Running Head: TOUCH, PAIN, ACUPUNCTURE Sensory Deficit of Touch, its Pain and Acupuncture Applied Learning Paper Debra A. Hankerson Abstract This writer will be exploring the topic, Is acupuncture an effective therapeutic treatment for the chronic pain associated with the sensory deficit of touch? Touch will be explored; what it is, causes for deficit of touch, chronic pain associated with the deficit, and the effects of the deficit. Acupuncture will be defined; its historical background and society’s acceptance or rejection of its use. This writer will identify its relevance as an alternative medicine for chronic pain either supporting or detracting in answering the topic question. Evaluate whether the research findings helped to answer the topic question. Concluding with what was learned; if it changed the perspective on the theory, did the writer’s Christian faith inform or bias the investigation, and does the theory fit within the Christian worldview. Introduction After reading about sensory deficits and acupuncture in the text book I began to wonder if new inroads had been made in the acupuncture therapeutic treatment as a long-term solution when dealing with pain and the deficit of touch. The focus of my paper being, “Is acupuncture an effective therapeutic treatment for the chronic pain associated with the sensory deficit of touch? ” My interest this topic came about because I have this sensory deficit; have gone through acupuncture as a therapeutic treatment to relieve pain. I was also interested to find out if there have been new inroads with this treatment as far as a long-term relief. For me it was not successful. Touch Touch is the sense that enables an organism to get information about things that are in direct contact with its body. As one of the five senses, touch allows a person to feel heat, cold, pain, and pressure. “The sense of touch is the only sense experienced all over the body” (Landau, 2008). Touch has been called “the mother of senses”, perhaps because it was the first to develop in evolution. Touch is the earliest sensory system to develop in all animal species. The term touch includes several tactile senses: pressure, pain, temperature, and all muscle movements. Bruno and Carnagie (2001) state, “Touch is a very important sense, since it tells an organism a great deal about its immediate environment. ” Bruno and Carnagie’s point is that touch is essential for our everyday well being. Touch is described as a group of senses by which contact with objects gives evidence as to their qualities, as registered by the skin and mucous membranes. Barth (2010) says, “There are several kinds of touch organs, called tactile corpuscles, in the skin and the mucous membranes. The sense of touch is identified with the largest organ in the human body – the skin. The fingers are more sensitive than any other area because they have more nerve endings. These changes help us to understand the causes. Causes of Touch Deficit The largest touch sensor, the Pacinian corpuscle, is located in the hypodermis, the innermost thick fatty layer of skin. This area responds to vibration. A disruption of the free nerve endings which are neutrons that originate in the spinal cord causes the transmission of information about temperature and pain to be somewhat non-existent (Strickland, 2001). This disruption is the result of injury, infection, and/or disease. With these significant changes, we need to understand just how touch deficit affects an individual. The Effects of Touch Deficit The loss or impairment of the ability to feel anything touched is called tactile anesthesia. Paresthesia is a sensation of tingling, pricking, or numbness of the skin that may result from nerve damage and may be permanent or temporary. Touch has widespread distribution, unlike the sensory receptors for sight, vision, smell, and taste which are clustered in the head (Angier, 2008). The disruption of the touch receptors heightens the pain receptors which are nerve bundles with bare endings that fire when surrounding tissue is damaged. This in turn causes the lessening of the feelings we identify with touch. The loss of these feelings may result in chronic pain due to the touch deficit. Chronic Pain Associated with the Touch Deficit Chronic pain is pain that lasts longer than six months. According to Field (2003), “People with chronic pain become depressed due to the ineffectiveness of the drugs they are taking and the dramatic changes in lifestyle they experience. Basically, Field is saying that chronic pain can turn a person’s life upside down. Individuals with chronic pain seem to have low endorphin levels. Alternately, any