Chronic pain is a complex, physiological process involving specialized sensory cells, nerves, your brain and spinal cord and a multitude of biochemical substances..
Chronic means the injury/damage/disease of the affected body region has gone through the normal stages of healing, but some degree of pain still remains. This can be due to incomplete healing, permanent physical damage to structures, continual re-injury/ aggravation of the area or even “imprinting” into the spinal cord where the central nervous system literally “memorizes” the pain signals, causing them to be ever-present.
Musculoskeletal conditions arising from trauma or gradual wear and tear dominate chronic pain cases (pain originating from bones, joints, muscles, soft tissues). Diseases affecting the nerves such as shingles, advanced diabetes, trigeminal neuralgia and other peripheral nerve diseases often become chronic in nature as well.
Research suggests that one’s conscious reaction to pain (how you respond to it) influences the severity of pain; that is, the perception of it. Someone who embraces his pain and defers to its presence out of excess fear or worry is less likely to improve than someone who resists giving in and “moves into” the pain by not focusing on it too much as he goes about doing what he desires. This strongly suggests that pain has both physiological (body) and psychological (mind) components to it, and therefore, treatment for it should incorporate methodologies that address both.
Options for Treating Chronic Pain
Treatment for chronic pain includes acetaminophen (Tylenol), non-steroidal anti-inflammatories (aspirin, ibuprofen), anti-depressant drugs used “off label” for pain (amitriptyline, Cymbalta), anti-convulsant drugs used off-label for pain (Lyrica), corticosteroids (Prednisone) and opiate drugs (morphine, codeine). They work in different ways to decrease pain; some not fully understood. And, they all come with side effects, which differ from person to person.
TENS units and spinal cord stimulators are instruments used to block or interfere with pain signals as they travel through the central nervous system.
So between strong drugs with unpleasant and often dangerous side effects and devices designed to block pain, the medical options for treatment are disappointing. These interventions are not intended to cure the problem at its source, but rather interfere with its manifestation via chemical and electrical means.
However, two instruments I have come across are in a “gray area” in that the mechanism of action involves stimulating actual, natural healing of injured cells. The first one is red light therapy, which works on human cells very much like how sunlight causes photosynthesis and energy production in plant cells. I recommend red light therapy for joint pain from osteoarthritis and sprains/strains. You can also use it to heal minor cuts and lacerations faster.
The second one is Pulsed Electromagnetic Field Therapy, or PEMF. PEMF uses low frequency, low power magnetic fields in the range of frequencies that is naturally produced by the human body, to normalize cells whose membrane charge, or voltage, has been disrupted by disease processes and strong environmental electromagnetic fields such as those from power cables and electronics. When the cell membran charge is normalized, the cell’s metabolism and respiration is boosted which results in faster healing of disease; especially inflammatory disorders. Pulsed EMF can be used to treat many types of chronic disorders including chronic pain, fibromyalgia, pulmonary disease, heart disease and headaches. Watch the video below where I explain how PEMF works:
If you suffer from chronic pain, I suggest you direct your attention to creating conditions in your body that optimize health. This may not “cure” chronic pain entirely due to its complex nature, but a healthy body is in a much better position to heal and regenerate than one that is not.
Know that:
Your body is a community of interconnected, living cells that affect one another. For example, an intestinal cell and a muscle cell have a functional relationship. This cellular relationship can be influenced via lifestyle changes, primarily through your diet, activities and thoughts/attitudes to reduce pain.
Cells are the basic unit of the human body, and like the human body your cells consume food, breathe oxygen, perform work, burn energy stored in food and produce waste.
What enters your body via your mouth, lungs and skin gets into all of your cells (with the exception of those substances that cannot cross the blood-brain barrier).
Areas of chronic pain are where cells are in a state of distress. They may be producing inflammation, abnormally firing nerves, and/or not getting rid of their waste products properly.
You can greatly influence the functional state of all your cells by what you think, what you eat and drink, and what you do with your body.
When it comes to pain it is better to think in wholistic terms — the whole body, not just where it hurts. This is how your body is designed; how your body functions; and how it heals itself. Your starting point is your mindset and attitude. Use it the create health in your body by all means available to you; and there are many. Use Pulsed EMF for maintenance to enhance energy in your cells and enable efficient cell function and healing. This is your best bet for overcoming chronic pain.
No, it’s not quit smoking, exercising more, or eating a healthy diet I’m talking about; although these things can add years to your life.
You know what it is? Answer: stop sitting too much!
