At any one point in our lives, we would have experienced pain. Unpleasant as it is, it is an important protective mechanism for the body. Generally, pain signals to us that there may potentially be an injury or damage to the body that requires our attention. It can also serve to prevent us from further injury as it discourages us from engaging our body in that particular way which causes pain. How does TCM view pain?
For a body’s healthy function, there needs to be both smooth and sufficient flow of Qi and blood. In TCM, there are two main mechanisms for pain, namely pain due to obstruction of Qi/blood flow and pain due to deficiencies in the body.
Let’s take a look at this analogy. Imagine you are a car and you need to get to your destination.
Scenario A: You experience traffic congestion
Pain due to obstruction
Just like Scenario A, this mechanism of pain is also known as ‘不通则痛’. Any factor that causes obstruction of Qi/blood circulation can cause pain. For example, a child may have eaten too much during meal time and later experiences indigestion and symptoms of pain. In this case, the accumulation of food causes the Qi flow in the abdomen to be obstructed. Often, this type of pain is classified as ‘excess pattern’. Clinical presentation of ‘excess pattern’ of pain involves acute pain, with sudden onset, and tenderness when palpated. TCM treatment for this type of pain typically involves clearing the obstruction, thereby restoring a smooth Qi/blood circulation.
Now, let's go back to the same analogy, but this time you experience low fuel.
Scenario B: You experience low fuel
Pain due to deficiencies
Another main mechanism of pain is due to deficiencies in the body (不荣则痛), depicted in Scenario B. It can be deficiencies in organ function or deficiencies in TCM vital substances like Yin, Yang, Qi or blood. This is known as the ‘deficiency pattern’ of pain. Deficiencies lead to lack of nourishment, resulting in pain that tends to be gradual in its onset, chronic in duration, and palpation of pain site may bring more comfort. For instance, an individual experiences chronic low back pain, with aches as the main complaint. In TCM, the low back area is associated with Kidney function. Taking the duration of pain into consideration, it is likely that the individual has deficiencies in Kidney function that result in presentation of pain in the low back area. In such a case, this individual will require nourishment of the Kidney during the course of TCM treatment.
Mixed?
As the human body is complex and everyone has different medical history, it is possible that there can be progression from ‘excess pattern’ to ‘deficiency pattern’ and vice versa, or even a mixed clinical presentation of both patterns of pain.
In conclusion, the two main mechanisms of pain in TCM are obstruction(不通则痛) and deficiency(不荣则痛). Clinically, the individual may present with a mix of both excess and deficiency patterns. Regardless of the mechanism of pain, they affect the Qi and blood circulation eventually. Hinging on the importance of proper Qi and blood circulation, here are some care tips to help manage pain at home:
Adequate rest is important. For musculoskeletal injuries, refrain from doing activities that cause pain as constant aggravation will impede recovery.
Avoid exposure to cold and damp environments: Singaporean homes have floors that can be cold, wearing slippers at home or sitting on a cushion can mitigate the cold pathogen from entering your body.
Avoid cold foods and diet such as iced drinks, sashimi, cold fruits and salads. In TCM, cold is often associated with pain as it slows down Qi and blood circulation, potentially aggravating your pain.
Avoid sitting directly under the air-conditioner. You may layer more clothes or wear a scarf to protect the neck from exposure.
Apply warm compression over affected area to improve blood circulation (not suitable for acute injuries)
Doing stretching and some light exercises can help manage pain as these promote blood circulation.
If these home care methods do not help alleviate your pain, we recommend seeking professional medical advice.
Author: Physician Aw Ching Yi Eunice
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