Pain is a complex entity to unlock. It’s a combination of many factors, from the obvious (car accidents, paper cuts) to the abstract (decades of cigarette smoking drying out the connective tissue surrounding the lungs), from the physical to the emotional or even the mental.

Unfortunately, the treatment of pain in mainstream Western society has degenerated into the widespread prescription of pain medications, a method that is sometimes so crude as to cause severe side effects or sedate the whole body. Who wants to be drowsy all day due to a pain pill? Moreover, such methods never cure the problem, they only mask the symptom.

In this article we’ll explore alternatives to pain relief that go above and beyond reaching for an ibuprofen. First, we’ll discuss how to think of and explore your experience of pain, as a starting point. Then we’ll explore a simple but useful way to conceptualize your pain through the stages of traumatic injury. Finally, we’ll discuss methods of treatment, many of which you can do at home.

The Process of Understanding Pain

The primary purpose of all of my articles is not just to provide useful content, it’s to initiate you, the reader, into grasping the process of healing—comprehending the concepts and methods by which pathological events happen, thus giving you control over them.

In other words, if you know how to think for yourself about your problems, then you have a greater chance of being able to solve them by yourself.

So in this process of learning how to think about pain, we begin at the beginning: What is pain?

We know what pain is on an abstract level: some sort of sensation in the body that signals that something is wrong. But it’s important to penetrate into the experience of this pain signal more deeply. The better you understand it, the better you know how to deal with it. Knowledge is power, and the more you’re educated about your own pain, the more you can help yourself, or help your doctors help you.

For any problem, not just pain, it’s useful to ask two questions:

  • What’s going on?
  • What does it mean?

This is the basic deductive process of a detective or a scientist. First, you make an observation; you collect data. Then, you try to make sense of your observations; you analyze and interpret the data.

So when you encounter something like pain, don’t just stop at the thought, “It hurts.” Take the time to observe the phenomenon a little more closely.

If you go to a competent health care practitioner, they’ll all engage in the process of differential diagnosis, by asking a number of questions. In Chinese medicine, these questions may include the following:

  • Location. Is the pain in a small or large area? Is it fixed in one place or does it move around?
  • Quality. Is it dull, aching, tight, sharp, stabbing, burning?
  • Depth. Does it hurt superficially, in the muscle, or can you feel it deep in your bones?
  • Intensity. How bad is it on a scale of 1 to 10?
  • Frequency. Does it hurt constantly, or is it intermittent?
  • Duration. How long does it hurt at a time, and how long have you had it?
  • Better/Worse. What makes it better, and what makes it worse?

The goal of this classification is twofold. First, it helps you to describe more articulately the nature and scope of your problem, and face how it affects your life. A lot of people live with pain in a long-term sense, to the degree that they’ve lost all perspective and don’t really understand that it severely limits the quality of their lives. Often this happens to people who have given up hope, because their doctors tell them that there is no hope. And that’s understandable, but still it’s a useful principle to follow that in order to arrive at a solution, you must first be intimately acquainted with the problem.

Second, this type of questioning yields valuable information about the types of things that can contribute to your pain and discomfort, and therefore gives you valuable clues as to how to find relief, which ultimately brings you to a practical result. Knowing these details points you toward things you can do to take care of yourself.

This is particularly true of the last question: “What makes it better, and what makes it worse?” There are a wide range of things that can affect pain, including (but not limited to):

  • Pressure (e.g. massage)
  • Time of day
  • Posture: Standing/sitting/lying
  • Meals or diet
  • Stress: Emotions, thinking, attitude
  • Menstrual cycle
  • Movement/rest
  • Temperature and humidity

This list is useful in and of itself. If you start to notice that your pain is worse with stress, then obviously that can point you in a certain direction. Take that information and run with it. Understand that stress (just to pick this example) can have a profound effect on your entire physiological functioning, and can indeed be crippling. Begin to explore other, more subtle effects stress has on your life, from upset digestion to disturbed sleep. This is a valuable and important process, not only for your pain, but for your whole health.

Another example: If you have pain that’s worse two hours after a big meal, then that points you in another direction. Start examining what you eat, and how you eat, and whether other foods might be more suitable.

Pain: The Basic Concept

Beaver Dam

Now let’s get more specific.

