PERSPECTIVE AND TYPES OF PAIN (WESTERN CONCEPT)

Perspective of Pain
Every one of us have experienced the sensation called “pain” in various degrees, types and forms under different circumstances, but scientifically what is it?  Most of us experience pain as an unpleasant sensation that originates in traumatized tissues and warns of damages or injuries from where it originated from.  Pain also have an emotional quality and most ancient philosophers considered pain as an emotion e.g. Aristotle called it, a passion of the soul but the standard definition for pain by the International Association for the Study of Pain as - An unpleasant sensory and emotional experience normally associated with tissue damage or description of such damage.
When pain is dealt on a clinical viewpoint, many physicians have an anachronistic and overly simplistic view that pain is merely an aversive sensation (a sensory problem).  The usual therapeutic solution to an aversive sensation is to turn it off in one of the following methods - remove the origin of the noxious signaling, gate signal transmission from the peripheral tissues with opioid or other drugs, prevent such transmission with temporary nerve blocks, introduce destructive lesions within the nervous system that prevent such transmission.  Pain proves notoriously unresponsive to conventional therapies that target its putative cause, can appear and persist without evidence of tissue trauma, and above all else it swallows the whole of the person who experiences it, interfering with normal living, functional capability and sleep.  In 1996, Chapman and Stillman defined pathological pain as severe persisting pain or moderate pain of long duration that disrupts sleep and normal living, ceases to serve a protective function, and instead degrades health and functional capability.  Originally pain serves as a warning or alarm system in our body to protect and warn us of the causation and the origin of the site where the pain originated.  This is to enable us to take appropriate action such as, to stop the flow of blood when fingers are accidentally cut, then evasive action - to stop further damage to the fingers.  Basically pain can be acute (temporary) or permanent (chronic) and both types can be excruciating and life threatening.
Pain Threshold
It is the least experience of pain that a subject can recognize.  Basically the pain threshold is the least stimulus intensity at which a subject perceives pain in a laboratory experimental setting.  In psychophysics, a threshold is defined as the level at which 50% of stimuli are recognized.  Thus, the pain threshold is the level at which 50% of stimuli, are recognized as painful.  Defining it, pain is always the experience of the patient, whereas the stimulus intensity measured by the psychophysicists is an external event.  Psychophysicists define the threshold in terms of the stimulus, and that limits the usefulness of pain threshold for clinical application.  The stimulus is not pain and cannot be a measure of pain outside the confines of psychophysical modeling.
Pain Tolerance Level
It is the greatest level of pain that a person is prepared to tolerate.  The pain tolerance level is the subjective experience of the individual and every individual has different level of tolerance and that limits the clinical value of pain tolerance value.

Acute (Temporary) Pain
Acute pain has been experienced by almost everyone on this earth and it could have been the worst pain that you can never forget but it is short-lived by comparison to chronic pain.  Examples are giving birth to a child, having a toothache with exposed nerve or stepped onto a broken piece of glass.  Relief comes when the baby is born, your tooth is extracted or your feet is cleared of the broken glass and treatment done by a doctor.  With treatment, time and natural body healing, the pain disappeared.

Chronic (Intractable Pain)
Chronic pain is that which lasts beyond the normal time required for healing following tissue trauma or that associated with a pathological condition that does not heal and can persist for weeks, months and even years.  Sometimes doctors cannot even find the reason or the cause for the pain in the sufferer although a few known causes are accepted, but generally the older generation suffers more due to the deterioration of their body systems because of ageing and degenerative changes in their bodies.
