Chronic Pain

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7 10, 2010

Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition where there is stiffness and pain in the shoulder joint leading to a limited range of motion in the joint. Frozen shoulder usually only affects one shoulder, but some people may eventually develop it in the other shoulder as well. This condition usually develops slowly, over a period of months. The shoulder starts out in the painful stage, where pain occurs with movement and the range of motion begins to become limited. Gradually there is a decrease in pain along with a drastic decrease in the range of motion of the shoulder.

Frozen shoulder can occur after an injury to the shoulder, a surgery or an arm fracture, or it may occur in people with other health conditions such as diabetes, heart disease, lung disease, thyroid problems, and Parkinson’s disease. Frozen shoulder is also more common over the age of 40. With frozen shoulder, the shoulder capsule (the connective tissue in our shoulder joint) becomes inflamed and stiff, which in turn can cause adhesions to develop between the joint’s surfaces and a decrease in the natural lubricating fluids in the joint, all of which contribute to the pain and reduced mobility. At night the shoulder might hurt when sleeping on the painful side and there can be a numbness or tingling in the arm and hand. With the limited use and mobility, strength is lost in the surrounding muscles.

The treatment in Western medicine consists of pain management by using painkillers, muscle relaxants and anti-inflammatory drugs. To regain mobility, physiotherapy or acupuncture may be recommended. A frozen shoulder that isn’t treated well can become a lengthy condition.

What can acupuncture do in these cases? There are several meridians (energy pathways) running over the shoulder or close to the shoulder. When the qi-energy and blood flow in these meridians is obstructed, problems begin to arise. This obstruction can be the result of an underlying problem in one or more of the related organs- in other words, if we have a constitutional weakness in our body due either to genetics or to the accumulated effects of our lifestyle, it can create the conditions for a problem to occur. Because there are many meridians that run over or near the shoulder, internal weaknesses or imbalances can create a weakness in the shoulder, leaving it prone to injury.

An acupuncturist investigates where exactly there is improper functioning within the patient and then will treat the underlying organ problems to get the blood and energy flowing again in the meridians. By increasing circulation and blood flow to the shoulder and reducing inflammation, we can relieve the symptoms of pain and increase mobility in the shoulder, setting the stage for further healing.

The significant difference between Western medicine and Traditional Chinese Medicine (TCM) is that Western medicine will treat the shoulder mainly locally, while in TCM we will treat the organ-related problems together with the meridians, addressing internal factors that contribute to the health and healing of the shoulder area. In fact we will treat the whole person and their imbalances, stimulating the body to return to its own natural equilibrium. By going to the core of the problem, relief through acupuncture can be long lasting if treated properly.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, downtown Kelowna, BC.

25 02, 2009

Sciatica

The sciatic nerve is the longest nerve in your body, running from the spinal cord to the buttock and hip area and down the back of each leg, and about the size of your little finger. Sciatica is a condition where the sciatic nerve is irritated. The most telltale symptom of sciatica is pain that radiates along the path of the sciatic nerve- from the lumbar area to the buttock and down the back of the leg. The pain can be anywhere from a mild ache to a severe sharp or burning pain, numbness or weak muscles along the nerve pathway, and tingling or pins and needles feeling in the toes or foot.

The irritation of the sciatic nerve can be the result of pressure from muscles that are too tense or too short, a bulging disc in the lumbar vertebral column that pushes on the nerve, an inflammation of the nerve, or bad posture or heavy work that involves a lot of lifting and bending over. The pain can be severe and often gets worse while sitting too long, driving, bending over and lifting heavy objects. Sciatica is a widespread injury and about 40% of us will eventually be affected by it in some form. Sciatic pain will sometimes be the sign of a herniated disc and it is certainly wise to pay attention to it in an early stage and get expert advice.

In Western medicine sciatica can be treated by many different health care professionals. The massage therapist will loosen the tension in the muscles of the back and leg, in order to relieve the sciatic nerve, the physiotherapist will give exercises to improve posture and stretch muscles and can apply ultrasound or interferential current. The chiropractor will align the spine in order to relieve pressure on the nerve. The doctor can prescribe painkillers or anti-inflammatories and the surgeon can do surgery to remove the bulging of the disc or contributing problem.

