So where does the pain really come from? Why is it there? It seems it is coming from what is called the sensitisation of our nervous system. So to resolve the pain, we do not need to do anything to the tissues – to remove that bulging disc or to undo the knots in the muscles – rather we need to desensitise the nervous system.
This is strange because pain is, or is supposed to be, an alarm system from damaged tissue to the brain. In the normal case of acute pain, as when we sprain an ankle for instance, this works fine. The nerve endings in and around our ankle pick up that some damage has occurred, and send alarm signals – pain – to the brain. The pain stops us from doing anything to make the damage worse; it makes us rest up, perhaps seek some kind of treatment. This is the point of pain.
So what should happen and what usually does happen, is that as the ankle heals, the pain subsides. There is no need for it any more, the ankle no longer needs protecting.
But what sometimes happens is that even after the ankle is healed, the pain remains. It is as if the alarm signal has got stuck on “on”. Its like if you have a fire in your kitchen which sets off your fire alarm. You put out the fire, but you can’t turn the alarm off. It may even get louder! Its not now that the alarm is detecting a fire, it is that the alarm is malfunctioning.
This is what chronic pain is often about; it’s a malfunctioning of the alarm system. Your brain is being sent a message that there is some injury or damage to your ankle, or whatever it is, when there is no damage or injury any more. So trying to treat this pain by treating the ankle is missing the point. It’s not the ankle which is a problem now; it’s the alarm system itself. Treating the ankle is like trying to stop the malfunctioning fire alarm by trying to put out a fire which is not even happening! What needs treating is the alarm system, the nervous system, itself.
This may go some way to explaining how the treatment of chronic pain with traditional acupuncture is often not targeted at the apparent source of the pain – or not solely targeted at it. It puts me in mind of the Chinese medical proverb, “All pain comes from the Shen” The word Shen here can be translated as heart or as mind, so the proverb suggests that the pain is not about the ankle, the knee or the back, so much as about the mind or nervous system itself. (There is no concept exactly corresponding to the nervous system in Chinese medicine, but we can speculate that it is partly covered by the word Shen.) So in treating chronic pain, a useful and commonly used treatment strategy in Chinese medicine is to ‘calm the Shen’ . So if you have acupuncture treatment for a painful condition which has been going on for some time, don’t be surprised if the needles aren’t going where the pain is.