Luckily the FDA, CDC, and many primary care physicians are recognizing the benefit of referring patients for acupuncture to treat acute and chronic pain. Since the discussion began in earnest in 2015 to reassess our current conventional practices in treating pain in the United States, acupuncture, mindfulness based meditation practices, chiropractic care, and specific movement modalities are gaining traction in pain management. However, in the search for alternative care for pain management during our current opioid crisis, Chinese herbal medicine often gets overlooked.

Chinese herbal medicine for pain management is an excellent tool to help a patient struggling with chronic pain. But first:

How does Chinese Medicine Understand Pain?

Pain can be complex or it can be simple. Regardless of how complicated your condition is, the goal to treat both the pain and its underlying cause remains the same. Pain can come from a variety of sources: qi and blood stasis, deficiency of qi and blood, deficiency of an organ, and damp, cold, heat or wind ‘invading’ the body.

Qi and Blood stasis:

To put it simply: qi and blood stasis is best explained as something has impeded the flow of energy and/or blood circulation into a joint or muscle. This can stem from an injury, chronic stress, or scar tissue that tightens up muscles in an area. Imagine the large muscles at the top of your shoulders being tight every day after work. Consistently tight muscles will clamp down on the capillary beds that bring fresh oxygenated blood into the muscle tissue and remove metabolic waste like lactic acid. With less blood flow into your muscles, less exchange of oxygen and waste happens. This can cause a cycle of continuing to reinforce tension in the upper back and shoulders.

Deficiency of Qi and Blood:

If there isn’t enough qi (energy) or blood to go around, certain areas of the body suffer from lack of nourishment from qi or blood. Another way to perceive this is if the blood doesn’t have the same vitality to it, such as with someone struggling with anemia, then again the blood’s ability to bring oxygen to tissues and to remove waste is compromised. Blood circulation occurs, but not as effectively as it does in someone without anemia.

Deficiency in an organ system:

Certain organs are associated with regions of the body and different tissues (muscle, tendons, bones, etc). Depending on where the pain is located and in what tissue can indicate fatigue in an organ system. If this is part of your pain pattern, your acupuncturist will incorporate herbs to strengthen those organs.

Dampness, Cold,Heat, or Wind Causing Pain

Weather from our external environment can sort of get stuck in parts of our bodies. Ever have pain that gets worse right before it rains? Or pain that is worse in winter when it is cold? Do you love standing in the wind or does it hurt? While many of us consider these colloquial old wives tales, they indicated different patterns of pain to an acupuncturists. Damp pain tends to be worse when exposed to damp, feels heavy and cloying, or a sense of pressure in the joint, and will often get better with warmth. Cold pain is fixed and intense, often better with heat. Pain from heat is better with cold, very painful, worse with pressure, and typically comes on fast. Pain from wind moves from one place to another and is worse in wind.

We can also create these weather patterns inside our body by eating too much of some foods, beverages, or other lifestyle habits. Certain foods and beverages can cause dampness, cold, and heat in the body. If you already have a cold, damp, or heat condition in the body, then certain cooking styles can make those worse. An acupuncturists will often also address how to cook your food, what foods to eat and what to avoid, based on your specific pain conditions. Food is considered our first medicine, before herbs. Learning how to eat foods and cook in ways that reinforce your acupuncture and herbal treatments will speed your recovery as well.

 Why Consider Chinese Herbal Medicine?

1. Chinese herbal medicine does not impair judgement.

Unlike a number of pain medications and medical marijuana, Chinese herbal medicine does not alter your state of mind. This allows you to both treat your pain and to carry on with your daily life.

2. Chinese herbal medicine works by identifying and treating the underlying cause of your pain.

The goal of both acupuncture and Chinese herbal medicine is to sleuth out what is causing your symptoms, in this case, pain.  We then aim to treat and help your body heal from the underlying cause of pain, while at the same time treating the pain. The end result is to help a patient become pain free without relying on constant medication or treatments. For instance, depending on the complexity of your pain, you will need a series of acupuncture, cupping therapy, and herbal treatments; but by focusing on treating the underlying cause of pain, over time, you will no longer need these treatments.

3. There Are Both Topical and Internal Herbal Treatment Options

Topicals: There are a wide array of topical herbal treatments found as patches, liniments, herb infused oils, and poultices to treat pain ranging from acute injuries to long standing chronic pain. There are many patches, sprays, and rubs available at any grocery store, but most of those are simply analgesic; meaning they mask pain, but don’t heal the underlying cause of the pain. The different varieties of Chinese medicine topicals have been created over 100s of years to treat the different causes of pain, while also being analgesic. So not all topical patches, sprays, salves, poultices, and liniments are used for the same types of pain.

Just like formulas that you drink, the herbs in your topical treatment treat different tissues (tendon, ligament, bone, muscle), different substances (qi or blood), and can help disperse any other complicating factors (inflammation, cold, dampness, or wind stuck in the joint). For instance, a formula for arthritis in the hands that gets worse in cold weather will have different herbs in it, than an old tendon injury that continues to have chronic pain. The topical treatment for the hands will most likely be a salve or oil to rub into the hands at night with herbs that warm the tissues, improve circulation, and influence bone as well as stop pain. The topical for the chronic pain in a previously injured tendon will have herbs that repair connective tissue, increase blood circulation to the tendon, and address any complicating factors associated with the chronic nature of the pain such as dampness, cold, wind, or heat.

Internal formulas: these come as small pills, powder that you brew into tea, or raw herbs that you brew into tea. Internal formulas are drank 2-4x a day. Similar to topicals, the herbs used in your formula will be individualized to you. It will treat the underlying cause of the pain, have something to stop pain, and something to guide it to the part of the body where you are feeling the pain. It will often also have herbs that help the tissue that is hurting (muscle, connective tissue, bone, skin). The unique thing about internal formulas is that we have herbs that guide the other herbs to a specific part of the body, like the lower legs, the low back, the abdomen, arms, and head. The head even has herbs that guide to the back of the head, the temples, the vertex, and the forehead/sinuses. These are mostly used to treat headaches.

4. Chinese herbal medicine is a few thousand years old

Chinese herbalism is older than the practice of acupuncture–over 2000 years. It is also one of the few herbal practices that did not receive persecution until the Cultural Revolution between 1966-1976. That means herbal medicine was able to be honed and perfected in China with formulas being finely crafted and fine-tuned for over 2000 years.

You can imagine that before modern medicine a large number of formulas were derived to treat injuries, pain from injuries, and to help injuries heal both quickly and properly. These formulas remain effective to this day.

To learn more about Chinese herbal medicine, please read Chinese Herbal Medicine 101.

If you are interested in adding another effective tool to your pain management arsenal, please consult your acupuncturist about Chinese herbal medicine for pain management.