The Missing Pieces to the Chronic Pain Puzzle
By Dr. Kevin Wong
How do you feel at this very moment? You can do a easy self-check just by moving your neck, shoulders, arms and legs around. Do you have any aches and pains anywhere? If your response is, "Don't most people have pain somewhere in their body?" or "Doesn't pain come with old age?" keep in mind that while that's true, it doesn't mean you have to accept it. And remember, pain isn't just physical. The emotional stress it creates can be as hard on you as the pain itself. Let's talk about ways you can find relief from your physical pain, which will undoubtedly lighten your emotional load at the same time.
Pain is defined as an unpleasant sensation that can range from mild, localized discomfort to sheer agony. Pain has physical and emotional components. The physical part of pain results from nerves being stimulated. Pain may be confined to a specific area, as in an injury, or it can be spread throughout the body. Around the world, millions of people live with pain in some form or another, involving many different body parts, on a daily basis.
One of the most interesting things about pain is how each human being deals with it. Some learn to live with pain. Others can't stand to feel even an ounce of it. The most common types of pain include arthritis, lower back, bone/joint pain, muscle pain and fibromyalgia (widespread pain, tenderness and fatigue in muscles,tendons and ligaments). Back pain is the most frequent cause of limited activities for people younger than 45 years old.
Acute vs. Chronic Pain
Acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself. This type of pain comes on quickly and can be severe, but it lasts a relatively short period of time. In general, acute pain is in response to an event that happens to the body. It may be a result of surgery or an accident.
Chronic pain is different. Chronic pain tends to stay around or progress over longer periods of time. Pain signals keep firing in the nervous system for weeks, months or even years. Oftentimes, chronic pain is resistant to traditional medical treatments. The emotional component of pain often comes into play in a chronic situation.
The Consequences of Pain
The loss of productivity and daily activity due to pain is substantial. Americans spend at least $50 billion per year on back pain, and that's just for the more easily identified costs. Pain has a negative impact on an individual's quality of life. It diminishes one's ability to concentrate, do their job, exercise, socialize, perform daily tasks and sleep. Over time, this can lead to depression, isolation and loss of self-esteem. Researchers have found that depression is the most frequent psychological reaction to chronic pain.
If you hurt an area of your body and do not restore proper, healthy movement patterns, you will end up with problems later down the road. I can't tell you how many patients I have seen who got in car accidents and hurt their neck and back, but waited to get treatment and used pain as the indicator for how they feel. Eventually, the pain went down or even away, but they were often left with problems in their bones and joints.
Common Causes and Sources of Chronic Pain
An initial injury like a trauma, fracture, sprain/strain, or serious infection may be the cause of the chronic pain. There could also be an ongoing cause like arthritis, cancer, an ear infection or injuries that never healed properly. Some people even suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), and psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).
Quite simply, pain can come from anywhere in the body. The source can be the neck, shoulders, low back, hips and everywhere else. Many times, the location of the pain depends on how the injury happened. Perhaps someone injured their shoulder while throwing a ball. Maybe someone sprained their ankle while running. How about the person who falls down the stairs and hurts multiple parts of their body simultaneously?
Solving the Chronic Pain Puzzle
Pain is a complex puzzle. For certain cases, it takes complex solutions to help solve that puzzle. In some cases, the individual's pain is so debilitating that it requires the use of X-rays or other special imaging to visualize the problem that is occurring in the spine or extremities. It may be appropriate to use any of the following: Chiropractic, Chinese medicine, acupuncture, nutritional supplementation, massage/bodywork, yoga and psychological therapy. In some cases, it may even require over-the-counter or prescription medication (although the goal is to avoid relying on these because of the potential side effects). But there are definitely things you can do that can help you prevent and treat chronic pain. Let's explore these strategies that, as you might have guessed, are all related to one another.
1. Posture: You have probably been told at different times of your life about the importance of good posture. "Sit up straight" or "don't slouch" are probably familiar phrases to you. Proper posture is difficult to attain, so don't stress yourself out about it. When you are sitting, put a rolled-up towel or sweatshirt in the small of your back. Sit all the way back to the rear of the chair so you feel the support in your back. When you stand, stand against the wall or a post so you can maintain erect posture. It is important to strengthen your core muscles, the muscles along the spine. Yoga, Pilates or a specific workout program with weights will help you achieve this. You may want to find a personal trainer to help you focus on specific exercises to help you achieve your goals.
2. Balance: As you develop strength, you begin to develop balance. Many of the positions utilized in yoga, Pilates and weight training work specifically on balance. Would you believe that your feet also have a lot to do with balance? The three arches you have in your feet must all be supported in order for the rest of your body to have good support as well. If one or more of the arches is flat, it can significantly affect the stress to your joints and your ability to exercise efficiently. Ask your chiropractor about analyzing your feet to see if you need arch supports.
3. Spinal Load and Stability: Understanding how to exercise or perform any type of sporting activity is crucial to your health. How many people do you know who lift weights incorrectly? On a daily basis, I see patients who have hurt themselves with physical activity. By being careful and doing your exercises properly, you can reduce the amount of spinal load (stress) and instability you create for your body. I cannot tell you how important it is to make sure your feet and all of the joints above them are healthy and moving properly. When your joints move well, you can perform activities optimally and with minimal stress on your body.
4. Alignment: Exercising makes your muscles stronger, which also helps maintain structural and bony alignment. Chiropractic care is hopefully a regular part of your life. Visits to your chiropractor at a frequency you both find appropriate will help you maintain your alignment.
Keep in mind that pain may be indicative of a serious underlying condition. Always talk to your doctor about any pain you are experiencing, particularly if it does not go away or worsens with time.
Kevin M. Wong, DC, a 1996 graduate of Palmer College of Chiropractic West in San Jose, Calif., practices full-time in Orinda, Calif. He is also an instructor for Foot Levelers, Inc.