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Treatments

Acupuncture

Acupuncture for pain control is more widely accepted. Needling is a painful stimulus which releases histamine, calcitonin-gene related peptide and causes a local inflammatory reaction (Wu,1999). Small afferent A-delta fibres are also stimulated that cause the release of b endorphin and leu-enkephalin in the dorsal horn of the affected spinal cord segment. These substances block the transmission of small C fibre mediated nociceptive input to the ascending sensory columns through the mechanism of ‘pain gating’ (Melzack and Wall,1996), thus reducing the experience of pain. Segmental mechanisms of pain control are most likely to act locally and are probably responsible for the analgesic effects of needling close to the site of pain. People with Chronic low back Pain see marked reductions in low back pain during Treatments.

De Qi and the classic description of a ‘heavy’, ‘numb’ or ‘sore’ sensation may be mediated by the activation of the small C fibres (Wang et al ,1985). The De Qi sensation appears essential for producing analgesia (Lundeberg 1995) via the endogenous opiate system. Ascending C fibre mediated nociceptive input stimulates the periaquaductal grey matter, hypothalamus and pituitary which in turn trigger the release of serotonin, norepinephrine, histamine, bradykinin, endorphin, dopamine and adrenocorticotrophic hormone (ACTH) (Chen and Han,1992). These chemicals modulate pain by both pre- and post-synaptic inhibition. Endorphin-like substances also appear in the cerebrospinal fluid post-needling (Shen ,2001) ACTH passes to the kidneys and stimulates the release of cortisol (Chen and Han ,1992) which is a powerful systemic anti-inflammatory.

The Release of Serotonin,Dopamine,Gaba,Dynorphin and Enkhephalins block A- delta group 3 primary afferents which carry sharp pain(noxious stimulation) to conscious mind and further heterosegmental effect brought about by neurohumeral mechanism involving three mechanisms-Free beta endorphins,meta enkephalin,serotonin and adrenergic release and Descending inhibitory Mechanisms(Longbottom J,2010).

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