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). |