Dr Maggie Ju
Acupuncture London

Dr Maggie Ju's pain clinic

We Specialize at headache, migraine, neck pain and jaw pain. 

Why do you experience pain?

Pain is a complex and multifaceted experience that serves as a crucial signal from our bodies, indicating that something is wrong or potentially harmful. Here are some reasons why people might experience pain:

Injury or Trauma: One of the most common causes of pain is physical injury or trauma. When tissues in the body are damaged, whether it's due to a cut, bruise, fracture, or internal injury, pain receptors called nociceptors send signals to the brain, alerting it to the damage. This type of pain is often acute and serves as a protective mechanism, prompting individuals to take actions to prevent further harm and allow the body to heal.

Inflammation: Inflammation is the body's natural response to injury, infection, or irritation. When tissues are inflamed, they release chemicals that activate pain receptors, leading to sensations of pain, swelling, and warmth. Conditions such as arthritis, tendonitis, and bursitis are examples of inflammatory disorders that can cause persistent pain.

Disease or Illness: Pain can also be a symptom of underlying health conditions. Chronic diseases such as cancer, diabetes, multiple sclerosis, and fibromyalgia can cause persistent pain due to their effects on the body's tissues, nerves, or organs. In some cases, the pain may be directly related to the disease itself, while in others, it may be a result of complications or side effects of treatments.

Nerve Damage: Damage or dysfunction of the nervous system can lead to chronic pain conditions known as neuropathic pain. Conditions such as diabetic neuropathy, sciatica, and trigeminal neuralgia involve damage to the nerves, resulting in abnormal sensations of pain, tingling, burning, or numbness. Nerve pain can be challenging to treat and may require specialized interventions.

Psychological Factors: Emotional and psychological factors can also influence the experience of pain. Stress, anxiety, depression, and trauma can amplify pain perception and make it more difficult to cope with. Conversely, positive emotions, relaxation techniques, and cognitive-behavioral therapies can help reduce the intensity of pain and improve overall well-being.

Genetic Predisposition: Some individuals may be more susceptible to experiencing pain due to genetic factors. Variations in genes related to pain perception, inflammation, and the function of the nervous system can influence an individual's sensitivity to pain and their risk of developing chronic pain conditions.

Lifestyle Factors: Lifestyle choices such as poor posture, sedentary behavior, unhealthy diet, smoking, and excessive alcohol consumption can contribute to musculoskeletal pain, inflammation, and other health problems that increase the likelihood of experiencing pain.

Environmental Factors: Environmental factors such as temperature, humidity, pollution, and noise can influence pain perception and exacerbate existing pain conditions. Changes in weather, for example, are often associated with increased joint pain in individuals with arthritis.

Pain is a complex phenomenon with various underlying causes, ranging from physical injury and inflammation to disease, nerve damage, psychological factors, and genetic predisposition. Understanding the underlying mechanisms of pain and addressing its root causes are essential for effective management and improving the quality of life for individuals living with chronic pain conditions.

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What Happens to the Nerves When You Have Pain?

Pain is a complex and essential biological signal indicating that something is wrong with our body. It’s more than just a sensation; it’s a multi-faceted process involving the nervous system. To understand what happens to the nerves when you experience pain, it’s crucial to look at how pain is detected, transmitted, and processed in the body.

The Anatomy of Pain

Pain starts with specialized nerve endings called nociceptors. These are sensory neurons that detect harmful stimuli, such as extreme temperatures, mechanical pressure, or chemical damage. Nociceptors are distributed throughout the body, including the skin, joints, muscles, and internal organs. They act as the body's early warning system.

Pain Detection: Activation of Nociceptors

When a nociceptor detects a potentially harmful stimulus, it converts this stimulus into an electrical signal through a process called transduction. This signal is essentially an action potential, an electrical impulse that travels along the nerve fiber towards the central nervous system.

The nociceptors respond to different types of stimuli:

Thermal nociceptors react to extreme temperatures.

Mechanical nociceptors respond to physical pressure or injury.

Chemical nociceptors detect harmful chemicals, such as those released by damaged tissue or inflammation.

Transmission: The Journey of the Pain Signal

Once an action potential is generated, it travels along the peripheral nerve fibers. These fibers are part of the peripheral nervous system and are categorized into two main types based on their diameter and myelination (a fatty sheath that speeds up signal transmission):

A-delta fibers: Myelinated, thicker fibers that transmit sharp, acute pain quickly.

C fibers: Unmyelinated, thinner fibers that transmit dull, aching pain more slowly.

The action potential travels from the site of injury along these fibers towards the spinal cord. The spinal cord acts as a relay station where the pain signal is modulated and then transmitted to the brain.

Modulation: The Role of the Spinal Cord

In the spinal cord, pain signals are modulated before being sent to the brain. This modulation occurs in the dorsal horn of the spinal cord, where nociceptive neurons release neurotransmitters like glutamate and substance P. These chemicals activate secondary neurons, which then relay the signal upwards.

At this stage, the pain signal can be amplified or dampened by various factors, including:

Descending pain control: Neurons from the brain can release substances that inhibit pain transmission, providing a form of top-down pain control.

Gate control theory: Non-painful stimuli, like touch or vibration, can inhibit pain signals. This is why rubbing a bumped elbow can temporarily relieve pain.

