Pain Theory vs Functional Theory?

Technique and Practice of Chiropractic

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…

Pain Theory:

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.

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