related nerve deficit damage could be the reason for the consumed body supply of natural painkilling opiates and this would reduce the effectiveness of natural endorphins. Most chronic pain disorders are unresponsive to surgical, pharmacological, or other medical interventions. The use of touch and pressure treatments (acupuncture, acupressure, massage therapy, etc. have proven to effective because they reduce anxiety levels, which tend to aggravate pain, and they also increase the productivity of necessary endorphins. We need to understand the components of pain and the psychological affects. Components and Psychological Cost of Chronic Pain Pain is the result of a chain reaction that involves all parts of the nervous system, including the brain. Pain has four components: stimulus, perception, suffering, and pain behavior. Despite intense research, chronic pain is still poorly understood by the medical community. According to Chapman (2010), “Many pain specialists believe chronic pain occurs because of a breakdown in the normal system of checks and balances that keep the nervous system functioning properly. ” Chapman’s point is that there is a malfunction within the nervous system. People with chronic pain are deprived of the peace of mind that comes with knowing their pain will end. Because peace of mind is important to the healing process, chronic pain can convert a person into an invalid. Psychological damage is often incurred with chronic pain, which can alter a sufferer’s personality. Sufferers withdraw from pleasurable activities, public outings and family, leaving often depressed, bitter, anxious, or helpless. These negative thoughts and feelings help create a vicious cycle of worsening pain and unhappiness. These symptoms are the basis for chronic pain syndrome. Chapman tells us, “Although there is no cure for chronic pain syndrome, people with this condition can take steps to help close the pain gates and reduce their psychological suffering” (2010). In other words, Chapman is saying that it’s up to the individual to take responsibility for how they regain normalcy in relation to their condition. Both the disease and illness can viewed as the complex interaction of biological, psychological and social factors. Biopsychosocial Factors Disease can be defined as a biological event involving the disruption of specific body structures or organ systems caused by anatomical, pathological, or physiological changes. In contrast, illness may be a subjective experience that a disease is present. In Gatchel, Peng, Peters, Fuchs, & Turk ( 2007) view, “The distinction between disease and illness is analogous to the distinction that can be made between nociception and pain. Nociception involves the stimulation of nerves that convey information about potential tissue damage to the brain. In contrast, pain is the subjective perception that results from the transduction, transmission, and modulation of sensory information (p. 582). ” The psychosocial factors involve both emotion and cognition. Emotion is the more immediate reaction to nociception and is more midbrain based. Cognitions then attach meaning to the emotional experience and can then trigger additional emotional reactions and thereby amplify the experience of pain, thus perpetuating a vicious circle of nicoception, pain, distress, and disability. Acupuncture Acupunctureis a method of producing analgesia or altering the function of a system of the body by inserting fine, wire-thin needles into the skin on the body along a series of lines, or channels, called meridians. The needles are twirled or energized electrically or warmed. Acupuncture originated in the Far East and has gained increasing attention in the West since the early 1970s. Historical Foundation of Acupuncture Acupuncture is generally held to have originated in China, being first mentioned in documents dating from a few hundred years leading up to the Common Era. Sharpened stones and bones that date from about 6000 BCE have been interpreted as instruments for acupuncture treatment , but they may simply have been used as surgical instruments for drawing blood or lancing abscesses . In her book, “Is Acupuncture Right for You? ”, Kidson maintains that “Documents discovered in the Ma-Wang-Dui tomb in China, which was sealed in 198 BCE, contain no reference to acupuncture as such, but do refer to a system of meridians, albeit very different from the model that was accepted later. Speculation surrounds the tattoo marks seen on the ‘Ice Man’ who died in about 3300 BCE and whose body was revealed when an Alpine glacier melted. These tattoos might indicate that a form of