We return to the question, “What is pain?” Pain, according to Chinese medicine, is stagnation. It is, in other words, the obstruction of free flow in the body. Free flow of what? Well, there’s a Chinese saying that “Movement is life.” If you stop moving, you die. And it’s true: the body, even in sleep, is constantly in motion, from the beating of the hurt to the firing of neurons.

So what moves? Blood, lymph, other bodily fluids, nutrients. You name it, it’s moving. The Chinese use a word, “qi,” often translated as “energy,” which can, in this context, be considered kind of an epiphenomenon of all of the above. For shorthand, we say that the “qi” is moving.

So when you’re in pain, we say that the “qi” is not moving, until it gets more serious and there are more obvious blockages, like the stagnation of blood.

In any event, obstruction of the free flow of circulation is the main immediate cause of pain.

There are many directions to go from here, many types of pain. Here we’ll just be dealing with the most common, musculoskeletal pain. Some of this may not apply, say, to pain from neurological problems; but, it might.

The Three Stages of Trauma
A useful model to understand pain is the three stages of traumatic injury. Obviously, not all pain is caused by a trauma, but this model can still be useful in all sorts of musculoskeletal pain situations, as you’ll see.

The three stages of trauma are:

  1. Acute
  2. Post-Acute
  3. Chronic

The acute phase, which typically lasts a few days up to a week, is well-known for its obvious signs of trauma and inflammation: heat, redness, swelling, and pain. It’s also known for the RICE therapy: Rest, Ice, Compression, and Elevation.

It’s useful to spend a few minutes understanding the logic behind this.

Traffic Accident

When you have an acute injury, it’s like a traffic accident on a highway. There are three components to the accident. First, there are the accident victims: the damaged vehicles and the injured people. Second, there are the professionals rendering assistance: police, fire engines, and EMTs. And finally, there are all of the other cars travelling on the highway.

The priority is to get the injured to the hospital. But how do you do that? If their damaged cars are blocking the highway, this creates a cascade effect so that emergency personnel have a harder time getting to them. Thus, trauma causes stagnation. The stagnation contributes to pain, and it also impedes circulation so that the body’s “emergency personnel”—clotting factors, anti-infective agents, etc.—have a harder time getting to injured area.

Thus, two aspects of RICE—compression and elevation—are focused on opening up the circulation. For a sprained ankle, you elevate the foot so that the fluid can drain out of it via gravity; and, you compress or massage around the area to encourage blood and lymph movement.

Building Fire

The other notable aspect of RICE is its use of ice. In this case, imagine a building fire rather than a car accident. The acute injury is the stage of the event where everything’s ablaze. In the case of a fire, the main priority is to put it out. So in injuries, ice is often used.

As a side note, here there’s a divergence between Western and Chinese medicine. The issue is that ice can contribute to stagnation, because even though it cools, it also constricts circulation. On the other hand, there are well-known and often-used Chinese topical herbs (which we’ll talk about later) whose actions both move stagnation and cool the temperature, and this is considered much more ideal.

In any event, in the first stage of trauma the principles behind RICE are mostly consistent with the concepts of Chinese medicine: Stop the pain and encourage the area to heal by removing pathological heat and improving circulation.

The post-acute stage, which can last a few weeks, is a somewhat ambiguous phase. In the car accident analogy, it’s the period of time when the victims have been carted off to the hospital and the cars are well off to the side of the road, but there are still emergency personnel around. As passers-by, most of us are familiar with this phase: There’s a mysteriously slow-down in the flow of traffic along the highway, yet no obvious obstruction.

In the building fire analogy, you could think of this as the stage where the fire is mostly out, but there’s an element of uncertainty, so that people are still advised to remain clear of the building, and firemen are still investigating and checking to make sure.

You may notice a continuing theme relating to temperature. The reason is that, alongside the general concept of stagnation, temperature is particularly important, both in the diagnosis and the treatment of pain and trauma.

The “temperature” of a painful area means two things. First, how does it feel when it’s touched? Does it feel hot, or cold? And second, when you apply heat or cold to the area, does that make it feel better or worse? Commonly, heat is encountered in the form of hot showers or baths, or heating pads; and cold can be encountered in the form of changes in weather, or air conditioning.

The reason temperature is singled out for significance is due to the reliance of Chinese medical theory on the concept that environmental factors—heat, cold, dampness, dryness, wind, and something called summerheat—can “invade” the body. Practically speaking, we’re warm-blooded creatures, so our bodies like to be at a certain temperature, and hundreds of processes are happening in us all the time to keep every part of us within a healthy temperature range.

