Jul 21 2013
Inflammation & Pain: Good or Bad?
Okay, so let’s take a look at inflammation. Many people think that inflammation is a bad thing. Well sometimes it is and sometimes not.
Remember the acute inflammatory process is what helps heal the tissue. Hypothetically, if it were possible to remove all the inflammatory chemicals after an injury, the damaged tissue would NOT heal. The key is to control inflammation versus stopping it.
Ice vs. Heat
So if the injury is severe and there are obvious signs of inflammation; (pain, heat, redness, swelling and loss of function), then ice works well as it causes the blood vessels to vasoconstrict thus slowing down the flow of inflammatory chemicals into the injured soft tissue.
If the injury is mild and there are minimal or no signs of inflammation then heat works well. Think about what works best after a hard day’s work. A nice hot tub is effective as your muscles are tight and even though there is some minor inflammation occurring it is best to keep the blood vessels open and encourage the fluids to flow on through! NOTE: Always consult with me first in terms of using ice or heat, if you are uncertain.
This is a bit different. Chronic inflammation may occur in soft tissue from old nagging injuries that never heeled properly or from serious disease processes of visceral organs. This can be serious stuff!
Now For Pain!
Pain should be seen is neither good or bad, rather as an indicator that something is happening. The severity of pain does not always correlate with the severity of the injury. Here are some examples: Calf cramps, paper cuts, hitting your shin on the coffee table, these all hurt like crazy but are no big deal. Certainly you are not headed to the ER.
Try this. Pinch the skin on your forearm. Go ahead. That really hurts, but the lesson is a high degree of pain is not always a big problem.
And try this. Bend your finger back until it’s painful. (I know crazy, silly stuff). A biopsy of the tissue won’t reveal a tumor, infection or any lesion. But releasing the finger and letting it return to its “position of comfort” will allow the pain to subside. We need to think about low back and neck pain in a similar way -functionally. 97% of back pain seen by primary care physicians is mechanical in origin -there’s something wrong with the muscles, ligaments or connective tissues. Physician & Sports Medicine, 1997.
The Potential Bad News. On the flip side many deadly diseases, cancer and diabetes, are life threatening but can cause virtually no pain in the early stages.
Chiropractic Edge! So many people are fearful of chiropractic because it may hurt or it looks like it hurts.
The reality is that for most patients it is a painless event. More importantly it can give you great relief! It is possible that you may be sore for a few days after the initial adjustment or two, but that is just old trapped inflammatory chemicals releasing and new chemicals flowing in. This can last 1-3 days and is a NORMAL part of the healing process.
If you have more questions about inflammation or chiropractic just ask: Dr. Lance Casazza.
Oct 15 2013
Pain Theory vs Functional Theory?
Pain theory is the idea that the only goal is to decrease or stop pain. Functional theory is the idea that we want the body region, soft tissue and joint to return to a maximum level of functionality.
A new patient wants or at least thinks they want just pain relief when they first come into a chiropractic office. There can be a huge disconnect between the chiropractor (who wants to restore function) and the patient (who wants pain relief) and why many patients are skeptical about chiropractic when they first come in. It is paramount that the patient understands the difference between the two ideals. And then if they still want just pain relief well then…
The quickest way to stop pain is to immobilize and ice the injured area. The good news is this will ease your pain. Just because you have no pain does NOT mean the joint is functioning properly!
The bad news is that with lack of motion and ice there are many negative physiological effects:
muscles atrophy and become weaker, muscles tighten reducing blood flow and function, soft tissue adhesions develop rapidly, proprioception of the joint is diminished and fluid flow (needed to bring nutrients into the injury site and remove toxic build-up) is slowed.
In other words besides decreasing pain everything to make the injury heal is being done backwards!
A Study Please:
Professor Lan Zhou and colleagues at the Neuroinflammation Research Centre at the Cleveland Clinic in Ohio discovered inflamed cells produce a high level of a hormone called insulin-like growth factor-1 (IGF-1) which significantly increases the rate of muscle regeneration. This suggests muscle inflammation after acute injury is essential to repair. Icing slows down the healing as it prevents the release of this hormone. This changes the idea that swelling must be controlled in order to encourage healing and prevent pain.
Additionally this could change how much patient monitoring is required when potent anti-inflammatory drugs are prescribed over a long period. It’s been known for a long time that excess anti-inflammatory medication, such as cortisone, slows wound healing. Federation of American Societies for Experimental Biology, Oct 2010.
Functional Theory: The idea here is let’s do everything we can to allow the injury to heal the best it can.
The goal is fast healing and maximal function. This is achieved by mobilization and heating of the injured site.
(Note: never determine this on your own, always check with your chiropractor as torn tissue or broken bones will both not respond well to this theory.)
The physiological effects of functional theory as compared to pain theory: muscles stay stronger and looser, adhesion formation is less, proprioception is maintained, and fluid flow is far better.
Chiropractic Adjustment: Functional theory is exactly what the adjustment is all about. Putting a joint into motion allows for optimal physiological function. A body/joint that moves well will always be healthier than one that does not.
If you have more questions about pain theory vs functional theory or chiropractic just ask: Dr. Lance Casazza.
By Dr. Lance Casazza • Chiropractic Treatments, Pain Management • Tags: chiropractic, Cleveland Clinic, Health, Medicine, Ohio, Pain, Pain Management, Spinal adjustment