However, the dominant medical model assumes that the presence of pain signals tissue damage or pathological process.  In other words, this approach views that the severity of an individual’s pain is in proportion to the extent of the tissue trauma.  In fact, the cause of pain is unknown for most of the common types of chronic pain such as low back pain.  Competing (and anachronistic) psychological views hold, that when pain complaint exists in the absence of a definable organic cause, the pain is an expression of unconscious psychological conflict, personal distress or an attempt to achieve secondary gain.  The best solution for most chronic pain problems lies with recognition of the multi-factorial nature of chronic pain, an abandonment of the implicit mind-body dichotomy (if there’s no evident organic cause, the problem must be psychological).  In other words, the chronic pain impacts and engages not only the physiology of the patient but also the psychosocial self.  The following are only some examples of chronic pains.
Arthritis Pain
Basically, arthritis is a condition affecting the body joints.  The two most common types are osteoarthritis which affects especially weight bearing joints such as the knees, spine and hips, and rheumatoid arthritis, an inflammatory joint disease which induced swelling, congestion and thickening of the soft tissues around joints.
Cancer Pain
The pain can be the result of a growing tumor pressing onto a nerve or the invasion of tumor cells into other organs of the body.  The result of radiation or chemotherapy treatment can lead to fluid accumulation and swelling (oedema) in the tissue.  Destruction or irritation of healthy tissues can cause pain and inflammation and probably causing nerve endings to be extremely sensitized.
Headache Pain
There are many types of headaches, namely, cervicogenic - referred to pain perceived in any region of the head caused by a primary nociceptive  source in the musculoskeletal  tissues innervated by cervical nerves.  Muscle - contraction headache caused by sustained muscle tension, restricted blood flow, stress, depression, anxiety or even wrong head postures.  Inflammatory headache - a symptom of another disorder, such as sinus infection.  Traction headache - caused by pulling or stretching pain - sensitive parts of the head e.g. when eye muscles are tensed to compensate for eyestrain.  Trigeminal neuralgia headache - a condition resulting from a disorder of the trigeminal nerve.  Vascular headache is caused by abnormal function of the brain’s blood vessels (vascular system).  Temporomandibular joint dysfunction - a disorder of the joint between the temporal bone (above the ears) and the lower jaw bone caused another type of headache, etc. etc.
Low Back Pain
Normally, low back pain is associated with overweight bad posture and lack of exercises especially for people who sit a lot such as cab drivers and desk job holders who have little chance for exercises or too lazy to do it.  This suggest weak or injured back muscles but this pain could also be caused by a ruptured disc in the spine and exerting pressure on the spinal cord or nerve root.  Another cause could be the wear and tear of the cartilage disc due to ageing or/and injuries sustained, thereby narrowing the gap between two vertebrae consequentially “pinching” or pressuring the nerves emerging from the spinal cord.
Migraine Pain
A vascular headache believed to be caused by changes of blood flow and certain chemicals in the brain resulting in a chain of events - including constriction of arteries, supplying blood to the brain and the release of certain brain chemical that result in severe head pain, stomach upset and visual disturbances.  There are many types of migraine.  The two main types are with aura and without aura migraines.  The others are occular migraine, migraine caused caffeine withdrawal, status migrainosus and many others.
Neuralgic (Nerve Damage) Pain
Results from damage to the peripheral nerves or to the central nervous system itself.  Examples are tic douloureux and shingles which produce extraordinary scaring pain.  Among other notoriously painful neurogenic disorders is pain from an amputated or paralysed limb -so-called “phantom” pain - and affects about 10% of amputees and paraplegia patients.
Nerve damage pain has two components, a “shooting” pain known as neuralgia or a constant burning pain.  Neuralgic pain occurs in conditions where the peripheral sensory nerve is damaged or irritated e.g. post-herpetic neuralgia. Trigeminal neuralgia, or compression of a nerve by scarring, disc material or tumor.  The sudden pain is probably due to an ectopic discharge in the affected nerve.  The constant burning nerve damage pain is more commonly seen when the lesion involves the sensory ganglion or is inside the cord itself.  Nerve damage is only marginally relieved by simple analgesics and opioids.  Specific therapies include anticonvulsants for neuralgic pain and Flecainide or Mexiletine with their neuronal stabilising properties for the constant, burning pain.  General therapies include the use of tricyclic antidepressants and transcutaneous electrical nerve stimulation.
