Treating Chronic Pain

WHY DO WE GET BACK PAIN?

80% of our body is musculoskeletal and prone to strain or injury.  Those of us who do physical jobs or a lot of exercise are prone to overuse injuries and accidents. While those who do a lot of desk work or driving have a higher tendency to postural muscle fatigue.  Then also, there are health factors like nutritional imbalances and illness.  Can you remember the last time you had the flu and your muscles were sore?  At that time you were probably a bit dehydrated and low on minerals such as magnesium.

WHEN YOU’RE “BACK is out of WHACK?

Well this depends on your activity.  For those with a physical job or aggressive exercisers it usually occurs in the low back.  If your job involves a lot of sitting then you will typically suffer neck and shoulder pain.  Trauma also has a strong affect.  Did you ever stub your toe and then seem to keep on hitting your toe again over the next few weeks?  This seems to occur due to the fact that the area of injury causes our body to be out of proper alignment to prevent further pain and injury.  Then there is also the fact that the nervous system is somewhat impaired causing local weakness and incoordination.

HOW DOES PAIN OCCUR?

Generally, physical activities lead to overuse or trauma while sedentary activity causes decreased circulation and stiffness.  Either way, the end result is pretty much the same causing our muscles to get tight and/or bones to get out of alignment. This causes restriction of blood flow by muscle spasm or bony impingement of a nerve resulting in pain.  Again, other factors like lactic acid buildup, dehydration, or nutritional imbalances have an additive effect to the amount of pain.  In addition, the more factors involved leads to more delay in healing.

HOW CAN I GET MY “BACK IN SHAPE?”

The first thing to remember is that pain, like a fire, is best put out with W-A-T-E-R!  Yes, water, a natural anti-inflammatory, is the best therapy to start out with. Also, anything else you take by mouth is going to need water to distribute your food, supplements, and medication to the injury site!  Next, I would think of a supplement with magnesium which is a natural muscle relaxant that is often found to be deficient in individuals.  After this I would look at either natural anti-inflammatory nutraceutical with  boswellia and/or turmeric for mild to moderate pain.  For more severe pain I recommend either a CBD or compounded medication pain cream.

WHAT ABOUT ADJUSTMENTS &/OR ACUPUNCTURE?

The primary focus of physical medicine is to enhance blood and nerve circulation to compromised areas of the body.  Simply stated, properly applied physical medicine allows nutrients and medication (if necessary) to get to “the job site.”  Acupuncture, in a similar way, opens up blood supply and additionally causes the body to release endorphins both locally and systemically.  I find soft tissue myofascial therapy is most effective to relax muscles, reduce pain, and increase circulation.

DOES A DOCTOR OF OSTEOPATHY (D.O.) APPROACH BACK PAIN DIFFERENTLY THAN A M.D. OR DOCTOR OF CHIROPRACTIC (D.C.)?

Doctors of Osteopathy (D.O.) have the same medical license as a M.D. but consider the use of musculoskeletal therapy before the use of medication to allow the body to participate in the healing process.  While Chiropractic Doctors tend to focus on   musculoskeletal problems, D.O.’s look at how musculoskeletal problems affect one’s overall health through compromised circulation.  Also, D.O.s have found that chronic musculoskeletal imbalances are best treated by focusing on the tight muscles that cause the joint to be out of alignment. This allows for a less painful and more permanent treatment healing experience for the patient.

WHAT IS REGENERATIVE THERAPY AND WHEN IS IT INDICATED?

Regenerative Therapy is a form of Prolotherapy that causes moderate to severe inflammation for 12 to 24 hours triggering the release of growth factors that initiate a healing response at the perceived site of injury.  This therapy is especially useful for chronic injuries that have had their healing response blocked by steroidal and nonsteroidal anti-inflammatory medication.  These injections are focused to painful joints and surrounding ligamentous trigger points such as the knee, hip, shoulder, or sacroiliac joint.

Although non-steroidal anti-inflammatory agents cannot be used, pain medication such as Hydrocodone is suggested during the initial healing process.  The usual approach is doing a trial of 4 injections every 2 to 4 weeks along with soft tissue myofascial therapy.  I have found this combination of Regenerative therapy with myofascial therapy to be about 70% effective.