Any time this delicate balance is disrupted, whether the temperature goes in an upward or downward direction, an environmental factor can be said to “invade.” This usually correlates with a disruption in the body’s ability to deliver energy—manifesting most obviously in the form of heat—to the appropriate area, or a disruption in the body’s ability to deliver toxins away from a congested area.

In an acute injury, the area is obviously “inflamed” and there’s a lot of heat, in Chinese medical terms and in Western as well. In the post-acute stage of a traumatic injury, the heat has begun to subside but often is still there. Like a car with a gas leak in the middle of the highway, it may not be particularly inflamed, but the potential for further disruption of healthy circulation remains.

Gutted Building

The chronic stage happens if an injury has not fully resolved—if the traffic flow remains blocked in the long term. In the building fire analogy, it’s what happens after a building fails to be rebuilt after a fire. The emergency’s over, the victims and emergency personnel are long gone, but the resources simply haven’t come back in to rebuild. There’s just a gutted shell of a structure left.

The lack of nourishment, circulation, activity, and energy in the area can be said to be a “cold” condition, and, handily enough, many chronic pains—even ones that are ostensibly labeled inflammation—are improved by the application of heat.

Chronic pain can, obviously, go on for many years.

Of course, not all chronic pain comes as the result of a single traumatic injury. However, it remains the case that many, if not most, chronic muscle aches and pains follow this model. It’s as if an injury did occur, and went directly to the third stage. Somehow circulation was impeded and left the area cold and undernourished.

This may be analogous to cars simply breaking down and being left on the side of the road, or a very old building with a deteriorating structure. Sometimes it’s just the wear and tear of age and use that causes circulation problems that lead to pain.

There are areas in between, of course. Repetitive stress injuries are a good example: They’re essentially chronic pain conditions that are constantly being microscopically re-injured acutely, leading to an ambiguous sometimes-hot, sometimes-cold situation. This is, of course, the second, post-acute stage of trauma.

Treating Pain

All right. So how do you treat pain?

Since pain is essentially some sort of blockage, treatment for pain essentially comes down to restoring the smooth flow and circulation of blood and energy through the painful area. This is a simple yet essential principle. All the methods that Chinese medicine offers to treat pain are based in this.

Additionally, you treat pain according to the stage it’s in, i.e. by temperature. You cool where it’s warm, and you warm where it’s cool.

The following methods are organized roughly so that the ones easiest for you to apply for self-treatment come first.

  • Exercise
  • Lifestyle and Dietary Therapy
  • Bodywork
  • Herbs
  • Acupuncture and Moxibustion

Exercise in a therapeutic context includes stretches, range of motion, and strength exercises. If pain is stagnation, it follows intuitively that moving the area around—gently, of course, within the range of comfort—can contribute to restoring the flow of blood.

It’s also important to understand that blocked circulation has systemic effects. Thus, if you’re aiming to restore circulation to relieve wrist pain, then don’t just open up your wrist—it’s important to free up your elbow, your shoulder, your neck, and your back. In fact, ideally the whole body is addressed, because each part will affect all of the others.

Strength exercises are a bit more about prevention than treatment, but they’re quite important in maintaining a good tone and circulation through the tissue. Much of our circulation comes, not just from the beating of the heart, but from the working of the skeletal muscles as we move through our day. It takes properly strengthened muscles to do that.

Your diet and lifestyle may not seem to be of any importance when it comes to pain, and indeed, in the acute stage of a bone break, it doesn’t really matter a whole lot what you eat. But the amount of physiological and metabolic energy that comes from lifestyle choices and dietary habits comes to have a great impact in chronic conditions. Anything chronic affects, and is affected by, the state of the internal organs, which is really the root of your whole physical functioning. So if you’re very fatigued, eating a lot of unhealthy foods, smoking like a chimney, very stressed, and sleeping very few hours, all of those things can impact your body’s energy and therefore your ability to circulate blood properly.

Conversely, bodywork is a pretty intuitive one: It’s easy to imagine how massage or other sort of physical manipulation (some aspects of physical therapy fall into this category as well) can improve circulation and help deal with pain.