stimulatory treatment similar to acupuncture developed quite independently of China” (2008). The first document that unequivocally described an organized system of diagnosis and treatment which is recognized as acupuncture is The Yellow Emperor’s Classic of Internal Medicine, dating from about 100 BCE. The information is presented in the form of questions by the Emperor and learned replies from his minister, Chi-Po. The text is likely to be a compilation of traditions handed down over centuries, presented in terms of the prevailing Taoist philosophy, and is still cited in support of particular therapeutic techniques. The concepts of channels (meridians or conduits) in which the Qi (vital energy or life force) flowed are well established by this time, though the precise anatomical locations of acupuncture points developed later. Society’s Acceptance or Rejection In exploring the topic, “Is acupuncture an effective treatment for the chronic pain associated with the sensory deficit of touch? I found several diverse opinion’s in reference to what society thinks of acupuncture. According to Dr. Andrew Hamilton (2009, p. 22) in a magazine article he wrote entitled ‘Try telling my patients that acupuncture doesn’t work’, he is quoted as saying, “I have found acupuncture gives rapid, and often long-term relief, through its action of local muscle relaxation and central endorphin release. Despite the skepticism of a few, acupuncture is fast becoming an established part of conventional medicine. ” In other words, Dr. Hamilton believes that acupuncture is a viable treatment for chronic pain in any area. However, in a contradictory article by Simon Singh (2008, p. 20) in a London Newspaper entitled, ‘Don’t believe the lie of the needle acupuncture is gaining credibility in medical circles’, he critiqued three trials with one using a placebo. He is quoted as saying, “Two out of three failed to show that real acupuncture offers any significant benefit beyond the fake treatment”. Singh believes that there is no significant benefit to acupuncture treatment. As with anything in today’s society there are pros and cons, differing opinions concerning acupuncture as a treatment associated with chronic pain. Here in the United States, our own Washington Post newspaper in an article by Ellen Edwards (2009), entitled ‘Millions Embrace Acupuncture, Despite Thin Evidence’ did an in depth study of local doctors and hospital physicians in all fields. Here article said that the American Medical Association takes no position specifically on acupuncture, saying “there is little evidence to confirm the safety and efficacy of most alternative therapies (p. 4). ” Although she received this statement from the AMA, during her research she found significant evidence to personally embrace acupuncture. She was quoted as saying, “I felt it had helped other people, and it might help me. I don’t know how it works, but it’s got 4,000 years of Chinese medicine behind it (p. 4). ” The essence of Edwards’ argument is with number of years used by the Chinese, there has to be some benefits from the acupuncture therapy. Acupuncture as a Treatment In reviewing the research I found when exploring this topic there are many favorable articles for the use of acupuncture for chronic pain, specifically sensory deficit of touch. According to Clinical Psychologist White (2000), many Americans are seeking alternative therapies for any area associated with chronic pain such as acupuncture. Acupuncture systematically treats the mind as well as the body when used by professional psychologists. The “medical field has started embracing this new field of integrative medicine” (p. 671), and there have been wonderful results. Burke, Upchurch, Dye, & Chyu ( 2006), conducted a survey on the use of acupuncture in the United States. Its objective was to establish that acupuncture has become an important provider-based complementary and alternative medicine treatment. The findings in relation to chronic pain were “A large number of respondents (44. 