Chronic pain is more common in women, regulate the body and mind and get out of the abyss of pain

Chronic pain is more common in women, regulate the body and mind and get out of the abyss of pain

(Hong Kong News) There are many causes of chronic pain, such as unhealed injuries, nerve damage, degeneration of muscles, bones and joints, cancer, etc.

Chronic pain is more common in women, and the pain site can cover the whole body. Clinically, the more common pain sites include the head, shoulder, neck, mouth, waist, hip, and abdomen. The specific sensations include soreness, stretching pain, needle pain, burning pain, etc. .

Insufficiency of Qi and Blood Causes Chronic Pain

Since pain is a subjective feeling, pain cannot be measured by instruments. Therefore, when evaluating the severity and impact of pain, doctors need to patiently communicate with patients and use experience to judge the condition.

Traditional Chinese medicine believes that there are two types of causes of pain: “external causes” and “internal causes”:

External causes are mostly due to environmental factors, such as wind, cold and dampness, or injury caused by falls, which often cause acute pain, with rapid onset, short course of disease, and faster recovery

Internal factors are mostly due to long-term poor body functions, such as stagnation of qi and blood stasis, insufficient qi and blood, which often cause chronic pain, slow onset, long course of disease, and slow recovery

The common internal causes and pathogenesis can be divided into “pain due to obstruction” and “pain due to lack of glory”: the former is a positive syndrome, which refers to stagnation of qi and blood, which leads to blockage of meridians and collaterals, resulting in pain. Clinical manifestations can be seen that the pain is fixed, showing swelling pain, burning pain, acupuncture pain, refusal to press, ecchymosis, petechiae or swelling in the affected area.

When examining the tongue, the color of the tongue is dark, there are ecchymosis, and the pulse condition is difficult and rough; the latter is deficiency syndrome, which refers to the deficiency of qi and blood, unable to moisten and nourish the meridian, which makes the meridian empty and causes pain.

The clinical manifestations can be seen that the pain is moving indefinitely, the pain is mild and sometimes severe, it is dull pain, soreness and numbness, and it is easy to press, and the skin of the affected area is pale and cold. When the tongue is examined, the tongue color is pale, the tongue body is swollen, and the pulse condition is heavy and weak.

Promoting qi and blood circulation and tonifying

For chronic pain caused by qi stagnation and blood stasis, the treatment needs to promote qi and blood circulation and unblock the meridians. Commonly used prescriptions include Xuefu Zhuyu Decoction, Shentong Zhuyu Decoction, Danshen, Cyperus Cyperi, Corydalis Corydalis, Panax notoginseng (Tianqi), etc. For chronic pain caused by deficiency of qi and blood, the treatment needs to replenish qi and blood. Commonly used prescriptions include Buzhong Yiqi Decoction, Siwu Decoction, Astragalus, Codonopsis, Danggui, Baishao, etc.

In view of the common clinical chronic pain patients, the syndromes are mostly mixed with deficiency and excess. In actual treatment, both attack and supplement are usually used, and the combination of promoting qi and blood circulation and tonifying is used.

Acupuncture and moxibustion to dredge the meridians – Acupuncture and moxibustion can select acupoints near the pain site, dredge the meridians and promote the circulation of blood and qi.

Acupuncture and moxibustion proximal acupoint selection to dredge meridians

In terms of acupuncture and moxibustion, for pain, it is generally possible to use proximal acupoints, that is, select acupoints near the pain to dredge the meridians and promote the circulation of qi and blood. For example, if the pain of muscles, bones and joints is fixed, acupuncture can also be used to stimulate the relevant tender points. In Chinese medicine, it is called “Ashi point”, and it also has the effect of regulating qi and blood.

According to the principle of syndrome differentiation and treatment, people with Qi stagnation and blood stasis can use “reducing method” during acupuncture, that is, strong manipulation stimulation; people with weak Qi and blood can use “replenishing method” during acupuncture, that is, gentle manipulation, or combined with the selection of tonifying function Such as acupuncture points, such as Beishu point, Zusanli point, Sanyinjiao point and so on.

Holistic diagnosis without pain relief

In addition to discomfort caused by pain, patients with chronic pain may also be accompanied by other symptoms, such as loss of appetite, insomnia, irritability, and depression due to unbearable pain.

Because these concurrent symptoms and pain can often affect each other, it is necessary to consider and deal with pain and general conditions together in TCM syndrome differentiation and treatment, rather than “seeing pain and relieving pain”.