Sympathetically Maintained Pain (S.M.P.)
SMP is a condition in which abnormal sympathetic efferent activity is able to stimulate the peripheral sensory C fibres and hence produce pain.  The pain is typically non-dermatonal and is usually burning in nature.  It is often associated with other features of abnormal sympathetic activity, such as a colour and temperature change in the periphery (usually of the hand or foot) due to vasodilation (red and hot) or more commonly vasoconstriction. (The limb is cold and blue).
Excessive sweating is another common sign.  S.M.P. may present following trauma to the limbs and be the cause of severe persistent pain despite healing of the peripheral tissues as occurs in Reflex Sympathetic Dystrophy.
It can also present as a following feature to inflammatory pain or nerve damage pain.  Sometimes this complex pathophysiological cause for pain can be misconceived to be psychological and not organic.
SMP does not respond well to simple analgesics or to opioids.  Control involves sympathetic nerve blocks with local anaesthetic and intensive physiotherapy.
Psychogenic Pain
It is pain without an organic basis and in the past, psychogenic pain was over-diagnosed in patients with severe pain without obvious pathology.  It is now being discovered that even minor pathology causing pain may lead to a hypersensitivity state of dorsal horn neurons in which any pain signal from the periphery is magnified to produce pain with a severity out of all proportion to the underlying pathology.  Chronic pain causes secondary psychological effects because of the interference with activities of daily living and independence.

ORIGIN AND CONCEPT OF PAIN

According to some western neuroscientists, their findings are the nerve ending are sensitive to touch if they are pressed very hard.  Other nerve fibres in the skin are stimulated by a painful pinch as well as a gentle touch.  Recently they found that there are many small nerve cells with extremely fine nerve fibres that respond mainly to an intense and potentially harmful stimulation.  They call them the nociceptors nerve cells, from the word noxious, meaning destructive or harmful.  There are various types of nociceptors which respond to different types of stimuli e.g. a hammer blow onto your thumb, a needle prick, a burning matchstick etc. and report the extent and type of damages sustained.  Take for example if you accidentally put your hand onto boiling water, the reflex contraction of your hand is in respond to pain signals reaching the nerve cells that control that particular muscles.  Some of the pain signals travel to higher centres in the brain along pathways.  One pathway reports the damages done - the location and the condition.  The rest of the pain signals travel along other nerve fibres making connection with other nerve cells (neurons).  The combination of all these pain signals travelling along the pathways and stimulating the neurons contribute to the emotional and physical impact of pain.
The resultant feelings will be feeling frightened, anxious, irritated or angry and the experts classified these feelings as the “suffering” component of pain.
The autonomic nervous system that handles the automatic vital functions of the body systems such as breathing, beating of the heart, digestion, filteration and elimination of system will also be affected.  Rapid or subtle changes in your body causing you to sweat., digestion of food stops, blood pressure and pulse rate goes up, dilation of the pupils of your eyes will occur.  The body will release hormones such as epinerphrine (adrenaline) which help to boost the responses and trigger the release of sugar stored in the liver for emergency - to fight or to take flight.  Somehow, the body senses the different types and intensity of pain and react accordingly to the cause and source of pain as well as the time and situation of the happening - take for an example, there are times when danger is present and we are pursued by a pack of dogs and while running, we may have stepped on some sharp rocks cutting our bare feet but yet we would not feel the pain until we have reached safety and only after a short while, we realised the cuts - then slowly the feeling of pain sets in.
Given such example, neuroscientists are aware of built in mechanisms in our nervous system that can block the feelings of pain in certain circumstances.
