In medicine we regard pain as a symptom associated with an injury or some type of pathological process. However this excludes a large proportion of sufferers with psychological pain where there is no obvious physical cause. Unlike acute pain which usually has an organic cause, patients with psychological ailments have no obvious cause of the pain. In the same way, chronic pain is also not a benign entity; the pain is continuous, can be disabling, lead to depression and overall the patients have a very poor quality of life. Often it is not just physical but also related to emotional and psychological reasons. Currently, it is estimated that anywhere from 3-7% of the population may have chronic or psychological pain.
Over the years many treatments have evolved for the treatment of psychological pain but none has proven to be effective in all patients. The traditional analgesics do not appear to work and with the current opiate crisis, these agents are no longer recommended. Most other drug therapies that include antidepressants and anticonvulsants do not reliably provide any significant pain relief in all patients. Plus, these drug therapies often have potent adverse effects, are costly and may be addictive.
Because of the failure of conventional therapies to manage psychological pain, many patients have been turning to acupuncture. This old Chinese treatment has been used to treat pain from a variety of causes with good success. Most of the literature on the benefits of acupuncture has looked at acute causes of pain but its role in the management of psychological pain has not been fully evaluated. The few studies published on the benefits of acupuncture for psychological pain appear confusing, with some reports indicating that the treatment works and others claiming that acupuncture does not work for psychological pain. Most of the older acupuncture studies with large numbers of participants were not randomized and the outcomes of pain relief were not always quantified, hence data from these studies are difficult to assess. Overall, these older studies have indicated that about 50% of patients with chronic or psychological pain do obtain some pain relief over time. Unfortunately, the studies did not indicate which patient would benefit from the treatment.
So what is the present status of acupuncture for psychological pain?
Recently researchers analyzed 6 studies involving 462 patients who had chronic pain. The patients were between 52-63 years of age and received treatment for a minimum of 8 weeks.
Unfortunately, the quality of evidence from these studies was low because the treatment was not compared to sham acupuncture and the participants were not blinded. The number of participants in some studies was small. Overall, the researchers stated that they simply did not have evidence to refute or support the use of acupuncture for chronic or psychological pain.
However, since the treatment is relatively safe when done by an experienced practitioner, it may be an option for an individual who has failed to respond to other conventional pain treatments.
Dr. Lucy Chen, a specialist in pain medicine and a practicing acupuncturist who works at the Harvard affiliated Massachusetts General Hospital states, “I think the benefit of acupuncture is clear, and the complications and potential adverse effects of acupuncture are low compared with medication.” More important acupuncture is not as costly as drug therapy nor does it cause physical or psychological dependence. So for patients with psychological pain, it may be worth a try.
References
- Research Finds Acupuncture Effective for Chronic Pain.(2018, May 21) https://www.aafp.org/news/health-of-the-public/20180521acupuncture.html
- Vickers AJ, Linde K. Acupuncture for chronic pain. JAMA. 2014;311(9):955–956. doi:10.1001/jama.2013.285478
- Yang Z, Zhao L, Xie X, et al. The effectiveness of acupuncture for chronic pain with depression: A systematic review protocol. Medicine (Baltimore). 2017;96(47):e8800. doi:10.1097/MD.0000000000008800
- Vickers AJ, Vertosick EA, Lewith G et al. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. 2018; 19(5): 455-474.
- Ingraham P. Does Acupuncture work for pain. (2018, Jun 13). https://www.painscience.com/articles/acupuncture-for-pain.php
- Ju ZY, Wang K, Cui HS, et al. Acupuncture for neuropathic pain in adults. Cochrane Database Syst Rev. 2017;12(12):CD012057. Published 2017 Dec 2. doi:10.1002/14651858.CD012057.pub2