MEDICAL THEORY: Pain syndromes result from stagnated, disordered, or interrupted circulation. The cause may be internal (emotional stress, diet, drugs, organ dysfunction, aging) or external (climate influence, primarily); physical injury by sudden compression or extension, or by burning is considered a separate category. The stagnation may involve qi (usually causing an ache but not a severe pain), moisture (which can cause numbness, swelling, and persistent or recurrent aching), or blood (causing sharp pain that does not change site); it may involve two or more of these. The longer the stagnation persists, the more likely there will be a combination of qi, moisture, and blood disorders. Also, persisting stagnation is said to lead to a heat syndrome which can have systemic as well as local impact.
TREATMENT OF PAIN
Chinese herbs are not as strong as pharmaceutical drugs in the treatment of pain, and thus the herbs should not be considered a viable alternative for severe pain in those situations where pharmaceuticals are effective. However, for less severe pain and for situations where pain is not responsive to modern medications, Chinese herbs should be considered. As described in Synopsis of the Pharmacopoeia by C.S. Cheung and U.A. Kaw, there are ten basic types of pain treated by Chinese medicine. These may be summarized as follows:
1) Draft pain (invasion of wind and internal wind) may be experienced accompanying arthritis, hypertension, stroke, convulsions and epilepsy. A distinguishing feature is migrating pain.
2) Cold pain (stagnation of Qi due to cold) is experienced with some types of arthritis and abdominal pain. A distinguishing feature is fixed location and spasmodic internal pain. Cold syndromes are treated by Yang tonic formulas.
3) Wet pain is experienced with sinusitis and common cold or with edema. It is characterized by congestion and a sensation of binding pain.
4) Heat pain is experienced with abscesses and inflammation of the internal organs. It is characterized by swelling and (when visible) redness.
5) Qi pain is associated predominantly with emotional factors and often affects the chest and abdomen.
6) Blood stasis and ecchymotic pain occurs in cases of traumatic injury (including surgical intervention and childbirth). The pain is usually very sharp ("pin prick pain") and localized.
7) Worm pain is experienced when there are intestinal parasites. Usually the pain is felt near the umbilicus. It is treated by anthelmintic formulas.
8) Food pain is experienced by individuals who have poor dietary habits, eat too fast, or consume foods that are too hot or cold. It can also occur following use of antibiotics or other drugs that effect the gastro-intestinal system.
9) Fluid pain occurs when there is phlegm accumulation placing pressure in the upper abdomen and chest. It can cause nausea, vomiting, headache, or Lymphatic swelling and is sometimes accompanied by shortness of breath and aching in the ribs.
10) Deficiency pain occurs when there is degeneration of the internal organs and reduced circulation to the extremities. Qi deficiency is accompanied by fatigue and disinclination to speak, Blood deficiency is accompanied by palpitations, Yin deficiency by restless heat affecting the palms, soles, and chest, and Yang deficiency by cold extremities.
Clearly, an understanding of the origins of the pain are important to proper treatment.
INFLAMATION AND PAIN
The inflammatory process is a means of allowing blood cells and other plasma contents to leak out of the vessels. It is initiated by the release of mediators, such as histamine, which increases blood flow (causing redness if the tissues involved are at the surface), making the capillaries leaky, and stimulating the nerves, causing pain. While inflammation is experienced by the individual as a negative event, it has the positive aspects of fighting infections, aiding healing of damaged tissues, and perhaps other benefits. However, in some cases, inflammation has an apparently negative impact from all views, such as when it occurs as part of an autoimmune disease (e.g. rheumatoid arthritis).
Reduction of inflammation is a common medical procedure, whether by applying ice to an injured part or corticosteroids to a rash. Whether or not inflammation has beneficial effects, it is usually deemed excessive and therefore something to be controlled.
In Chinese medical practice, promoting blood flow to an area that is inflamed is viewed as a means of reducing inflammation. This apparent paradox mirrors the concept that hemorrhage can often be treated by promoting blood circulation. This is because the pathological aspect of the blood circulation is thought to be a response to another, more basic, pathology. Blood stasis leads to increased blood flow and bleeding, therefore, clearing up blood stasis returns blood flow to normal and helps stop bleeding.