We are living in a society that encourages sitting, thanks to computers. Many jobs require it. Using the computer at home to surf the web, check bank accounts, shop, etc. require it. School requires it. Going to restaurants and coffee shops require sitting. Evidence is showing that prolonged sitting promotes disease, malady and death in epidemic proportions.
The latest study examining the relationship to prolonged sitting and morbidity tracked over 50,000 men and 69,000 women over the course of 13 years. Study participants indicated if they sat less than 3 hours per day total or over six hours per day, total. The results showed that women who sat the most were 37% likely to die, and for men who sat the most, they were 18% more likely to die than the rest of the study participants. The association remained virtually unchanged after adjusting for physical activity level; meaning, a woman who sat for more than six hours a day who exercised regularly still had the same chance of dying than a woman who sat for more than six hours per day and did not exercise regularly.
Numerous other studies done in the past show that prolonged time spent sitting, independent of physical activity, affects metabolism and may influence things like triglycerides, high density lipoprotein (HDL cholesterol, the good cholesterol) fasting plasma glucose, resting blood pressure, and leptin, which are biomarkers of obesity and cardiovascular and other chronic diseases.
It is clear by now that prolonged sitting, which can be defined as over four hours per day, is a threat to your health. There needs to be more public health announcements on this. Imagine the billions of dollars in health care costs that we as a country can realize if everyone knew not to sit too long, as well as all the lives that can be saved.
If you are in a job that requires prolonged sitting, I suggest that you print out the study (link below) and show it to your supervisor. Tell him or her that you take this seriously, and you must be allowed to stand up and walk at least once an hour, for 15 minutes. Or, stand up and walk every 15 minutes of sitting, for about five minutes.
Delayed Onset Muscle Soreness, or DOMS is a condition where your muscles feel pain a day or two after hard or unfamiliar exercise. DOMS is thought to more likely be worse with exercises that emphasize eccentric muscle contraction, where the muscle lengthens as it contracts. Examples of eccentric contraction include negative weight lifting (like lowering a curling bar slowly, squatting, and lunges). It is believed to be the result of microscopic tears of muscle and fascia fibers and consequential inflammation. Pain from micro injury is generated by inflammatory biochemicals interacting with nociceptors (nerves that transmit pain signals). In DOMS, the injuries are so small that it takes 12-24 hours before the inflammatory response is enough to generate pain and stiffness.
The muscle pain from DOMS is different in nature than a typical muscle sprain/strain injury. It generally is more widespread, depending on the muscle groups that were worked out the most. Contracting the affected muscles will increase symptoms. For affected muscles that cross a joint such as the knee and shoulder, stiffness reduces joint range of motion.
DOMS, while it can be quite uncomfortable, usually self-resolves in about 7-10 days, with rest and a break from physical exertion. But for some people, that is too long.
So, what can one do to prevent and treat delayed onset muscle syndrome?
(1) Take it easy, tiger. If you do not exercise frequently and decide one day to make up for all the months you slacked off by going “all out” you are setting yourself up for pain, stiffness, and movement limitations. If you haven’t been exercising for months, your muscles won’t be acclimated to taking loads and repetitions and will likely incur microtears in the fascia, tendons, and muscle fibers. So, use the 10% rule, which basically is a scaling up of exercise over a week or two depending on how often you go, to re-acclimate your muscles to your normal, maxed workout. Let’s say you usually curl 40 pound dumbbells. Start day one with 5 pounds, day two with 10 pounds, day three with 15 pounds, until you get up to your max.
(2) Seek out a professional. A personal trainer can show you the right exercises to do for your goals, and the proper technique to get the most out of it, without injuring yourself.
(3) Warm up. Do about 15 minutes of cardio before you do strength or functional training like Boot Camp and similar, full body exercises. Jumping jacks, jump rope, treadmill with incline are good choices.
(4) Do some light stretching. Although recent studies showed that stretching before exercising did not significantly reduce injuries, stretching feels good and can put you in tune with your body.
(5) Hydrate 30 minutes before your workout, competition, or task that will involve heavy lifting (like helping a friend move out of his house). Most sports drinks are formulated to provide the major electrolytes (sodium, potassium, calcium) that muscle use to contract.
(6) Know your limitations. As you age, you lose muscle mass; and therefore strength. Adapt your workout routine accordingly: lighter weights, exercises that are easier on the joints; more rests in between sets.
Now, if you still get DOMS, congratulations, you weren’t cheating; way to go for it! But seriously… here are things you can do to minimize it:
(1) Get a Swedish style or lymphatic drainage massage (NOT a deep tissue or acupressure massage) from an experienced, skilled massage therapist. The long, light pressure strokes towards the heart will increase lymph circulation and help your body clear out the inflammatory products. If you can find a place in your town that does endermologie (cellulite treatment), that is even better. Endermologie is a type of negative pressure massage done with a special machine that can increase skin circulation by over 300%, for up to six hours.