The overall view is that the body is capable to process the pathway of pain signals whether to let the pain signals go through to the brain or prevent it from getting through.  Some neuroscientists in the mid sixties have speculated that when pain signals first arrive at the nervous system, they trigger response in a group of small neurons, that form a kind of pain “sector”.  If the intensity of pain signals, activating these neurons reaches a certain mark, a hypothetical “gate” opens up and the pain signals reach the higher brain centres.  On the other hand, neurons including large ones which are in contact with the pain all “sector” can suppress responses in that “sector” so that the gate can remain shut.  The gate closing cells can be activated by gentle touching, pressing or massage of the skin.  The brain cells can also activate a descending pathway to stop the pain.  They called it the “gate theory of pain”.
This theory explains why, when we have painful bruises, we can lessen the pain by gentle massages on the affected area.  The other instance, such as sportsmen ignore or not aware of pain from injuries sustained during an important game and only discover it or attend to it after the game.
Neuroscientists were aware that chemicals in the body called “neurotransmitters” were responsible for conducting nerve signals from cell to cell crossing the gap between them.  Some neurotransmitters excite the second cell to generate an electrical signal and other neurotransmitters stop the second cell in generating an electrical signal.
The neuroscientists found a whole family of pain suppressing proteins which they called the smaller members of the family enkephalin meaning “in the head” and later the larger proteins were also isolated and were called endorphins, meaning the “morphine within”.  Nowadays the whole group is known by the term endorphins.
The endorphins confirm the general concept of the gate theory of pain.  The brain nerve cells, under certain circumstances release endorphins which suppress spinal cord pain cells through pathways descending to the spinal cord from the brain proper.  When you massage your aching limbs or muscles or scratch a patch of itching skin, endorphins are released.  Neuroscientists have confirmed in their laboratory research that in such stimulation, the release of endorphins was confirmed by their presence in cerebrospinal fluid circulating in the spinal cord and the brain, calming agitated nerve cells.

CONSEQUENCES OF PAIN
 
All of us have experienced pain in some form or intensity whether acute, chronic or both and the devastating effect it played on our lives. The worst of the two is chronic pain which is estimated that one in three suffers some form of chronic pain but the worst thing is that other people around you would not “understand” your “pain” and they will judge you to be lazy, irresponsible, psychotic or all of it.
Pain, especially chronic pain overwhelms the sufferer, depriving the person of peace of  body and mind. In many cases, such as migraine sufferers, they are totally disorientated during attacks especially those with “aura”, any movement aggravates  the pain – they become like recluse hiding in the dark, shutting out the light and even the slightest sound tortures them. These sufferers have lost spouses who have suffered enough of their afflictions, lost out on social functions, cancel a number of family gatherings and outings, and even lost jobs or could not hold onto any permanent jobs because of frequent absentees during attacks.
Most of the chronic pain sufferers cannot sleep at night and the next day’s tiredness aggravates the problem in leading to more pain, depression and irritability, appetite goes off and the person suffers from malnutrition. Physical and mental activity  of any type becomes tiring and may aggravate the pain. Specialist call the situation the “terrible triad” of suffering, sleeplessness and sadness, a tragedy that affects the victim and the family. The sufferer will try to do anything to stop the pain, ending up as drug dependent and go for ineffective operations or worse type of questionable treatment which may be more harmful and increase the pain.  The final alternative is suicide to escape the excruciating pain that destroys family life, social life, employment prospects and promotion and even the very sane existence of the sufferer concerned.
One world health authority said that chronic pain is the most costly health problem in America. He estimated about US fifty billion dollars inclusive of direct medical charges, lost of income and productivity and other costs and expenses.
A leading migraine organisation estimates about 45 million American suffers from chronic recurrent headaches and had spend four billion US dollars. Migraine sufferers took more than 60 million days sick leave every year.
About 15% of US adults have incidents of low back pain at some time in their lives. About 5 million are partially disable and about 2 million so severely disable that they cannot work. This problem cost the industry and business more than 90 million workdays and lost more than US$5 billion in medical treatment and care. About 20 million people in America and cost of over US$4 billion is lost to medical care, lost income and productivity.