0%) indicated that they used acupuncture because conventional medicine would not help treat their health condition, supporting the role of acupuncture as an alternative medicine” (p. 645). Acupuncture has also been shown to be a beneficial approach in reducing chronic pain, and specifically the sensory deficit of touch. In a review of the literature on acupuncture and pain, Eshkevari (2003) found that: (1) acupuncture could, in fact, be viewed as a useful therapeutic modality in the management of chronic pain (p. 366), (2) acupuncture causes the release of endorphin substances (p. 367), (3) acupuncture reduces norepinephrine levels in certain brain areas and blood circulation, accompanied by a rise in pain threshold (p. 367). Basically, Eshkevari is saying that there is mounting evidence of acupunctures effectiveness. There was a study done by Sood, Sood, Bauer, & Ebbert (2005), on the Cochrane systematic review of acupuncture. This study consisted of the controlled trials in acupuncture across different topic areas and journals with the common subject of chronic pain. After the review it was concluded that that diversity exists in the comprehensiveness of the data on acupuncture. Even though there is data to suspect its effectiveness, according to Sood, Sood, Bauer, & Ebbert, “This diversity makes reviews prone to bias and adds another layer of complexity in interpreting the acupuncture literature” (p. 19). Sood, Sood, Bauer, & Ebbert, are insisting that the systematic reviews are not reliable. With all of these facts mounting, the JRRD (2007) sums up many discrepancies, They state, “Although many studies have documented the efficacy of acupuncture for pain and other medical conditions, understanding how it works within a Western medical paradigm remains challenging” (p. 215). The JRRD’s point is that there is still a lack of concrete evidence that acupuncture is an effective therapeutic treatment for the chronic pain associated with the sensory deficit of touch. Evaluation The articles that I presented and the books reviewed for the most seem to indicate that acupuncture is an effective means of reducing or eliminating chronic pain associated with the sensory deficit of touch. The articles and books I used seem to support and even advocate the use of acupuncture. However, there are differing perspectives in the field of psychology which I have not been able to ascertain and include in this paper. In order for me to be more conclusive there has to be more studies, articles and books to support this subject. Included in this paper were articles and studies on the prevalent use of acupuncture in Western alternative medicine. Acupuncture is being used in all areas and many medical physicians are becoming proficient in its use. It is felt that acupuncture can and should become an integral part of the health care system. Overall, I feel as if I have made some serious headway in discovering the use of acupuncture in the therapeutic treatment of the sensory deficit of touch. However, I believe there is much more to be learned about how it relieves chronic pain, and more specifically the pain associated with the sensory deficit of touch. Conclusion This topic of acupuncture and its effectiveness on the chronic pain of the sensory deficit touch is very close to my heart. I suffer from the deficit of touch and understand the chronic pain which is experienced. I have personally tried acupuncture to relieve the pain but it proved unsuccessful for me, as did many other treatments. From my research of the subject there is evidence that some do feel as if the use of acupuncture violates or contradicts the Christian worldview. As with most every controversial subject there are pro and con opinions. Some Christians may have an aversion to using acupuncture because of its origin. According to the John Mark Ministries as written by Croucher (2005), “There is evidence that acupuncture works for a few painful conditions and there are suggestions for a rational scientific basis such that no belief need be placed in Eastern religion. I do not believe acupuncture necessarily involves the occult at all, though as in all alternative treatments I advise caution about the therapist. ” In making this comment, Croucher argues that there needs to be careful scrutiny of the practitioner. Steve Godwin (2005) writing for Watchman Fellowship, Inc. has stated, “The religious basis for traditional acupuncture should cause Christians to exercise caution when considering acupuncture treatment. The main point to remember is that we should use discernment when investigating any medical treatment, because any treatment based on a false worldview can be harmful not only physically but spiritually as well. ” The before two opinions advise caution in who you allow to perform this procedure. However, a more negative opinion is offered by Let Us Reason Ministries (2009). They state, “As Christians we should not seek practitioners who offer metaphysical cures that manipulate invisible energy. The acupuncture theory is incompatible with both scientific evidence and diametrically opposed to the Christian world view of the human body and spirit. The Bible never describes energy zones or meridians in the human anatomy. ” This last statement I find contrary