskeletal pain, from neck and lower back pain, to sciatica and rheumatoid arthritis. As you'll see in the next section, it is applicable to both acute and chronic conditions, and to mild and severe problems.
Identifying the type of pain
Pamela, a patient in her middle 40s who frequently enjoys skiing and other sports, came to my clinic in September to alleviate a sharp pain on her lower back. It was an acute recurrence, (only shows up during the beginning of autumn), from a chronic problem (reappears every year). She had triggered it the previous day while arching to prevent a glass from breaking on the floor.
Her case helps us illustrate two variables present in any kind of pain.
Time. Pain that appears recently is classified as acute, whereas the one that persists for longer than expected is called chronic.
Severity. Pain can range from mild to intense.
This classification is a very useful tool to identify pain in its particular qualities of time and severity. It is a guide that will help patient and acupuncturist to better understand pain, how to treat it and how to solve it.
Outlook and time of treatment
factors to consider
The number of acupuncture sessions and the time needed to achieve positive results depend several factors:
Severity. Mild pain can be solved with one or two sessions. Serious lesions due to a car accident, for instance, may need several courses of treatment of six to 10 sessions each.
Chronicity. A recent problem tends to be solved more quickly than a chronic one.
Re-occurrence. Pain that reappears frequently throughout someone's life can be solved during a longer time than pain appearing for the first time.
Vitality. Since this medicine achieves its goals by stimulating the body's own potential, the more vitality of a person the better the possibility of recovery and responding favourably to the treatment.
Adhesion. The capacity of a patient to follow the acupuncturist's recommendations―related to lifestyle, level of activity, exercise and rest―has a good impact on the degree and time of healing.
Attitude. Those with an optimistic disposition towards pain have a higher capacity to recover.
From this point of view, acupuncture implies a process that requires the patient's active participation.
In Jan's case, she had a severe lesion with a history of three months of intense pain with a torn tendon. However, she has great vitality, adhered very well to my recommendations and kept a positive attitude towards the improvement of her condition. Those factors played a definitive part towards the healing of her shoulder and arm. She recovered from the pain after receiving 14 sessions during three months. After that, she didn't need any further treatment or surgery.
Pamela was a different story. She only needed three sessions within one week in order to recover from the acute episode on her lower back. The fact that she sought treatment the next day of her injury optimized the outcome.
Protocol examples
Some acupuncture protocols for sports injuries mention that many cases without complications have good results within six sessions with twice a week sessions during three weeks. For chronic cases of musculoskeletal pain, other protocols suggest one session per week during four to six weeks with monthly follow-ups.
Assessment and diagnosis
An acupuncturist will generally lead a thorough interview in order to know your situation in detail. An assessment may be accompanied by orthopaedic tests, which will be relevant to your condition. Radiology test results (X-ray, CT scan, MRI) and other laboratory test rersults―recent and old―that you bring will always be welcomed, for they are useful tools that may greatly clarify your condition and optimize the outcome.
Establishing a treatment plan
It is recommended that in the first session you and your acupuncturist establish together a treatment plan that includes the number, frequency and objectives of the sessions, all of which will be defined by your particular situation and all the factors mentioned before.
The cases of Jan and Pamela clearly show how positive results and the time of treatment have a direct relationship with the severity and chronicity of the problem, as well as the vitality, attitude and capacity of the patient to adhere to the acupuncturist's recommendations.
Treatment results can be optimized when patient and therapist team together with the objective of a common goal: solving the pain.
Carlos Becerra is a registered acupuncturist in BC. He practises acupuncture, acupressure and Tuina massage therapy in the Greater Vancouver area and has a special interest in solving musculoskeletal problems. www.carlosbecerra.ca 604-788-2455