A national survey indicated that more than one-quarter of U.S. adults had recently experienced some sort of physical pain lasting more than a day. 
Pain is a feeling triggered in the nervous system. It may be sharp or dull, off-and-on or steady, localized or all over. Although pain usually goes away once the underlying problem is removed, it can last for weeks, months, or even years.
To relieve their pain, many people take over-the-counter medications including aspirin, naproxen, and ibuprofen. Stronger medications, including NSAIDs in higher dosages and narcotics, are available only by prescription.
People may also try non-drug approaches to help relieve their pain, including physical and occupational therapy, cognitive behavioral therapy, self-care techniques, and complementary and alternative therapies, such as spinal manipulation or acupuncture.
From the Chinese medicine perspective, pain is caused by two energy imbalances. One is the blockage of energy channels. Energy or qi needs to flow smoothly to maintain normal function of body and mind. Wherever there is blockage of energy channels, there will be pain existing in the area. In other words, when energy is stagnated in the area, it causes pain.
The factors that are involved in causing the blockage of energy channels (also called meridians) include physical trauma, emotional distress, and excessive pathogenic energy from the environment, such as heat, cold, and dampness. Insect bites and excessive alcohol intake contribute to the problem as well. This type of pain is usually acute, severe, or intermittent, and it is migrating or fixed.
The other type of pain is principally caused by a deficient amount of energy moving in the body or body aches due to lack of nutrition supplied through good circulation. This type of pain is normally dull, chronic, and consistent and is in a fixed location. Very often, people have pain caused by both of above conditions.
Acupuncture treatment is often used after the evaluation of energy channels and determining the types of energy imbalances that are present.
Acupuncture needles can always be placed at areas of tenderness, called Ashi points. In addition, a combination of acupuncture points should be selected to address the energy imbalance in the related meridians. For example, for a middle-aged man with chronic lower back pain caused by deficient qi in the kidney and bladder meridians, some points on the kidney and bladder meridians will be selected.
Also, the points in the spleen and stomach meridians may be chosen because they are supportive of kidney and bladder energy. There are a couple of points on the back of hands that are very useful for back pain.
After the points are selected, the techniques of inserting and manipulating the needle may differ based on the whether the energy is blocked or deficient. For example, if energy is blocked, a needle should be inserted against the direction of the energy flow and twisted counterclockwise. If energy is deficient, the needle is inserted to the direction of the energy flow and twisted clockwise.
Traditionally, people receive acupuncture on a daily basis targeting certain conditions. In the United States, people receive treatments once or twice a week due to financial and time constraints. People need to have persistent courses of treatment in order to fully benefit.
Acupuncture is being studied for its efficacy in alleviating many kinds of pain. There are promising findings in some conditions, such as chronic low-back pain and osteoarthritis of the knee. The problem with research is that it often fails to make accurate evaluation of energy imbalances of each patient, and it does not treat frequently and persistently enough to demonstrate its effectiveness is greater than placebo needling.
In animal studies, acupuncture seems to be able to stimulate the production of endorphins and regulate neurotransmitters. Neurophysiologic studies in humans indicate that acupuncture can reduce the electrical activity in the area of brain involved in the perception of pain. However, none of these findings can explain the dramatic and rapid reduction of pain.
Acupuncture is generally considered safe when performed by an experienced practitioner using sterile needles. Relatively few complications from acupuncture have been reported. Serious adverse events related to acupuncture are rare, but include infections and punctured organs.
Additionally, there are fewer adverse effects associated with acupuncture than with many standard drug treatments (such as anti-inflammatory medication and steroid injections) used to manage painful musculoskeletal conditions like fibromyalgia, myofascial pain, osteoarthritis, and tennis elbow.
1. National Center for Health Statistics. Health, United States, 2006. With Chartbook on Trends in the Health of Americans, Hyattsville, MD: 2006
Dr. Yang is a board-certified psychiatrist and is a fourth-generation doctor of Chinese medicine. His Web site is taoinstitute.com