Sources of Chronic Pain

Chronic pain can arise from many sources.  Common sources include injuries that do not completely heal, long-term disease processes and injuries to the nervous system.  There are many potential sources of chronic pain, but they all have in common a state of injury or disease that has failed to completely resolve.  There are also categories of psychogenic chronic pain, such as phantom leg syndrome, that work through a different mechanism than classic chronic pain but are troublesome and even debilitating for many people.

Pain Management

Pain is a useful crisis messaging system for the body.  It is a message that something is wrong, at a volume that cannot be easily ignored.  It exists to protect the body, encouraging protective action to prevent further injury.  The network that carries these messages is the nervous system, from the peripheral nerves to the spine, and then to the brain. While pain is a useful tool to keep us healthy and to minimize injuries, it can also get out of control and continue long after its purpose has been served.  Chiropractic treatment is useful in reducing or eliminating many kinds of pain, and may be most effective with chronic pain.  Before we examine how chiropractors treat pain, it is necessary to delve a bit deeper into the subject of pain.

Chronic vs. Acute Pain

Acute pain occurs suddenly, in response to an injury or unhealthy change in physical function. Pain from running into a doorway, for example, is acute pain.  Chronic pain is pain that may have started suddenly, but persists long after.  Many accidents and disease processes, for example, result in pain that lingers long after the event that triggered it.  Chronic pain is a complex entity, as the longer we feel a particular pain, the more our bodies and brains change to accommodate it.  It’s as if chronic pain creates grooves in brain function that complicate attempts to reduce or stop it.  Chronic pain, in some cases, can become a habit, one that’s very difficult to break.

Pain Perception

Pain is a somewhat mysterious experience, not well understood by science.  Pain can be intense and overwhelming, and yet it can also be modified by opiates, hypnosis, sugar pills (placebo effect) and meditation.  It can also be modified by physical therapies such as massage, acupuncture and chiropractic.

While we may ask why pain is necessary, there are documented cases of people dying of organ failure, a burst appendix and massive internal infections, all because they did not feel pain and thus did not seek treatment in time. Though unpleasant, pain is quite useful, most of the time.

There are several competing theories to describe exactly how pain is perceived by the brain, but most agree on the same fundamentals.  There are three basic components to the perception of pain: the sensory effect, which involves the electro-chemical perception of pain by the brain; the emotional effect, which is our immediate response to pain; and the sensory-emotional effects of chronic pain.  Each of these components relates to a different part of the brain, and this gives some clues into the mechanism of various pain mediation techniques.  Hypnosis, meditation and placebo effects, for example, work primarily on the emotional component.  That is, those using these therapies will sometimes report that the pain is “still there,” but seems less unpleasant or uncomfortable.  Manual techniques, such as massage, acupuncture and chiropractic, work on the sensory component, interrupting or mediating the pain signals before they get to the brain.

Chiropractic is particularly effective in the treatment of chronic pain that results from nervous system irritation, injury or damage due to its action on the nerve roots.  Chiropractic is also effective in reestablishing normal function of muscles, joints and the vascular system, helping to eliminate the root causes of chronic pain.