Chiropractic and Chronic Pain
Pain is a useful crisis messaging system for the body. It is a message that something is wrong, at a volume that cannot be easily ignored. It exists to protect the body, encouraging protective action to prevent further injury. The network that carries these messages is the nervous system, from the peripheral nerves to the spine, and then to the brain. While pain is a useful tool to keep us healthy and to minimize injuries, it can also get out of control and continue long after its purpose has been served. Chiropractic treatment is useful in reducing or eliminating many kinds of pain, and may be most effective with chronic pain. Before we examine how chiropractors treat pain, it is necessary to delve a bit deeper into the subject of pain.
Chronic vs. Acute Pain
Acute pain occurs suddenly, in response to an injury or unhealthy change in physical function. Pain from running into a doorway, for example, is acute pain. Chronic pain is pain that may have started suddenly, but persists long after. Many accidents and disease processes, for example, result in pain that lingers long after the event that triggered it. Chronic pain is a complex entity, as the longer we feel a particular pain, the more our bodies and brains change to accommodate it. It's as if chronic pain creates grooves in brain function that complicate attempts to reduce or stop it. Chronic pain, in some cases, can become a habit, one that's very difficult to break.
Sources of Chronic Pain
Chronic pain can arise from many sources. Common sources include injuries that do not completely heal, long-term disease processes and injuries to the nervous system. There are many potential sources of chronic pain, but they all have in common a state of injury or disease that has failed to completely resolve. There are also categories of psychogenic chronic pain, such as phantom leg syndrome, that work through a different mechanism than classic chronic pain but are troublesome and even debilitating for many people.
Theories of Pain Perception
Pain is a somewhat mysterious experience, not well understood by science. Pain can be intense and overwhelming, and yet it can also be modified by opiates, hypnosis, sugar pills (placebo effect) and meditation. It can also be modified by physical therapies such as massage, acupuncture and chiropractic.
While we may ask why pain is necessary, there are documented cases of people dying of organ failure, a burst appendix and massive internal infections, all because they did not feel pain and thus did not seek treatment in time. Though unpleasant, pain is quite useful, most of the time.
There are several competing theories to describe exactly how pain is perceived by the brain, but most agree on the same fundamentals. There are three basic components to the perception of pain: the sensory effect, which involves the electro-chemical perception of pain by the brain; the emotional effect, which is our immediate response to pain; and the sensory-emotional effects of chronic pain. Each of these components relates to a different part of the brain, and this gives some clues into the mechanism of various pain mediation techniques. Hypnosis, meditation and placebo effects, for example, work primarily on the emotional component. That is, those using these therapies will sometimes report that the pain is "still there," but seems less unpleasant or uncomfortable. Manual techniques, such as massage, acupuncture and chiropractic, work on the sensory component, interrupting or mediating the pain signals before they get to the brain.
Traditional (Palmer) Chiropractic theory brings a unique perspective to both the perception and cause of pain. While organ dysfunction or physical injury may be the original cause of pain, nothing in the body happens without involvement of the spine. Any impact to the body sufficient to cause more than a minor injury will involve the skeletal structure in general, and the spine in particular. Likewise, organic disease or failure causes muscular reactions. These muscles, anchored in the bones of the skeleton affect the spine as well. Nerve impulses blocked or impeded at the spinal roots due to subluxation will lead to chronic pain and dysfunction along the nerve pathways.
The Role of Chiropractic in Chronic Pain Management
Though different styles of chiropractic practice may differ on the theory of pain, some tending toward Palmer's theory of subluxation, while others employ modern explanations from neurology and orthopedics, all chiropractors employ spinal adjustments in the treatment of pain. Chiropractic is particularly effective in the treatment of chronic pain that results from nervous system irritation, injury or damage due to its action on the nerve roots. Moreover, chiropractic is effective in reestablishing normal function of muscles, joints and the vascular system, helping to eliminate the root causes of chronic pain.
Doctors of chiropractic are also trained in a number of other therapies that are useful in the treatment of chronic pain. These include trigger point therapy and massage. Chiropractors are also trained in the use of nutritional supplements, and may prescribe a regimen of vitamins, minerals and other supplements to strengthen the overall treatment.
Trigger point therapy, in particular, is often quite helpful in mediating pain. A "trigger point" is a hyper-irritable point in muscles that are associated with tight bands of muscle fibers. Manipulation of the point will, at first, replicate the patient's pattern of pain, but on continued manipulation the pain will be reduced and even resolved. Many chiropractors use trigger point therapy in their practices.
Taken together, chiropractic and related therapies are among the most effective treatments for pain. Chiropractic offers the additional advantage of a low risk profile, with no drug side effects. Chronic pain sufferers, no matter the source, may find chiropractic just the right therapy for long term pain management, and perhaps even the elimination of pain.
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