It is estimated that about 80 million people in America suffers some form of chronic pain, mostly of non - cancerous origin.
Currently scientific studies show that prolonged pain is an aggressive, physically \, destructive disease. It induces harmful hormonal and metabolic changes, alterations of brain chemicals essential to pain modulation,, suppressed responses of the immune system and even interference with our genetic makeup.
There are people, especially the elderly, who suffers excruciating pain due to unsuccessful back surgery, multiple sclerosis and polio, severe headache and migraines, accidents, arthritis and neurological diseases, have been told by their doctors that there is nothing wrong with them, that the pain is “all in their head” and that they have to learn to live with it and asking for medication is because the sufferers have become “drug addicted” depending on regular medication.
The chronic pain have degraded sufferers into displaying subhuman behaviour of terrible tantrums, anti-social feelings and the sufferer may become social outcast, recluse as well as losing all their human pride.

SOME OF THE CURRENT METHODS/WAYS FOR PAIN MANAGEMENT

A number of methods had been devised for pain management, some on a temporary basis while others are permanent (e.g. destruction of the problematic nerves conveying the signals).  Below are some of the methods currently used to control pain:

Medication Management
Different types of health problems such as arthritis, migraine, cancer, low back pain, etc. needs different types of medical approach and different types of medications altogether.
Drugs are the most common treatment for migraine and headaches.  There are too many types to mention here but the few are as follows:- non-prescription analgesics for mild to moderate tension type headache.  This includes asprin, acetaminophen, ibuprofen and naproxen.  For moderate to severe migraine attack, Serotonin Agonists - Ergot Alkaloids such as ergotamine and injectable dihydroergotamine are used.  Another type of drug, Serotonin Agonist - Sumatriptan, under the brand name Imitrex (oral and injectable preparation) is used.  Some people experienced side effects that include burning or redness at injection site, dizziness, drowsiness, chest or throat tightness, nausea and muscle aches, etc.
In the case when the headache pains do not respond to other medications, some of the emergency room medications administered in the physician’s place or hospital are given by injection such as Dihydroergotamine (brand P.H.E.45), Opioids (Narcotics)such as Meperidine (brand Demerol), Butorphanol (brand Stadol).  Also used are Neuroloptics such as Prochlorperazine (brand Compazine) and Chlorpromazine (brand Thorazine and Ormazine).  Another type is the Corticosteroids - Methylpredinsolone (brand - A-methaPred, etc.) and prednisolone (brand Pedates, etc.).  All the above medications may induce many side effects.
Arthritis are treated with asprin and nonsteroid anti-inflammatory drugs like idomethacin and ibuprofen which may have serious effects.  Low back pain are also being treated with asprin and muscle relaxant for mild cases.  Cancer pains are being given strong painkillers.
Acupuncture Method
Acupuncture is a form of therapy invented by the Chinese more than 2,000 years ago.  It is based on the Qi (Energy) system of the human body which are inter-link to the nervous system in the body.  During the procedure, very fine needles are inserted under the skin at selected “meridian” points of the affected part in the body to produce pain relief which some patients say last for hours and even days.  Many specialists agreed that when the needles are placed near where it hurts, and not at the body points indicated on traditional Chinese acupuncture charts, many patients reported pain relief benefits.
The local needling of the skin in acupuncture excites endorphin systems of pain control.  Wiring the needles to stimulate nerve endings electrically (electroacupuncture) also activates the endorphin systems.  There were some experiments which show that following acupuncture, the amount of endorphins in cerebrospinal fluid to be higher.  Skeptics said that long term studies of chronic pain patients have no lasting benefits from acupuncture treatment.
