Health Education Articles

Pain from Strokes

By Kimberly Guorong Du

There are three major kinds of pain resulting from stroke. Stroke-related pain could range from mild to absolutely excruciating. Here's a look at the three conditions:

• Spastic pain means increased muscle resistance, as if the muscles are always flexed. It hurts when you try to stretch the muscle, and it can hurt in one or a few spots, one limb or one entire side of the body.

• Shoulder pain can be an "arthritis-like" pain. When the shoulder loses half or more of its range of motion, it is called "frozen shoulder". If ignored, it can become what is called complex regional pain syndrome (CRPS), which can further debilitate the patient. CRPS is more nerve pain than shoulder pain.

• Center pain is also called nerve pain or neuropathic pain. Stroke survivors describe it as constant, ranging from merely painful to almost indescribable.

Besides conventional treatments and medications for these pains, acupuncture and Chinese herbal medicines can treat these stroke-related pains effectively. In China it is typical practice to use acupuncture to treat stroke pains. Usually if patients start to receive acupuncture treatment early, many patients would avoid these pains or suffer less pain. In other words, when the patient's condition is stable after the emergency, the patient should start acupuncture treatment to treat paralysis, aphasia etc. as soon as possible. This is the key to get optimal result, significantly shorten the disabled period, prevent the pain and recover from stroke.

Actually these three types of pain do not always appear separately, sometimes they appear simultaneously. So, the most important point is "differentiation of syndromes". In the terms of Chinese medicine it means that we always need to make sure that the cause of the pain is because of cold or heat, deficiency or excess, yin or yang, chi or blood, one organ rather than another. To treat these pains we need to keep three rules in mind:

1. Treat the disease cause

   Stroke is usually caused by "wind", "fire", "phlegm" and "chi". These are mostly from kidney weakness, liver wind stirring internally, internal phlegm turbidity block, disharmony of chi and blood. So, to enrich kidney yin, clam the liver and subdue yang, sweep phlegm and open the orifices, move chi and quicken the blood are the treatment for the disease cause.

   In clinical practice, we often use some acupoints that are not paralysis cure points, but using them to treat the cause of stroke can increase the effectiveness of the treatment.

2. Manipulation of acupuncture and moxabustion

   For kidney weakness or chi depression we prefer to use more moxabustion; for phlegm-fire we use more acupuncture; for disharmony of chi and blood, we use acupuncture and moxabustion together; for spastic paralysis with pain we use acupuncture no tonify method. Whether acupuncture needles are used on paralyzed side or on the functioning side, there is not a definite rule; it depends on the patients ongoing response.

3. Besides the often selected paralysis cure points, the acupoint formula varies in accordance with patient's symptoms. For instance for spasticity we may use more moxabustion on some acupoints from experience; for arm, shoulder or leg pains we may use acupuncture on other effectively experienced acupoints.

In summary, the stroke-related pains can be treated by acupuncture. Choosing correct acupoints and the correct formula can make the treatment very effective.