Last month, the Institute of Medicine (which is the medical branch of the National Academy of Sciences) issued a report that estimated that chronic pain affects 116 million people in our country. That is far more than was originally believed. For patients who suffer from chronic pain, this acknowledgement from the Institute of Medicine is a seminal event. Chronic pain usually goes untreated, because most doctors view pain as a symptom of an underlying problem. And with chronic pain, there may be no underlying problem. When a doctor can’t find any cause for the pain, the patient usually gets dismissed as either crazy and referred out for psychotherapy, or as a drug seeker looking for a high.There can be many different causes of chronic pain.
In the report by the Institute, it stated that childbirth is a common cause of chronic pain. 18% of women who had a Ceasarean delivery and 10% who have had vaginal deliveries are still in pain 1 year after giving birth. 10 to 50% of patients who have had surgery develop chronic pain after the procedure. 1 in 4 Americans have low back pain.
The largest determining factor to having low back pain is having had it in the past. The number of people suffering from chronic pain is more than those suffering from diabetes, cancer, and heart disease combined. In the report by the Institute, it is stated that chronic pain often outlasts the original injury, causing changes to the nervous system that get reinforced over time. Doctors often cannot find an underlying cause, because there isn’t one.
Chronic pain becomes its own disease. It becomes an entity unto itself. “If the doctor can’t figure out what the underlying problem is, then the pain is not treated, it’s dismissed and the patient falls down the rabbit hole,” said Melanie Thernstrom, a chronic pain sufferer who wrote “The Pain Chronicles”. “We’re finding that there are significant changes to the central nervous system and spinal cord that cause pain to become amplified and persistent even after the injury has gone away,” said Dr. Sean Mackey, chief of pain management at the Stanford School of Medicine. What happens is that when a muscle is injured, it establishes an neurological pathway between the spinal cord and the muscle. This pathway becomes a reflex arch. This reflex arch perpetuates muscle spasms by causing neurological input to keep going into the muscle telling it to contract. This is a reflex, and therefore does not ascend to the brain where you become conscious of it. This reflex can keep the muscle spasming for months, if not years.
Once this pathway is established, it is easy for the muscles to fall back into these patterns of spasm and inflammation, even once the injury is resolved.“Having pain that is not treated is like having diabetes that’s not treated,” said Ms. Thernstrom. “It gets worse over time. Pain changes your nervous system, and pain pathways develop.” Pain changes the body. These neurological pathways become facilitated, meaning the longer they are around, and the longer you are in pain, the more ingrained these pathways become and the harder it is to break out of those patterns. So what can you do if you suffer from chronic pain? See someone who does deep tissue or trigger point therapy.
The type of therapy I do is a specific form of chiropractic trigger point therapy called Nimmo. It cuts off the neurological input into the muscles that perpetuates the muscle spasm, and increases blood flow to the area to help decrease the associated inflammation. If trigger point therapy is not available, then traditional chiropractic is a good alternative, so is message. Also doing some type of muscle training such as Alexander Technique. You must address the muscular imbalances and irritations before beginning exercise.
Once you begin exercising, go easy and do low impact exercise. Yoga, Ti Chi and Pilates are good choices. If you can get through the first 2 weeks of discomfort from starting up a new exercise routine, then chances are it will help you out. The upcoming program that I designed is very good for those who are looking to decrease their pain.If you suffer from chronic pain, please keep in mind that there might be nothing out there that will get rid of your pain, but there are a lot of things you can do to decrease your pain, and make life more manageable.
Which can be a success in itself.