Spinal Cord Stimulation
It is electrical stimulation at a precise level of the spinal cord.  This stimulation causes a sensation of tingling in the area where the brain previously felt pain.  The patient’s pain is replaced by a tingling sensation.  Patients who respond well to this therapy include those with Failed Back Surgery Syndrome, arachnoiditis, reflex sympathetic dystrophy and isohemic pain.  This therapy is nondestructive and entirely reversible if it proves not to be effective for the patient.  This method is normally used for people whose pain is primarily in the extremities and effective for neuropathic pain which is pain related to pathology of the nerves.
Implanted Intrathecal Drug Administration Pumps
Patient is implanted with a total system with catheter and infusion pump placed subcutaneously either under general or local anesthesia.  Intrathecal (into the cerebrospinal fluid of the spine) infusion of narcotics such as morphine provide highly effective analgesia with one three-hundredth of the equally effective oral dose of morphine and with such small doses, side effects are usually minimal.  Intraspinal drug in fusion therapy is effective in treating pain that is physical, such as bony pain.  Advantages of the fully implantable drug infusion pump include patient freedom from external devices and requirement for infrequent refill since the daily dose administered is so small.
Psychology Treatment
It is a treatment basing on psychological and emotional support.  Severe depression is present in many persons suffering from severe chronic pains.  Suicidal thoughts are not uncommon.  Psychological support is extremely helpful to these people.  Relaxation training is also useful to reduce the anxiety and help the patient cope with the pain and lifestyle changes.
Physical Therapy
It is a method by which the therapist will also train or instruct the patient to use the TENS unit (transcutaneous electrical nerve stimulation) which is helpful sometimes in minimising the pain.  The TENS unit uses electrodes on the skin which replace the pain with a tingling sensation in a matter similar to the more sophisticated spinal cord stimulation.
Nerve Blocks and Injections
Differential nerve blocks with the use of a anesthetic and steroid can be a powerful tool to diagnose the pain generator.  Various injection treatments are used to reduce pain by blocking the nerve impulses carrying the pain message or by decreasing the inflammation in the swollen nerves by the use of injected steroids.  Nerve blocks used alone are of no long term value to patient with chronic pain, but temporarily abolish a patient’s pain to allow him an opportunity to participate in exercise and rehabilitation .  Some of the most used steroid injections are as follows:
Epidural steroid Injections which are normally used on patients with back and limb pain of which may be caused by inflammation or irritation of the nerve roots which in turn can be caused by arthritic degeneration of the spine or disc herniation.
Selective Nerve Root Blocks is performed with the aid of fluoroscopic x-ray imaging in injecting a small amount of local anaesthetic and steroid in close proximity to the spinal nerve root where the pain is being generated.  This method is more effective as the medicine is placed closer to the pain generating site.
Facet Joint Block and Facet Denervation - lumbar facet injections are used for patients with low back pain and leg pain stemming from inflammation of joints and cervical facet injections are for neck pain as a result of degeneration of these joints.  The effect of the facet joint injection is usually temporary to give an opportunity to the patient to participate in physical therapy.  Facet injections are performed using a C-arm fluoroscope to direct the needles through the skin into the facet joints and inject a mixture of local anesthetic and steroid into the joint itself or in direct proximity to the nerve which innervates the facet joints.
Biofeedback
The biofeedback approach assumes that subconscious psychological or physiological response is responsible for the chronic pain felt by the patient and that the control of this response will help lessen the pain.  There are several methods of biofeedback which all measure a physiological function such as body temperature or muscle tension.  Through the use of electrodes properly placed on the patient, these functions are measured and converted into an understandable form to the patient.  In certain situations as low back and chronic tension headache, it is believed that abnormal muscle contraction supports or bring about these pain syndromes.  Through the use of biofeedback, the patient is made aware of this abnormal tension.  As the patient learns to control the abnormal muscle tension, a reduction of pain is often reported.

