Relieving back pain with pins and needles

Published on 24 June 2024

Acupuncture has become an increasingly popular form of treatment for chronic back pain in recent years, due to its effectiveness in providing non-invasive pain relief and its holistic approach to addressing underlying issues.

Although acupuncture is often considered an 'alternative' form of treatment in Singapore, its popularity has grown significantly in recent years, largely due to its drug-free and minimally invasive approach.

Indeed, over 4,000 patients are referred to the Acupuncture Clinic at the National University Hospital (NUH) annually, with many hoping that this traditional therapy – which dates back thousands of years to the Chinese Stone Age – will offer them relief from their chronic pain and discomfort.

According to NUH Senior Acupuncturist Dr Qiao Tian Ru, most of these patients suffer from musculoskeletal pain in the back and the neck.

Speaking at the first  National University Spinal Institute (NUSI) Public Spine Symposium on March 30, Dr Qiao shared that patients often turn to acupuncture when Western medicine fails to provide relief.

“Patients can explore acupuncture treatments if they suffer from adverse side effects from Western medicine, or if Western medicine has been ineffective in managing pain,” she said.

Tackling imbalances in ‘qi’ and chronic pain 

The core principle of Traditional Chinese Medicine (TCM) involves restoring balance in the body's qi, which is considered the vital energy or life force. This is achieved by opening up the meridians—pathways through which qi flows—to promote health and well-being. 

The balance of qi is represented by Yin and Yang, embodying opposing energies in TCM. According to TCM principles, an imbalance in these energies can adversely affect one’s health.

Through acupuncture, TCM aims to clear qi blockages to alleviate pain, sickness, and discomfort.

To further illustrate this point, Dr Qiao shared an anecdote about a 55-year-old patient she had previously treated for chronic pain. 

The patient was diagnosed with degenerative disc disease and presented with worsening neck pain, severe stiffness in the upper limbs, and a noticeable purple tinge on the tongue. “In TCM terms, a purplish tongue is a sign of cold and blood stasis stagnation,” Dr Qiao revealed.

Dr Qiao also discovered that the patient had been working in a cold warehouse for the past 30 years, which she believed contributed to his symptoms.

To treat him, Dr Qiao employed acupuncture techniques aimed at 'expelling cold', which included methods like moxibustion—a traditional Chinese therapy involving the burning of mugwort leaves to warm the body. She also recommended heat therapy using an electric blanket, which proved especially beneficial during cold nights for maintaining warmth.

After three months of treatment, the patient reported a significant reduction in stiffness. “His pain was no longer persistent,” she noted.

How does acupuncture treat pain?

When you think of acupuncture, the first thing that you will think of is needles – lots of them. But how exactly does inserting these needles into the body help relieve pain?

Dr Qiao explained that these needles are inserted into specific parts of the body known as ‘acupoints’ to stimulate the central nervous system. This prompts a natural response in the body, triggering the release of neurochemicals such as endorphins into the muscles, spinal chord, and brain.

In addition, acupuncture can promote healing in specific areas of the body, as Dr Qiao elaborated, “When needles are inserted into the shoulder to treat localised pain, it stimulates the release of neurochemicals that aid in reducing inflammation and relieving pain in that area.”

Acupuncture can also alleviate the mental and emotional toll often associated with chronic pain, making it an effective treatment for anxiety and depression. According to Dr Qiao, many patients report feeling notably calmer after a session.

Does acupuncture hurt?

One common reason people avoid acupuncture is the misconception that it is a painful treatment—after all, the thought of multiple needles pricking the skin can be intimidating.

In truth, however, acupuncture is much less painful than it looks. In fact, the diameter of an acupuncture needle is just 1/20th the size of the smallest intravenous needle.

The tips of acupuncture needles are also rounded, unlike intravenous needles, which have a sharp point. “The round tip of an acupuncture needle separates the skin tissue fibres rather than cutting through them,” Dr Qiao shared. 

As such, acupuncture is regarded as a minimally invasive procedure, and most patients experience mild tingling sensations rather than severe pain. Since the needles only penetrate the surface of the skin, it is considered one of the safest therapies in the medical world.

In consultation with Dr Qiao Tian Ru, Senior Acupuncturist, Acupuncture Clinic, NUH.