Holistic treatment is the characteristic of TCM treatment of chronic pain, emphasizing holistic diagnosis and examination. Every symptom and sign of a patient may have guiding significance for diagnosis and syndrome differentiation, so it needs to be paid attention to.

By carefully observing the patient’s expression, facial expression, tone of voice, posture and movement, and understanding the patient’s medical history, diagnosis and treatment experience, etc., it will help the doctor to grasp the patient’s pain condition, physical condition and mental state, and improve the treatment plan.

After the “raw snake” repeated pain, difficulty sleeping and eating, depression

A 60-year-old woman “had a snake” half a year ago. Although the herpes zoster lesions on the right chest and armpit have healed, the local pain still recurs from time to time, such as acupuncture, burning, electric shock, touching The pain in the affected area intensified, causing the patient to have trouble sleeping and eating and feeling depressed. In the past six months, he lost more than 10 pounds due to poor appetite.

The patient has a haggard face, mental fatigue, dry mouth, easy dizziness, loss of appetite, and a low voice. Tongue examination showed dark red tongue, thin white fur and dry texture, deep thready pulse. TCM syndrome differentiation considers the patient’s medical history and pain to reflect the stasis of the meridian, and if it is blocked, it will cause pain.

Promoting qi, activating blood, soothing the liver and relieving stagnation

The comprehensive mental state of the patient also reflects the deficiency of both qi and blood, and stagnation of qi in the liver, which cannot nourish the meridians, which will hinder recovery. The treatment strategy for this patient should be both attack and tonic, with strengthening the spleen, nourishing blood and strengthening the body, so that the qi and blood are sufficient to promote recovery, supplemented by promoting qi and blood circulation, soothing the liver and relieving depression, and eliminating the factors of qi stagnation and blood stasis that hinder recovery. Add and subtract Xiaoyao San and Xuefu Zhuyu Decoction. (Specific medication omitted)

Cooperate with more outdoor activities

After 8 weeks of treatment, the patient has a better understanding of his physical condition and condition, and cooperates with more outdoor activities such as walking and outings. The pain and discomfort have been greatly improved, the appetite has increased compared with before, falling asleep is easier than before, and the mood is also better than before. cheerful.

Although the affected area still occasionally hurts, the attack frequency and pain have been significantly reduced, and it will not affect daily life and sleep. In terms of treatment, continue to benefit the essence and blood, and use Guipi Decoction, Liuwei Dihuang Pill and so on.

Fighting Pain—Relaxes and decompresses to achieve the effects of body, mind and breath regulation, which helps to fight pain.

In addition to medicine, acupuncture and massage should be used to keep in good health and adjust the thought.

The condition of chronic pain is closely related to physical and mental conditions, and can affect each other.

Therefore, in addition to medication, acupuncture, massage and other treatment methods, it is also necessary to cooperate with health care, adjustments, and ideological enlightenment.

Aiming at chronic pain, there is a science of “pain management” in modern times. Through the interdisciplinary cooperation between Chinese and Western medical care, it helps patients to correctly understand their condition, eliminate misunderstandings and unreasonable expectations, and take appropriate treatment, nursing, rehabilitation, and physical and mental adjustment. Methods to improve the degree and impact of pain and improve the quality of life.

Light diet and moderate exercise

Health care precautions for patients with chronic pain:

1. Keep your diet light.

It is advisable to eat mild foods, such as lean meat, eggs, dark vegetables, grains, etc. Foods that are too spicy, warm and dry, such as peppers and ginger, are easy to get angry and may induce inflammation; foods that are too cold and cold, such as watermelon and cold drinks, are likely to stimulate the spleen and stomach and hinder the circulation of Qi and blood. These foods with excessive attributes should be avoided .

2. Keep your mind at ease.

Depression or excessive anxiety will aggravate the discomfort of chronic pain, and long-term insomnia will also make the pain relapse. If you are troubled by negative emotions, you can talk to others, or take the initiative to seek professional help. Learning mindfulness, sitting still, meditating, or listening to soft music, cultivating healthy interests, etc., all help to relax and decompress, stabilize emotions, divert attention, and help relieve pain and its extended discomfort.

3. Moderate exercise to promote the circulation of Qi and blood.

Traditional Chinese medicine health-preserving exercises such as Tai Chi and Baduanjin can help improve muscle tension, adjust posture, promote blood circulation, relax and reduce stress, and achieve the effects of body, mind and breath regulation.

However, strenuous exercise should be avoided in the affected part of the pain to prevent injury.

Text Qiu Yufeng (Chinese Medicine Physician)

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