How To Avoid Pain

Avoidable pain is frequently associated with injury to muscles, tendons, ligaments, bursae, discs and joints. While it is unlikely to live completely free of these common aches and pains, it is possible to minimize their severity, frequency and duration. There are 4 general rules to accomplish this goal.

1. Maintain the biomechanics of your body. This requires a periodic visit to your chiropractor even when you are feeling well. The chiropractor will help restore proper biomechanical alignment to your spine and extremities before any problem becomes clinical.

2. Exercise regularly. Do not over-exercise, however. The goal in exercise is to increase your heart rate but not to get out of breath. For some, this may be as little as stretching to maintain range of motion. All joints need motion to assist in repair and maintenance. In fact, studies show that if a good joint is immobilized, it will degenerate. Joint motion brings in nutrients the body needs for maintenance and removes waste product generated by normal activity.

3. Find ways to keep stress levels low. Rest following exercise. Learn relaxation techniques. Take up meditation. Explore Tai Chi. Find activities that promote a calm state-of-mind.

4. Pay attention to nutrition. The body will only maintain and rebuild most effectively based on the nutrients it has available. Foods today don’t contain the same levels of nutrients as in the past. The soil in which foods grow is depleted of some important nutrients. High quality nutritionals from specialized sources (not the supermarket or pharmacy) are critical.

The solution is simple and needs only a little planning. Avoid junk foods and fast foods. Use high quality foods that can be found in natural and organic stores like Whole Foods Markets. Obtain high quality supplements from health food stores or your health care professional, not supermarkets and drug stores. Get some exercise. Find ways to relax. See your chiropractor when needed but no less than once a month. This lifestyle will help keep you pain-free for many years.

CURRENT THOUGHT ON PAIN REDUCTION IN MYOFASCIAL PAIN SYNDROMES (Part 2)

In Part 1 of this discussion of myofascial pain syndromes (MPS), we talked about symptoms caused by trigger points (TP). While this type of pain syndrome is aggravating for the sufferer and complex for a physician to treat, it is actually fairly straightforward in comparison to those without trigger points. The TP generated pain conditions are caused by lesions that are local and readily identifiable once the symptom pattern and history are considered. Myofascial pain in the absence of TPs is a different matter.

Some people regard this as a completely separate condition but that may be splitting hairs. The results of both are similar in that there is muscle pain, joint pain, tenderness, and inflammation. In fact, the American Medical Association’s (AMA) coding manual used by almost every physician, insurance company and workers’ compensation organization uses the same code number for myofascial pain syndrome, myofascitis, myositis, fibromyositis and fibromyalgia. For clarity, we will refer to this form as Fibromyalgia and the pain caused by trigger points as TP Syndrome.

While the AMA, the National Institutes of Health (NIH) and the World Health Organization (WHO) recognize the existence of Fibromyalgia, some physicians do not. Consequently, many patients spend years and visit a number of physicians looking for an accurate diagnosis. Patients become frustrated with treatments that do little or nothing to address their complaints; some even undergo surgeries that are, at best, unnecessary.

There are clear differences, though, between Fibromyalgia and TP Syndromes. Fibromyalgia is more systemic than the localized TP Syndromes. Both cause and affect of Fibromyalgia are more widespread. Most recent research supports central nervous system (CNS) involvement. It is thought that the CNS is made overly sensitized to stimuli.

Defining the problem is necessary but is certainly not a solution. It is only a first step. What must follow are investigations into characteristics of the condition. Research has shown chemical, endocrine and hormonal differences between Fibromyalgia sufferers and the wider population. What findings differentiate the Fibromyalgia group from the “normal” population? What causes the changes in some patients? What can be done to alleviate the symptoms? What can be done to assist the patient in eliminating this painful and debilitating condition completely? These are complex questions I will attempt to address in the next part of our discussion.

A FEW THOUGHTS ON THE SIGNIFICANCE OF PAIN

Pain is one of your brain’s interpretations of information received through your nervous system and is the result of some sort of stimulus from outside or from within your body. Most of us have a variety of interpretations available to us, including pain, pleasure, irritation, vibration and others. Pain is the way your brain tells you that something isn’t right and you need to find the cause.

The brain is also frequently capable of discerning the general location of this noxious stimulus. For example, if you feel a pain in your left leg, you initially look at your left leg to see if something from outside your body (exogenous) is causing this pain. If you find the cause, you remove it; a thorn, splinter, bee sting, etc.

Pain from an internal cause (endogenous) is more difficult to identify. But the solution is the same. Identify the cause and remove it. This is best done using approaches starting with the least invasive and moving one step at a time toward most invasive.

There are many possible causes of internally generated pain but it can be classified into two main categories: Acute and Chronic. Pain can also have a number of different descriptors like sharp, electric, stabbing, burning, throbbing, achy, etc. Each gives us information useful in determining the real cause and location of the pain causing lesion.

Acute pain is frequently exogenous but can also be endogenous. This is usually more severe and immediate in the sense that it often appears quickly and demands immediate attention because it instantly alters your daily activities. Chronic pain can also be severe but is longer term. It doesn’t come as a surprise because the sufferer has had this condition for an extended period. Chronic pain can also interfere with your daily activities but many patients have worked out a way to do at least some of their activities by changing how they accomplish these.

The brain can sometimes be fooled, especially by endogenous pain. Pain can be generated by problems with the bones, joints, muscles, ligaments, tendons, blood vessels, lymphatic vessels or the nerves themselves. The situation can be complicated by pain perceived by the brain as occurring in one location but the cause may be in a completely different one. For example, a tear in one of the muscles may cause that left leg pain but it may also be caused by pressure on the nerve that runs to that region suffering interference at a different location.

One area where this interference frequently occurs is in the spine. There are a number of structures near that nerve where it exits the spine that can put pressure on it. The brain interprets the input as coming from where that nerve terminates rather than at the point of interference. So, leg pain may actually have little or nothing to do with the leg. Physical examination, nerve testing and imaging with x-ray, MRI and CT are invaluable in making the correct diagnosis.

Medications can help with some pain in the sense that the nerve impulses can be interrupted or altered so that the brain no longer interprets pain messages. But these medications are for temporary pain relief only. They do not indentify or eliminate the cause of the pain.

Medications should only be used as a Band-Aid, not as a cure. Hiding your pain with pain relievers, muscle relaxants and anti-inflammatory medications can help you feel better for a little while, but before too long, the continuing damage will worsen to a point that the medications are no longer able mask the pain. Remember that your pain is not caused by a steroid deficiency and that the medications should be used to make you feel more comfortable while you and your physician look for the real cause of the pain.