Perception: The Brain's Role in Pain

The pain signal reaches the brain, where it is processed and interpreted in several regions:

Thalamus: Acts as a central relay station, distributing the signal to various brain areas.

Somatosensory cortex: Interprets the location, intensity, and nature of the pain.

Limbic system: Contributes to the emotional response to pain.

Prefrontal cortex: Involved in the cognitive appraisal of pain, including attention and planning.

The brain integrates this information, producing the conscious experience of pain. This is where the subjective perception of pain occurs, influenced by individual experiences, emotions, and context.

Pain and Neural Plasticity

Chronic pain, where pain persists beyond normal healing, can lead to changes in the nervous system, known as neural plasticity. This can involve:

Central sensitization: Increased responsiveness of neurons in the central nervous system, making pain signals more intense or long-lasting.

Peripheral sensitization: Heightened sensitivity of nociceptors in the periphery, reducing the threshold for pain.

These changes can create a persistent pain state, even after the initial injury has healed.

Conclusion

Pain is a critical protective mechanism involving a complex interplay between nociceptors, nerve fibers, spinal cord, and brain. Understanding how pain is detected, transmitted, and processed by the nervous system helps in developing effective treatments and interventions for pain management. The journey from a harmful stimulus to the conscious experience of pain underscores the intricate nature of our nervous system’s response to injury and harm, highlighting the essential role of nerves in safeguarding our well-being.

 

Acupuncture is emerging as the predominant method for alleviating pain

Pain is an inevitable part of life that can significantly impact one's quality of life. When we experience pain, it is transformed into a nerve signal that travels to the brain, where the sensation and response to pain are produced through integration and processing. Various neurotransmitters, such as opioid peptides, γ-aminobutyric acid, norepinephrine, 5-hydroxytryptamine, and glutamate, have been found to play a role in pain modulation.

While painkillers have traditionally been effective in managing pain, they come with the risk of addiction, drowsiness, and other side effects that cannot be ignored. The misuse of painkillers can also lead to serious damage to brain function.

One notable advantage of acupuncture is its minimal side effects. Acupuncture has been gaining popularity worldwide and is now considered a mainstay treatment for pain management. Originating from China, acupuncture has long been recognized for its effectiveness in relieving pain. Today, numerous studies have confirmed its positive analgesic effect. Clinical trials have shown that acupuncture can effectively control pain and inflammation associated with various diseases. It has shown excellent curative effects in alleviating conditions such as headaches, neuropathic pain, back pain, and knee osteoarthritis. Several international clinical guidelines even suggest that acupuncture's pain-relieving effect is on par with traditional pharmacology or interventional technology. Due to its positive effects and superior safety profile, acupuncture is increasingly accepted by the general population.

In 1997, the National Institutes of Health (NIH) officially acknowledged the pain-alleviating effects of acupuncture. Modern research has shed light on how acupuncture stimulates specific acupoints, modulates neurotransmitters, and produces analgesic effects.

A recent research paper analyzed the progress and research trends in acupuncture analgesia over the past ten years (2011-2021). The study examined a total of 4,781 English articles through bibliometric analysis. The publication of acupuncture analgesia research has more than doubled during this period, increasing from 304 articles in 2011 to 687 articles in 2020. These articles were sourced from 1,043 journals, with Evidence-Based Complementary and Alternative Medicine publishing the highest number of articles (7.8%), followed by Medicine (4.8%), and Acupuncture in Medicine (4.8%). Notably, 91 countries have contributed publications on acupuncture treatment for pain, with 32 countries publishing over 20 articles. The top five countries in terms of publication volume were China (1,577 articles), the United States (1,205 articles), South Korea (465 articles), England (330 articles), and Germany (258 articles).

The growing body of research and publications on acupuncture as a treatment for pain reflects the increasing recognition of its efficacy and benefits. As more studies and clinical trials are conducted, acupuncture's role in pain management will continue to be refined and further solidified. With its minimal side effects and positive analgesic effects, acupuncture is poised to play an essential role in the future of pain relief, offering a viable alternative to traditional pharmacological approaches.

Here are some ways in which acupuncture can benefit individuals experiencing pain:

Pain Relief: Acupuncture helps relieve pain by promoting the release of endorphins, which can reduce discomfort and provide a sense of well-being.

Reduced Inflammation: Inflammation often accompanies pain. Acupuncture has been found to have anti-inflammatory effects, helping to reduce swelling and improve joint mobility. By addressing the underlying inflammation, acupuncture can contribute to long-term pain management.

Improved Blood Circulation: Acupuncture enhances blood circulation, delivering oxygen and nutrients to the affected area. This improved circulation aids in tissue repair, reduces muscle tension, and accelerates the healing process.

Muscle Relaxation: Tense or tight muscles can contribute to pain. Acupuncture can help relax muscles and alleviate tension, promoting better flexibility and range of motion.

Holistic Approach: Acupuncture takes a holistic approach to healing, considering the interconnectedness of the body, mind, and emotions. By addressing the underlying imbalances and promoting overall well-being, acupuncture can have positive effects on both the physical and mental aspects of pain management.

References

Menglong Zhang, et al Evid Based Complement Alternat Med. 2022; 2022: 1451342.