to my personal beliefs. Using all the research books, articles, and journals, I have come to the conclusion that acupuncture provides some viability to the relief of chronic pain in all areas, and specifically the sensory deficit of touch. Although I feel that it does work, it is limited to only certain patients. Some patients have no relief from acupuncture. I speak from personal experience that it doesn’t work on all patients. Even though acupuncture treatments can conjure up mystery, there is still some usefulness as a healing presence, and this can depend on the practitioner. Giving some insight in to the healing presence, Jonas, & Crawford (2004) tell us , “Religious and spiritual traditions from all cultures and all times describe the spiritual or loving presence of the faithful contributor of healing. In addition, the common belief that some individuals are highly effective healers, independent of whether they use a ritual, prayer, needle, pill or knife, perpetuates the common belief that a special “presence” can exude from certain practitioners. This presence is capable of inducing an experience of recovery wholeness, peace or well-being in people who suffer. Acupuncture is nothing more than a very ancient form of healing, and in healing there is God’s presence in the midst. God puts those He would have in place with the gift of healing. 1 Cor. 2:28 says, “And in the church God has appointed first of all apostles, second prophets, third teachers, then workers of miracles, also those having gifts of healing, those able to help others, those with gifts of administration, and those speaking in different kinds of tongues” (NIV) I truly believe that there is nothing contrary to God’s word in the use of acupuncture, and if we are diligent in seeking the best practitioner to administer this treatment it does not defy Christian beliefs. I am inclined to believe that this is the correct Christian worldview. Thus, I answer the question, “Is acupuncture an effective therapeutic treatment for the chronic pain associated with the sensory deficit of touch? ” Yes, for some it is. I also am made aware, through the research, that great strides are being made to further the use of acupuncture as a viable tool in the everyday health care field. References Angier, N. (2008, December 9). Primal, acute and easily duped: our sense of touch. The New York Times, Section D; Column 0; Science Desk; BASICS; Pg. 2. Barth, D. S. (2010). Touch. World book online reference center. Retrieved April 21, 2010 from https://wf2dnvr11. webfeat. rg/YzT4O17522/url=https://www. worldbookonline. com/pl/reference Bruno, L. C. , & Carnagie, J. (2001). Touch. U*x*l complete life science resource. Retrieved (2010, April 21) from https://find. galegroup. com/gvrl/infomark. do? &contentSet=EBKS&type=retrieve&tabID=T001&prodID=GVRL&docID=CX3437100265&source=gale&userGroupName=29081_mdpls&version=1. 0 Burke, A. , Upchurch, D. M. , Dye, C. , & Chyu, L. (2006). Acupuncture use in the united states: findings from the national health interview survey. The Journal of Alternative and Complementary Medicine, 12(7), 639-648. Chapman, C. R. 2010). Pain. In Grolier Multimedia Encyclopedia. Retrieved April 21, 2010, from Grolier Online https://gme. grolier. com. article? assetid=0218110-0 Croucher, R. (2005, March 9). Acupuncture – a christian assessment. John Mark Ministries, Retrieved April 21, 2010 from https://jmm. aaa. net. au/articles/14661. htm Edwards, E. (2009, March 17). Millions embrace acupuncture, despite thin evidence. The Washington Post, HEALTH; p. HE04. Eshkevari, L. (2003). Acupuncture and pain: a review of the literature. American Association of Nurse Anesthetists, 71(5), 361-368. Field, T. (2003). Touch. Cambridge, Massachuetts: The MIT Press. Gatchel, R. J. , Peng, Y. B,. , Peters, M. L. , Fuchs, P. N. , & Turk, D. C. (2007). The Biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological Bulletin, 133(4), 581-624. Godwin, S. (2005, April). Evaluating acupuncture. Watchman Fellowship, Inc. , Retrieved April 21, 2010 from https://www. wfial. org/index. cfm? fuseaction=artNewAge. article_10 Hamilton, Dr. A. 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The Journal of Alternative and Complementary Medicine, 11 (4), 719-722. Strickland, B. (2001). Touch. Gale encyclopedia of psychology. Retrieved (2010, April 21) from https://find. galegroup. com/gvrl/infomark. do? ;contentSet=EBKS;type=retrieve;tabID= T001;prodid=GVRL;docID=CX3406000641;source=gale;userGroupName=29081_ mdpls;version=1. 0 Unknown, . (2009). Acupuncture – acupressure. Let Us Reason Ministries,
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