Chronic Pain

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As a chiropractor with a post graduate degree in neurology I couldn’t wait to read the March 7, 2011 Time magazine. On the cover was a large headline, “Understanding pain.” I had suspected that the three in-depth articles they wrote on the topic would not mention the word chiropractic and I was dying to know if I would be right. They did a great job discussing massage, yoga, acupuncture, herbal supplements, and bio-field therapies, but of course nothing about chiropractic.

O.K. I was hurt, but I wasn’t mad, however, the quote from Dr. Michel Dubois of New York University’s Langone Medical Center who said, “We don’t know much more about pain than we did 200 years ago” did horrify me just a little. Seriously, this begs the question, has this guy read a book about chronic pain that was written after 1811?

The textbook, “Principles of Neural Science”, by Kandel, Schwartz, and Jessell is used in practically every medical school in the world and is the gold standard on all things neurological. Chapter 24 in the fourth edition is titled, “The perception of pain.” It’s really quite complicated, but certainly a doctor should be able to understand it. Let me give you some real basic simple easy to understand concepts about pain. Once we understand pain then we can have a little more hope regarding chronic pain.

There are basically three basic types of nerve fibers in the human body. They are labeled A, B, and C fibers. Tough stuff so far, huh? C fibers are for the transmission of pain. Picture you wanting to go from your house in the boondocks to your nearest big city downtown area. You could take the back roads, which would be the equivalent of traveling along a C pain fiber in the sense that you would not be able to drive very fast on such a small road. Yes it is quite hard to believe that when you get stuck with a pin that pain signal is traveling on the slowest road in the body.

Another way to get downtown would be to take the bigger surface streets, which is equivalent of a B nerve fiber; they are bigger than C fibers. And if you’re lucky enough to live by a freeway you could take that and if there was no traffic, you would arrive at your desired destination much quicker than if you used the other two routes.

All pain in our body has to get to downtown, which in this case is the Thalamus portion of our brain. If for any reason the pain signal in the C pain fiber doesn’t arrive at the thalamus you are feeling good. An example of this would be say you chose to go to Dustin Hoffman’s Nazi dentist from the movie Marathon Man. Lawrence Olivier, the Nazi dentist, is drilling holes into poor Dustin’s nerves under his teeth and he is not feeling all that well. If the dentist would have been so kind as to use Novocain, Dustin would have been having a better day. Of course the tissue damage would still be occurring, but he just wouldn’t notice it for a while.

The point here is besides picking your dentist wisely, is that the body has all kinds of mechanisms to block pain.

We’ve all heard of Ben Gay and other analgesic ointments. They work because they irritate the B fibers in our skin. Since a B fiber is bigger than a C fiber it gets to downtown (our thalamus) quicker and it takes the pain’s parking spot. Well, for a little while anyway. When the meter expires, the analgesic effect drives off and the big bad pain signal pulls in and triggers the thalamus where it is then sent to different areas of the brain. These other areas lets you know where the pain is, what kind of pain it is, it triggers memories, and goes to your emotional center, which is going to determine just how emotional you’re going to get over this.

When chiropractors adjust your spine, they are firing off the A fibers, those wonderful giant freeways of nerves that gets to your thalamus (pain relay center) even quicker than the previous mentioned B fibers, hence one reason why chiropractic is so much more effective at pain control than scraping a coin up and down your skin for a while. (Analgesic ointment) A variation on this theme and brilliantly applied by the medical team of Drs. Moe, Larry, and Curly, is the strategically placed poke in the eye to make you forget about the anvil that fell on your foot.

Additionally, pain signals have to enter the spinal cord in order to get to the thalamus. Adjusting spinal segments modulates pain signal production at this level. Furthermore, stimulating these large A fibers found surrounding spinal joints also alters the neurochemistry of pain. I will discuss neurochemistry and nutritional therapies for pain management at another time.

As usual, Time magazine has done a great disservice to its readers. I’m totally dismayed at why they would use a doctor who hasn’t read a book on the subject of chronic pain since 1811 to educate the public on such an important issue. But seriously, it was a long piece and the result of much collaboration that included many doctors. That the editors chose to ignore one of the most powerful and well understood natural methods for pain control is troublesome at best. I’m going to go off the deep end and speculate that they may have a conflict of interest with their sponsors, the drug companies, whose advertisements are interspersed throughout the magazine.

In vitro Fertilization costs about twenty thousand dollars a session. It is only 10% effective. A patient can typically require four to five sessions, which can exceed $100,000 in costs. A major reason for this expense is because women are more stressed than ever, which is a leading cause of infertility. They are starting a family later, typically at 37 years of age and higher. They are experiencing a lot of pressure from work and family members.

While it is hard to believe, it’s so important that I’ll state it again. A major reason for infertility is stress. Chiropractic addresses the negative effects of stress directly by working with the central nervous system. The part of our nervous system most commonly associated with stress is the sympathetic nervous system. The adjustment of spinal joints has direct effects to the central nervous system and the sympathetic nervous system. Additionally, the adrenal glands also known as the stress glands are the only glands in the body that have a direct neurological connection via the spinal cord.

After obvious medical conditions have been addressed, the first overall step with regard to infertility is to evaluate and adjust the sacrum and atlas to reduce sympathetic overload (the actual result of stress). The pubic symphysis is often overlooked in most patients, but it is especially important regarding fertility. Pubic symphysis subluxations can torque the fallopian tubes. There are specialized maneuvers for adjusting the pubic bone region and are non-painful.

Another key to improving the probability of success is to remove heavy metal toxicity. While we may think of pregnancy as being a hormonal thing, the nervous system regulates the endocrine system, and heavy metal toxicity can interfere with nerve signals. Removing heavy metals can often be accomplished without having to use intravenous chelation therapy methods. Chlorella and other specialized nutritional supplements have been shown to be beneficial. A related issue is drug toxicity. Many people do not realize that medications can cause infertility. For example, inhalers can cause sterility and Crohn’s disease. ( a kick to your front and back side)

We all know that the natural birth process has been turned into a pathological disease process. It is important to understand that getting pregnant shouldn’t require hundreds of thousands of dollars of hi-tech medical interventions. Often the body can resume its normal healthy physiology without hi-tech methods. Many women who were considered medically not able to conceive have gotten pregnant with the help of chiropractic methods.

The first time I became aware of this concept was 28 years ago. I had recently graduated. One day I walked into a restaurant and I noticed a table full of women and one of them was pointing at me, quite emphatically. I went over to her table and realized she was a patient who came in once for a headache. She was almost yelling, “This is the man who got me pregnant” After vehemently stating that I never touched her, she explained that she was told that she could never get pregnant and after that first treatment she did and that she always attributed to me. At the time I was more inquisitive to know if her headaches went away, which they did. I reviewed her records and of course she didn’t note infertility on the intake questionnaire. But I’ve found most patients don’t give a complete history because they don’t see how their conditions could be associated with their central nervous system. (Spine) Apparently, at the time I didn’t even think it was possible; I was too relieved knowing that I wasn’t being named in a paternity suit. After discussing this with many colleagues, I realized that this might have been more than a coincidence. As of now, the literature is inundated with anecdotal evidence. While this is not considered a scientific double blind study, considering the costs of in vitro fertilization and weighting them against the possible amazing benefit of chiropractic, you might want to consider putting off waiting for the day that an institution decides to study this phenomenon in more depth. The worst thing that can happen is what usually happens with chiropractic patients; things you didn’t bother to mention get better.

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