Thus far, these approaches don’t require any extra equipment or supplies, other than an adjustment in the kind of food you buy. The ideal self-healing approach is free of gear and free of charge. but, of course, the more severe the condition, the more outside help you need in order to resolve your problems.

There are three general categories of tools in Chinese medicine to relieve pain: Bodywork, herbs, and acupuncture.

Bodywork has been mentioned already, and is intuitive to most people as being eminently effective for freeing the circulation and relieving pain.

Herbs are the easiest thing to apply for yourself. Herbs can be applied topically, and they can be taken internally.

The forms of topical products made include:

  • Liniments
  • Creams
  • Poultices
  • Plasters
  • Soaks
Dit Da Jow

Liniments are a liquid, usually a combination of water, alcohol, and herbal extracts. They’re essentially made by soaking herbs in an alcohol-water solution. They are commonly used in Chinese medicine, as they are inexpensive and easy to apply. The alcohol preserves the herbs and also helps them penetrate into the skin quickly; the caveat is that liniments need to be applied more frequently in order to be effect.

The product shown on the right is a commonly used class of liniment called die da jiu, or dit da jow, translated as “medicated wine for hits and falls.” This type of treatment was common for Chinese martial artists, who had great need for medicine that would help them to heal from sparring and fighting injuries.

Liniments are among the easiest and most convenient to use.

Creams are well-known in the Western world. In Chinese medicine they’re usually combinations of herbs in a thick base.

Poultices are herbs that you apply directly to the painful area itself, as long as the skin isn’t broken. It’s a simpler and more direct method , but is often messy and difficult to apply to hard-to-reach or awkward locations. Still, they have a reputation for being powerful.

A more convenient form of the poultice is the plaster, most of which are as easy to put on as a Band-Aid. In these, the herbal ingredients are condensed into flat sheets and adhesive is added. All you do is peel off the backing and stick it on where it hurts.

Some plasters are “cool” in temperature, some are warm, some are very hot. These are, clearly, formulated for different stages of trauma.

Soaks are similar to poultices, except that the herbs are steeped in water, like a tea, and the afflicted area of the body is soaked in the water.

Chinese herbal formulations almost always use multiple herbs, and in most or all topicals you’ll find combinations of herbs that open the circulation (“move blood,” in Chinese medical parlance), as well as herbs chosen or added to suit a cool or warm temperature.

The benefit of these topical formulas is that they tend to be pretty inexpensive while still being quite effective. I recommend everyone have some in their home medicine kit.

Yunnan Baiyao

There are also Chinese herbs taken internally for each one of the three stages of trauma, targeted specifically to the stage and, often, to the part of the body that is injured. This tends to be more individualized, and it would be best to see a qualified practitioner if you wanted to take something internally. There’s a popular herb formula called Yunnan Baiyao (“White Medicine from Yunnan Province”), however, that is commonly used and very effective particularly in the first and second stages of trauma, as it has the additional effect of stopping bleeding.

Finally, acupuncture, and adjunctive methods such as moxibustion (a form of heat therapy using an herb called moxa, also known as mugwort), and also acupuncture combined with electrical stimulation, can be the most effective and quickest method of pain relief. Self-treatment with acupuncture is impossible for the untrained, but in the right hands it can yield immediate and dramatic results.

I see many people for pain, and despite the utility of all of these other tools, acupuncture is my top choice for achieving a powerful result very quickly. Perhaps 80% of the time the patient will see an instantaneous result, and this is quite a boon particularly for those who’ve been suffering for a long time.

Stabilizing the pain relief is a separate matter from generating the relief in the first place, though, and depends a great deal on the general condition of the body. So don’t think that the other things mentioned here don’t apply. Acupuncture can be a powerful tool, but in my opinion is best used in the context of a multifaceted approach including most or all of the elements we’ve outlined here.

Pain can be a difficult thing to live with. Hopefully you’ve learned that you may not have to. Pay attention to your pain and the things that affect it. Understand the stages that pain goes through, and what is seen in each stage. And begin to experiment with various approaches—whether it’s exercises, lifestyle modification, or herbs and acupuncture.

As a specialist in pain, I am always available for consultation. Many, if not most, of the products I mention I carry in my clinic; but, as I said, the quickest form of relief for many pain conditions is to be found in acupuncture, and I am more than happy to demonstrate.

If you’re interested in these approaches and want more information, contact the clinic for a free consultation.

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