UNDERSTANDING PAIN AND PAIN RELIEF THROUGH QIGONG/QI-SYNERGY AND PAIN RELIEF THROUGH MASTER WONG’S EVERGREEN QI-SYNERGY PROGRAM

Theoretical Understanding of Pain and Pain Relief through Qigong/Qi-Synergy
Pain, whether acute or chronic is a distress SOS signal sent by affected cells of the body to the brain (command centre) calling for help due to the fundamental reason that the area of distress is under duress, injured, damaged or in the process of being hurt or damaged.  Basically our human body is a survival machine and it has been programmed by our genetic composition to defend, reproduce, regenerate or repair itself by nature, and automatically, without outside help or interference.
However, in certain circumstances, the body structures that contain the affected tissues are unable “to repair” itself or themselves due to situations beyond its genetic programmed capacity, such as the amputation of limbs, i.e. hands or feet during accidents or war - then rejoining or reattachment of the detached limbs have to be performed by external third party/parties, i.e. the surgeon does the job of attachment but the rest of the healing of the limbs attachment is done by the body itself.  Similarly, when the body is down with debilitating diseases, such as arthritis, diabetes, etc., a third party or agent such as a doctor using drugs, a herbalist using herbs and a acupuncturist using acupuncture needles is used to stimulate and assist the human body to heal itself.  Fundamentally it is the body that practically “heals” itself, i.e. by nature or God - depends whether you are religious or not.
In all cases, the “pain” is an indication of the affected part/parts being not in order or in the process of being put in order (in the process of healing).  The process of “healing” depends on the blood flow, supplying oxygen and nutrients (spare parts) for repair, replacement and the energy (Qi) to do it but unfortunately in many cases, the healing is “not complete” due to insufficient Qi and Qi flow to the affected area and thereby insufficient blood flow.  Chinese Medicine says that if Qi does not flow, blood does not flow, so the whole point boils down that the affected tissue cells are under duress or distress due to lack or insufficient amount of oxygen and food (nutrients) and may eventually atrophied if not corrected in time.  In many cases, the affected tissue cells have been helped by manual means (massages) and/or chemical means (by drugs, herbs and medicines) to induce blood and Qi flow and thereby assisting the body to “heal” itself.
Unfortunately in many other cases, the human Qi system (meridians) of that affected part are severely blocked due to stress, toxin pollution or injury of the affected part/parts and therefore the repair to the affected part/parts are non-existent or incomplete with the resultant of the “pain” being always present or comes in regular intervals.  Western Science generally has not accepted the idea of Qi system (Qi meridians) yet but it is already in the Eastern Science for a few thousand years which anyone can survey the Qi system (meridians) in the Chinese Acupuncture Diagram produced by the Chinese Academy and University in China or any professional acupuncturist office in any part of the world.
The proverb says - “If you want to reap corn, then you must plant corn” - to restore the Qi systems (meridians), the best people to do it will be the Healing Qigong or Healing Qi-Synergy experts or masters who have attained the necessary standard, ability, knowledge and Qi power to restore the flow of Qi (Energy) in the affected part/parts effectively. Some Qigong masters can effect the reactivation, restoration and repair the Qi system of the affected parts by “touch” method and some higher Qi masters can effect the “healing” by “remote control” or “transmitting” Qi without touching the patient (from a distance).  (Important caution - if you want to engage a Qi master, make sure you find a real master or else you will be greatly disappointed and disillusioned) - The proverb - “The proof of the pudding is in the eating”- Judge the Qi-master by results produced, i.e. the healing results.
Summarising the above, when the body is not able to heal itself at all or completely at the affected part due to insufficient Qi supply, nutrients, inadequate blood supply and non removal of toxins due to various reasons, then the “pain” is an urgent SOS distress call to the “brain” and the “total body” to help to rectify the situation i.e. to restore qi and blood supply in adequate quantity to the affected part.  When the obvious has been accomplished, i.e. Qi and blood supply has been normalised to the affected part, then it is a matter of time that the affected part become normal again and the “pain” slowly but surely disappeared when the healing is completed by the human body.
