San Diego Chiropractic Blog

Chronic pain is defined as pain that persists longer than 90 days beyond the course of the natural expected healing time. As a chiropractor in San Diego, I get calls from both new and established patients on a regular basis who complain of back pain, neck pain, etc. One of the factors that comes into play when planning a chiropractic treatment program is the duration of the patients pain. In general, the longer that a patient suffers with a painful condition, the longer / more intense the treatment is needed in order to fix it. Acute or recent episodes of pain respond much quicker than do chronic conditions.

Pain is very difficult to quantify by any practitioner. Pain is subjective in nature and completely defined by the person experiencing the symptoms, the fact that chronic pain can exist without an obvious cause makes it much more difficult to treat.

I see the difficulties that my chronic pain patients have with their conditions on a daily basis. Aside from the actual pain that they experience, those who suffer with chronic pain often limit their activities for fear of exacerbating their conditions. They also have a much harder time focussing on mental tasks as the pain is a constant source of distraction. The more severe the pain, the more difficulties these people have with attention demanding tasks.

While we strive to avoid pain, pain is a wonderful tool of the nervous system. Pain lets us know of actual or potential tissue damage with an unpleasant sensation that directs our attention to the affected area so that we can either immediately take action to stop the process or focus on healing the injured body parts. Chronic pain sensations are a bit more insideous.

Chronic pain often involves a decrease in the sensativity of the nerve fibers that send messages of pain from the damaged area. With a decreased sensativity (threshold), the nerve is much more likely to transmit painful sensations to the brain then a healthy nerve / tissue combination. This activity within the nervous system is know as a wind up phenomenon and it is very difficult to stop once it has been established. In some other cases, nerve fibers that normally don’t carry painful sensations not only begin to transmit pain signals but it is thought that they may actually generate the signals themselves.

In my office, chronic pain is often the result of untreated sprain / strain type injuries of the joints. In untreated or under-treated sprain / strain injuries, the joint or the muscles that move the joint are laden with scar tisuue that acts to either limit or alter motion of that joint. With time, the awkward, unnatural biomechanics of the scar tissue laden joint results in irritation, inflammation and finally pain and spasm. While chiropractic care is often successful at re-establishing “clean” biomechanics of a joint, it is always better to get the care in the beginning of an injury versus waiting for that injury to become chronic, with a requiring more care with a decreasing chance of complete recovery.

Because of the possibility of an acute painful condition becoming a chronic one, I always encourage my patients to take care of themselves immediately when they first start to experience pain. I have practiced chiropractic care for almost two decades now and I can say that chronic painful conditions of the spine are devastating. Not only do they make you expereince pain, but in most instances they limit your physical activities creating a situation that can easily degrade from inactivity secondary to pain, to deconditioning and eventually to obesity and ill health in general leading to a dissatisying lifestyle.

The bottom line on chronic pain is this - avoid it if you can. Don’t ignore your pain. Painful acute conditions that are left untreated can easily spiral into a chronic condition that has the potential to alter your lifestyle in a negative way.

Your’s In Good Health

Dr. Jones San Diego Chiropractor

www.JonesPainRelief.com

When was the last time that you felt pain?

I treat people with back pain, neck pain and various other pains on a daily basis.

Pain is a very complex sensation. The body’s interpretation of pain involves both nerve and chemical processes that are relayed to the brain for interpretation. In my San Diego Chiropractic office, I hear my patients complain of neck pain, back pain, headaches, sciatic pain etc. Some of these patients suffer from acute pain while others who are less fortunate complain of chronic long lasting pain.

A study completed recently in Chicago revealed some very interesting things about brain activity in people suffering with chronic pain.

Brain scans taken of people in chronic pain show a constant activity in areas of the brain that are at rest in those who don’t suffer with chronic pain. Researchers said that this finding could help explain why chronic pain patients have higher rates of depression, anxiety and other disorders.

Apparently they found that chronic pain seems to alter the way people process information that is unrelated to pain. They found that enduring long periods of pain affects brain function even with tasks that demand minimal attention.

Studies have shown that in healthy people, certain regions of the brain take over during a resting state, something known as a default mode network. “It takes care of your brain when your brain is at rest,” Dr. Chialvo said.

When a person performs a task, this default mode network quiets down, but not in people with chronic pain.
Instead of quieting down, a front region of the cortex of the brain associated with emotion is constantly active. This constant activity disrupts the brains’ normal equilibrium.
To study this specific brain activity, Dr. Chialvo did a type of brain scan on 15 people with chronic back pain and on 15 healthy people.

In this study, volunteers were given a simple attention task — tracking a moving bar on a computer screen - in order to observe the brain shifting out of default mode to handle the task.

Both groups performed the task well but when they measured areas of the brain that were activated, the differences emerged.
“Where we were surprised is the difference in how much brain they used to do the task compared with the healthy group. It was 50 times larger,” Chialvo said.

They said disruptions in this brain activity could explain why pain patients have problems with attention, sleep disturbances and even depression.

So there you have it. If you feel a little off or if someone you work with or care about has trouble focusing or staying on task because of pain, your observations are correct. Give yourself and others a break.

Here’s To Your Health

Dr. Jones

www.JonesPainRelief.com