One of the most significant differences between Eastern and Western Medicine comes in the way each system diagnoses a disease. I’m not even talking about the language and terminology variations, which can be remarkably extreme and even overtly flowery in ancient Chinese, such as assigning “an effluence of ministerial fire stirring up interior wind” for a “hypertension” diagnosis. However, what really separates the two in terms of treatment for a patient is not just “how” each system characterizes the disease process, but “when” they choose to do so. To be a little less vague, you have to understand that within our modernized medical system there are many symptoms, such as certain pains or tightnesses or twitchings you might be feeling in your current state, which fall outside of the “quantifiable scope of a labeled disease.” Although very real to you, these same symptoms may be considered “normal anomalies” — not pathological enough to limit everyday function — and therefore, not even classifiable as warranting a cure.
Even the smallest and most insignificant of symptoms actually exist on a much larger continuum of illness and disease. There is no sharp cut off period where one set of problems you were once experiencing is now considered worthy of attention. For example, the tight upper traps and neck muscles you may be feeling could be due to the same stress response inside your body that is also causing anxiety and insomnia. In this case, a simple neck problem is actually part of a deeper internal dysfunction that should not be ignored.
Not every stiff neck is the same. Treatment for the exact same diagnosis, called “cervicalgia” in Western medicine, may have very different treatment variations in Chinese medicine, regardless of what your Xray shows. Many contemporary physical therapists dismiss the idea that neck pain can come from sitting in a draft, simply because it is not a rigidly based in anatomical studies.
I’m sure you already know that you can catch a cold in your lungs, such as when a virus invades your immune system, but did you know you can also catch a “cold in your neck?”
I remember a twenty-five year old office worker who came to me once because of a sudden, unprovoked onset of severe neck pain and stiffness. She had no prior injuries or history of a neck problem. She just woke up from the pillow, sat up, and she couldn’t move her head in any direction. From an orthopedic perspective, it definitely seemed odd that everything hurt and nothing made it better, except a warm pack placed atop the muscles around the base of her head and neck.
Upon a further and more holistic examination, the skin around her neck was cool to the touch, compared to the other regions of her body. She recently had a depressed mood, stomach reflux pain, and strange body aches for a couple of days prior to her neck problem. As an acupuncture diagnosis, I knew exactly what this way, “a cold pathogen invading the superficial muscle levels of her body.” The treatment was specific and intentional, releasing the tension from the skin and muscles by stimulating meridian points, followed by the use of warmth to drive out the coldness. Like many other “colds,” in three to five days it spontaneously resolved itself.
The contemporary, Western diagnosis, was simply “neck spasm,” and all those unrelated symptoms of reflux and depression were just part of having a bad night’s sleep. The treatment could be Tylenol, a hot shower, your spouses soft-handed massage, or whatever you need to do to make yourself feel better.
It’s not that there’s anything inherently unethical with an orthopedist prescribing this sort of seemingly half-hearted, hands of approach to treatment, they’re just performing within the industry’s limitations of what they can do. They’re not bad doctors, and I’m sure they genuinely care about you. Unfortunately, in the absence of an MRI showing indisputable degenerative disc disease or other spinal injury, your nuisance collection of recent neck aches doesn't push you far enough down the bell-curve to be a "problem" in the Western Medicine system.
As a counterpoint argument, it is important to realize and consider that in some cases insignificant pains may be indicative of deeper problems elsewhere in the organ systems as well.
I distinctly remember the case of my patient Ian's incurable rib pain, as one such example I'll never forget. Ian was a robust, athletic, rock climber in his late thirties, who came through the front door with sharp left ribcage pain, which he had been suffering with for one week already. It seemed to be coming from his ribs when I touched the area, and would only hurt when Ian would bend sideways or take a deep breath in. There was no obvious mechanism of injury, but he thought maybe he had pulled a muscle when climbing up on a boulder at the mountain, or something. He was recently treated by a physical therapist a couple of days ago, who worked on fascial releases, deep breathing exercises, and all sorts of other avante garde energy flow/meditative techniques before getting a second opinion from me. Ian was normally such a physically guy. It was so frustrating for both of us that he wasn’t getting any better at all.
My assessment and treatment did not yield much benefit by the end of his first — and only — session. However, I knew that there was something “bizarre” or “off” about his rib pain that did not seem musculoskeletal to me. Before he left, I told him that he should not waste time with physical therapy, acupuncture, or massage and should instead go right to urgent care and get imaging of his chest.
It turns out that this seemingly healthy, super-fit, Adonis-type athlete actually had a large pulmonary embolism sitting deep in the base of his lung, just waiting to dislodge and cause a fatal stroke.
Again and again, I cannot emphasize to you enough the importance of imaging and testing... and at the very least, a doctor’s screening. It’s always great to read books and discuss theory about anatomy, pain variations according to soft tissues and myofascial restrictions — but only after a potential serious condition is ruled out.
There is an old Chinese expression about physicians that says “a mediocre doctor can cure the disease when it’s in front of him, but a good doctor can prevent the disease before it manifests.” This is only possible if your doctor is able to put together your seemingly “irrelevant,” or “unclassifiable,” symptoms and construct a diagnosis based on a pattern of what “may likely happen” if left untreated. In fact, much of the mysticism around many renowned Chinese doctors stems from their almost supernatural ability to foresee someone’s future illness.
The point here is not to belittle one system over another, but to realize the inherent advantages of both Eastern and Western medicine together. Personally, I would not hesitate to go to an emergency room instead of an acupuncturist if I suffered heat stroke with severe dehydration and feared I could imminently die.
I’ll be the first to admit, I do not hesitate to rely on other skilled practitioners to work with me for the betterment our mutual patients. My patients rely on me to help guide them toward the best specialists within the larger healthcare system.
And if, indeed, it does turn out that your pain symptoms have progressed to the level of a significant classifiable disease, such as osetoarthritis, you have to be accommodating and adaptable if you really wish to give the holistic, conservative treatment process an honest try. Many such conditions, especially chronic pain-based ones may require you to change your mindset, modify your expectations, and recreate a lifestyle that may be a little more restrictive — or inconvenient — but ultimately more conducive to healing.
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