The Dragontree

This month’s theme is one of my specialties: pain management. There’s so much I could write about dealing with pain, but the fact is the approaches that are of greatest benefit to most people don’t need much explanation. As with most simple things, they’re easy to dismiss because we put so much value on complexity. Now that we have mapped out the human genome and can control the weather with our iPhones, who’s going to believe that the simple approach is the best?

Interestingly, many of the complex health-related developments don’t entail much involvement by the user. Just swallow this pill, which is the culmination of years of work by people much, much smarter than you. The simple interventions, on the other hand, often represent more work and/or lifestyle change by the user, but by the same token, they stand to heal you in a way that few pills could.

Now, let’s get down to business. I’d like to teach everyone to understand the meaning of pain from the perspective of Chinese Medicine. One of the most fundamental principles of this medical system is that all pain is due to some form of stagnation. When things move freely we feel good, and when they don’t we feel bad.

If we overeat and food is stagnant in our digestive tract, it feels bad. If blood stops moving through the vessels in our heart, it feels bad. If our muscles are irritated and taut (i.e., stagnant), they feel bad. If a joint is damaged and inflamed (stagnation again), it feels bad. If we broke up with someone but we keep fantasizing about them or replaying our conversations, this is mental and emotional stagnation, and it feels bad. If we’re attached to life being a certain way but it’s not that way, and we don’t accept it, it feels bad. Guess why. No matter what kind of pain you’re in, restoring healthy movement or flow will make you feel better.

Now for three important sub-principles. First, all parts of us are interconnected, so stagnation on one level can readily lead to stagnation on another level. For example, if we’re chronically angry, tense, or sad (emotional stagnation) this can eventually show up as, say, a tension headache or lower back pain (physical stagnation). Vice versa, living in a tight and inflexible body (physical stagnation) can contribute to a lack of mental flexibility – rigid thinking, frustration, depression, etc. Physical stagnation is easier to cure in this case, as emotional stagnation needs not just a treatment, but also your willing to get well. There is the natural product that can help to reduce stress and improve your emotional state.

Second, clearing stagnation on any level tends to promote healthy flow on all levels. For instance, physical exercise is beneficial for depression, because moving the body moves the mind. Likewise, using the mind to imagine energy and blood coursing freely through a painful area of the body can often be as effective as painkillers. For the same reason, if we’re in physical pain, it is always worthwhile to look inward and see if there’s some story or emotional pattern we need to let go of.

Third, you can’t argue with reality. Resistance produces stagnation. So, resisting pain doesn’t help. Acceptance does. Accept your pain (and everything else) and let it go.

Almost everything that benefits pain does do by mobilizing stagnation. We’ll explore a handful of the most beneficial interventions this month.

Let’s start by addressing conservative care for injuries. For several decades, the standard has been RICE: Rest, Ice, Compression, and Elevation. All of these tactics are aimed at inhibiting movement, based on the notion that the inflammatory process in injuries is somehow a mistake by the body. We’ve been taught that it’s vital to stop the influx of immune cells that causes swelling. As for Rest, it’s a good idea not to cause more damage, so avoiding activity that could be injurious is smart, but total immobility can slow the healing process. Contracting the muscles around an injured area gets the congested fluid (lymph) moving out of there. Controlled, low impact movement speeds healing.

The use of ice is the subject of fierce debate. In Chinese Medicine (and thermodynamics), cold is considered a contractive force. It inhibits movement. Therefore, if the goal is to get fresh blood into the area and clear out lymph and particles of damaged tissue, we need to keep the vessels in this area open. Cold constricts vessels, while heat opens them. Cold blocks pain signals, but inhibits healing. In fact, emerging research shows it may contribute to increased tissue death and slower healing. If you really love the refreshing feeling of brief cold application after minor strain (like working or exercise), I don’t think it’s a problem. But for healing pain, heat almost always works better.

Compression is meant to keep an area from swelling, but again, the influx of fresh blood to nourish damaged tissue and the immune macrophages, cells that clean up debris, are beneficial. We don’t want to restrict this response; we just need to keep things moving. Although there are some cases in which compression is useful, I generally advise against it for acute traumatic injuries.

Of the four RICE interventions, I find Elevation the least objectionable. It’s meant to reduce gravity’s contribution to swelling and to improve the return of blood to the heart through veins. The thing is, most of the fluid swelling in trauma is lymph, not blood, and lymph moves through lymphatic vessels, not veins. Gravity alone isn’t going to help much in moving that lymph. Instead, the muscles around these lymphatic vessels need to contract to squeeze the fluid along. Again, this is why controlled, low impact movement is vital.

So, next time you get injured, try slow, low impact movement and heat application. Next week I’ll discuss more strategies for alleviating this and other forms of pain. Stay tuned and keep moving.

Be well,

Dr. Peter Borten