In Traditional Chinese Medicine (TCM), sciatica is considered to be a lower back problem, an area that is strongly influenced by the bladder and kidney channels. Sciatica can be differentiated into different types, depending on the exact cause. Damp-cold invading the back channels can occur in both acute and chronic cases, causing a dull, heavy, radiating pain that may be worse with cold or dampness. Sciatica due to stagnation of qi-energy and blood in the back area can cause either an acute or chronic condition that is aggravated with the absence of movement. Sciatica due to kidney deficiency will result in a chronic condition because of the fact that weak kidneys are unable to properly nourish the lower back area, making it susceptible to injury and dysfunction. This type of sciatica has a slow, gradual onset and typically will get worse in the evening and with fatigue.

Acupuncture can be extremely effective in the treatment of both acute and chronic back pain, including sciatica, regardless of how long the condition has been present. Sciatica often takes longer to treat than other types of back pain, but acupuncture can produce great results, both in treating the pain and in addressing the underlying weakness that is contributing to a sciatic problem.

Often in cases where there is a stubborn problem that doesn’t seem to respond to treatment, acupuncture can remove the blockages and open the doors for healing. Combined with exercises and postural advice, is a very valuable tool in treating sciatica.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.

17 12, 2008

Lower Back Pain

Lower back pain is a common complaint that we see often at our clinic. It is most commonly attributed to chronic ligament strain, spinal degeneration or osteoarthritis, or a prolapsed lumbar disc, problems that can be aggravated by a modern lifestyle that may involve a lot of sitting, or heavy strain from physical work or exercise.

Treatment often can include pain medication, chiropractic to realign the vertebrae, massage therapy to relax the muscles, and physiotherapy to correct posture and strengthen the muscles. Surgery may also be considered in severe cases.

Acupuncture can thankfully give very positive results to lower back pain sufferers, in part because Chinese medicine brings quite a different approach to the treatment of lower back pain, and one that is very effective. Back pain in Chinese medicine can be due to a number of factors that either make the back more susceptible to pain or lead to the pain itself, the most common being a weakness of the kidneys, causing a lack of nourishment of the lower back and spine.

The kidneys have a strong influence on the strength and nourishment of the tissue and bones of the lower back area so we always look at the strength of the kidneys when treating back pain, and what may be causing a kidney weakness. It is common for back pain to have a number of causes which create different kinds of pain. The type of pain that is experienced often tells the acupuncturist the underlying cause of the pain and helps point towards the proper diagnosis for treatment.

Invasion of cold and/or damp in the low back area can be a factor. It is usually due to the lower back being exposed during cold and damp weather, which allows the cold and dampness to invade and block the flow of energy and blood circulation.  This type of low back pain usually produces pain that is worse in the morning, better with exercise, better with heat, and worse when weather is cold and damp. 

Back pain due to stagnation of qi-energy and blood is usually caused by an acute sprain or, in chronic conditions, repeated sprain and underlying kidney weakness. Excessive physical work and over-lifting can often lead to this type of pain. Back pain due to qi-energy and blood stagnation is characterized by pain that is severe and stabbing, which gets worse with rest and better with light exercise. The area will be tender to the touch and there will be stiffness of the back muscles and inability to flex, extend or turn the waist.

Because the kidneys have an important function in the creation of energy, general overwork can also lead to chronic pain due to the constant drain on the kidneys’ energy, leading to an overall kidney weakness. Chronic back pain due to kidney weakness is usually dull and comes in bouts. It is better with rest and worse when a person is tired. This type of weakness creates a further vulnerability for an invasion of cold and damp or sprains. 

These are just a few examples of how Chinese Medicine diagnoses lower back pain. Acupuncture is then used to remove blockage in the lower back area which cause pain and weakness, and to stimulate and strengthen weak and depleted kidneys to aid their function of nourishing the tissues of the lower back. Treatment targets many internal factors, the goal being not only to alleviate the pain, but also to effectively resolve chronic conditions and strengthen the body to prevent future pain from arising.

Lower back pain is a common ailment that I see in my practice, and it generally responds very positively to acupuncture, whether it is a recent problem or a chronic problem. A person will usually first notice a reduction in the pain within a few acupuncture treatments, followed by an overall improvement of health, strength, and mobility in the lower back. With additional treatments, many cases of lower back pain can be resolved, allowing a person to resume their former lifestyle free of pain and negative symptoms.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.