Unfortunately, we are rarely the first doctor people see for their aches and pains. That means most patients that walk in the door have already consulted a professional about their problem. That means they’ve already heard at least one opinion on why they’re having the problem. Here are some of the most common things we hear:
1)X-ray findings like Arthritis, Degerative disc or joint disease, a straightened curve, or a spinal misalignment.
2)MRI findings like a bulging disc, a tendon or cartilage tear, or stenosis.
3)Arbitrary muscle problems like muscle imbalances, inactivity or failure to fire, or being too short or tight.
4)Anatomical asymmetries noted by observation like a short leg, scoliosis, or a high shoulder.
Did you notice anything about these explanations? They all are related to ANATOMY. Something every Medical doctor, chiropractor, physical therapist, and trainer has studied for hours on end in their life.
However, pain is not an anatomical process. It’s a process of physiology.
Pain is nothing more than a signal to our brain that a receptor in a tissue somewhere in the body perceives a threat. If you want to know what can cause these signals, revisit our earlier blog post on the five ways to irritate a nerve. *Spoiler alert* none of these signals get sent by way of anatomical signs of aging, asymmetries, or imperfections.
Why is this important? Mainly because people trust professional opinions, and tend to get attached to them. If someone thinks their pain is due to their arthritis, or a doctor says they “have the wort back/knees/shoulder they’ve ever seen on an X-ray or MRI, the patient immediately associates their pain with those findings. Or if a personal trainer tells them their back hurts because “their glutes aren’t firing” they endlessly train a muscle that is probably functioning just fine. Unfortunately, most of these things either can’t be changed or are unlikely to be changed without several months of focused training, when pain can be often be alleviated in 2-4 weeks.
What about diagnoses made by MRI or X-ray? Well, they are riddled with false positives - meaning there is a finding on the picture that is not actually the cause of your pain. Several findings on Xrays or MRIs are more indicative of your age than your pain - Findings like arthritis, degenerative joint disease, rotator cuff and meniscal tears. All of these findings increase in likelihood as we age, and are commonly present in people with no pain in the joint in question.
So how do we explain - and ultimately treat - pain? Well, the kind of pain we are successful in alleviating is mechanical in nature. That means it is coming from forces of compression or tension on joints or soft tissues. We treat these problems of compression through Mechanical Diagnosis and therapy and Chiropractic manipulation, and issues with tension through functional rehab and/or soft tissue work.
And we explain how these forces are created through gravity, posture, and loading of the joints and soft tissues through sustained postures and repeated movements. We then emphasize the things patients can do THEMSELVES, AT HOME, to decrease these forces to allow healing to take place. This leads to full understanding of pain, and that is the only way to truly manage it for a lifetime.