Another complication of damaged tissue cells is numbness feeling, eventually leading to “no feelings” at all.  When such a situation arises, the affected area is devoid of live nerves or nerve system, i.e. all the nerves and local nerve system have died or atrophied.  This type of scenario happens in diabetes melitus case where the microvascular system in the dermis, epidermis, and limb extremities have been blocked and therefore the local nervous network slowly dies and becomes non functional.  This is the reason, why diabetes sufferers contract gangrene on the hands and feet easily, as the fingers and toes could be injured very easily and without their knowing it, because they do not feel pain at all or rather no feelings at all. Healing takes place in this case when Qi and Qi-system is being restored in the affected area, then nerves and local nerves network will regenerate.  When that happens, “pain” will be felt by the body from the affected part and this “pain” can become quite painful but it will slowly diminish until no more.  We call this period  - the healing crisis period.

Practical Application of Qi-Synergy Healing  by Master Wong in Pain Relief
Master Wong has helped to relieve pain in hundreds of cases where the pain results from migraine, headaches, internal injuries, arthritis and other types of problems without the use of any medication, drugs or herbs.  Not only that, he has caused sensation or feeling to return back to people who had suffered from stroke, diabetes, etc ie. restoration of nervous system function.  The Qi-Synergy treatment using Qi alone by Master Wong was usually done on groups of people, from one to hundreds of people at the same time in the past scenario, without touching them (remote control or distance healing) in all the venues of training and healing during Evergreen Qi-Synergy Program sessions.
Beneficiaries to the above include Dorothy Lee, who had paralysed vocal cord for twenty years (able to talk now) and at the same time, her shoulder pain as well as painful muscle cramp were resolved.  In the case of Mercury Mah who had serious head injury many years ago, leaving his right face numb and painful and left side face being affected by painful shingles attack a few months ago, all pains disappeared and blood flow normalised within a few days, during one of Evergreen Qi-Synergy Program (EQSP) conducted by Master Wong.  Then, there is the case of Ms. Bibiana Chew and Ms. Josephine Liew who had migraine pains which was resolved during the EQSP and Bibiana Chew’s low back pain was also resolved at the same time.  Another case was Mr. Thanasegaran  who had his low back pain solved during EQSP.  In Kota Kinabalu, Police Inspector Maurice Coleman, a  Tae Kwon Do black belter had a serious injury in the chest sustained during black belt upgrading time.  He was in terrible pain for a long time and his health condition had degenerated into a serious condition when he went to see Master Wong in Stella Maris Church in Kota Kinabalu town in January 1994.  Three months later after the completion of the EQSP, Inspector Maurice Coleman and his wife ran up the stairs of Wah May Hotel in Kota Kinabalu and thank Master Wong profusely because the “pain” in the chest had completely disappeared.
The above examples are cases where Master Wong applied in actual practice of Eastern Science theory on pain and pain relief and the results obtained are usually the same i.e. the disappearance or the relief of pain when the affected part/parts are normalised in Qi and blood flow.  The “healing” by Master Wong are holistic by nature, in other words, the Qi being transmitted by Master Wong to the patients/students penetrate from head to foot and that is why people who came for the relief of migraine or headache in the head found to their surprise and joy that their arthritis pain in their hands and feet had also disappeared besides other pains which had also disappeared.
Besides that during the EQSP, the students were taught the Evergreen Qi-Synergy Art (EQSA) where they learned how to generate Qi effectively, stored Qi effectively and distribute Qi efficiently into all parts of the body.  In effect, not only the affected parts got healed but every other parts had an upgrading of Qi supply and in the long run, the students actually becomes much healthier and stronger than people much younger in age than them and they hardly fall sick at all.  Not only that, they were able to recover from future operations, injuries, accidents and wounds much faster than other people. 

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