(2) Rest, ice, compress, elevate (RICE). If your whole body is affected, try a cold water bath for 20 minutes. Epsom salts added to the water, and eucalyptus can be helpful.
(3) Do some light exercise– walking, stretching, yoga.
(4) Take fish oil supplements. This may reduce the inflammation somewhat.
(5) Get some protein in you: whey protein drinks, eggs, fish. This gives the body the amino acids it needs to rebuild torn muscle.
(6) Rest. Try to get at least an hour more sleep per day while you are recovering.
And of course, no smoking or over indulging in alcohol during DOMs. When you are ready to start up exercising again, work up to max gradually over a week.
If you use your hands in a repetitive fashion at work or at play and notice your hands and wrists are feeling achey and fatigued, it’s partly because the muscles in your hand are out of balance. Usage of the hands is predominantly a flexion action, where the flexor muscles of the arm contract to bend the fingers inward. This is true for gripping and typing.
So what happens is that the extensor muscles of the arm, which are the ones that straighten out the fingers and bend the wrist upwards, are “overwhelmed” by the action of their reciprocal muscles, the flexors (flexor digitorum, flexor carpi ulnaris and radialis). The action of the joints in a flexor-dominated repetitive activity puts excessive wear to the same, small area on the joint surfaces and can gradually lead to stiffness and pain in the hands. And, it de-conditions the extensor muscles over time; meaning, makes them weak and less responsive. That explains the fatigue factor.
The solution is to do exercises for the extensor muscles to counteract the amount of flexion you do. A simple yet effective exercise is to use a thick rubber band (like the ones that hold together broccoli in the grocery store) and place it around your fingertips and thumb. Open your hand (extend your fingers till they are straight at the knuckles), about one repetition per second. Do about 50 every hour, four hours per day; depending on how much you use your hands. What you’re trying to do is work the extensors as much as your flexors to ensure both groups are getting an equal amount of work out. This will keep the hands strong and resistant to weakness and pain from frequent use.
Osteoarthritis occurs when the cartilage lining the articulating (contacting) surfaces of a joint gets damaged or wears out, exposing nerve endings inside and leading to inflammation. Since a joint is a precision, biological mechanism the slightest change in any of its components will eventually lead to breakdown, much like car engine.
As the cartilage thins, bone on bone contact occurs. Since bone is living tissue, it will respond to this irritation by forming osteophytes, better known as bone spurs. The osteophytes compound the problem by disrupting proper joint movement and irritating surrounding ligaments. And to make matters worse, the joint fluid, called synovial fluid gradually loses its ability to cushion the joint. Synovial fluid to a joint is like motor oil to a car engine’s cylinder: it enables “near frictionless” movement. It forms a thin, lubricating buffer between the ends of the two bones that make up a joint; for example in the knee, the tibia (lower leg) and femur (upper leg).
The knee is perhaps the most common joint to experience osteoarthritis. It is a large, primary weight bearing joint that takes a lot of punishment in the course of a day. Basic activities like walking, running, going up stairs, stepping down from a curb, exercising, and sports really put the knees to task. Those who have advanced osteoarthritis in the knees realize how important they are to a normal life.
I ran across this treatment for knee osteoarthritis that involves a single injection that can last for six months. It is called Synvisc-One, and it’s made from the combs of roosters. Apparently, the substance found in rooster combs is similar in biochemical make up to that of synovial fluid. If you’ve ever pressed or bent a rooster’s comb, you can see why– it is soft, cushiony, and rebounds quickly to its original shape.
The procedure is a relatively quick outpatient procedure. After filling out the necessary forms to ensure you have no contraindications, especially any known allergies to birds, the doctor injects the Synvisc into your knee joint using a large caliber needle. There, it occupies the capsular space just like motor oil occupies a car engine’s cylinder. The substance cushions the knee joint surfaces (distal femur-proximal tibia articulation) and lubricates the space to minimize abrasion of these surfaces.
Synvisc is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and simple analgesics, e.g., acetaminophen. It can be an option for total knee replacement for some people.
The drawback is that you have to keep getting them. But for those who have severe osteoarthritis in both knees and can’t afford or do not desire knee replacement surgery, six months of less pain is a pretty big deal. As with all forms of treatment options, a lot of it is personal choice. Not everyone’s situation is the same.
Check out our Self Treatment for Knee Pain video for non-drug, non-surgical therapies to manage osteoarthritis of the knee.
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