The Secret of Chronic Pain
Musculoskeletal pain signals that a tissue in your body is injured. This tissue could be a muscle, a tendon, a ligament, a joint, and so forth (all defined below). You can easily have an injury without experiencing a traumatic event or an accident. A car accident or a fall can obviously lead to musculoskeletal injury, but the body can also be injured in many simple and subtle ways. Just being in one position for too long, such as at a computer, or bending over in an unusual position at work, or even lying in a particular position while sleeping, can cause a muscle to strain or a ligament to become distended and tear.
The musculoskeletal pain that signals injury means that some tissue in your body is either swollen, inflamed, torn, broken or damaged in some way. If you are guessing what tissue is injured and where it is, finding an effective method of healing the injured part can be quite elusive. But if you can find the injured place precisely, it can usually be treated and get better.
Scar Tissue Scar tissue forms primarily in muscles, tendons, ligaments and joints. Movements that stress the injured area cause re-tearing of tissue which has healed poorly and stimulates the formation of more adhesive scar tissue to take its place. Therefore, if we feel pain as we use an injured area, it is often a signal that we are re-tearing the tissue and developing more scar tissue. Breaking the cycle of tearing and re-tearing of adhesive scar tissue is the secret of effective therapeutic treatment.
Tendinitis Ligament Sprains Joint Inflammation Muscles Effective treatment means finding the adhesive scar tissue that is causing the pain, and eliminating it. This can be done through a variety of techniques. If the adhesions are new and due to a misalignment, then a manipulation performed by a physician, chiropractor or osteopath can quickly eliminate the adhesions and the pain. If the scar tissue has been in place for a period of time and the pain has become chronic, then friction therapy or injection therapy might be the more appropriate treatment. Friction therapy is a technique developed by a British physician named James Cyriax. When using friction therapy, the therapist manually breaks apart the scar tissue with very gently strokes in the correct direction. This is done over a period of weeks or months, depending on the seriousness of the condition. The treatment also includes daily gentle exercise to prevent the return of adhesive scarring. Injection therapy is performed when more conservative treatment has failed. The skillful physician uses the tip of a needle to break apart the scarring and uses an anti-inflammatory medicine to break the cycle of pain and inflammation.
© copyright Ben Benjamin 2001
Most people don't realize that the cause of the majority of chronic pain in the body is the poor healing and repeated tearing of adhesive scar tissue. It is normal for scar tissue to form in the body when we are injured. A little bit of scar tissue located in the right places is the good glue that holds torn fibers together. But sometimes this process of scar tisue formation is random and tissues heal by forming a jumbled matrix of adhesions. When this occurs, the adhesions can suffer constant re-tearing, causing recurring pain. To avoid adhesive scar tissue formation which results in chronic pain, a thorough assessment must be done, the appropriate treatment needs to be applied and the right exercise regimen must be given.
Tendons attach muscles to bones. We use them every time we move. Tendinitis is an inflammation of adhesive scar tissue which has formed on the surface of the tendon. This scar tissue can also cause the tendon to stick to other, nearby structures (forming what are called external adhesions), making the entire area vulnerable to further injury.
Ligaments attach bones to bones; these strong, cord-like bands hold our structure together. Torn, inflamed ligaments often form adhesive scar tissue. This process usually makes the ligaments weaker; they often stretch and distend. Thus, they are vulnerable to re-injury, more inflammation, more scar tissue, and yet more injury.
Joints are enclosed by a joint capsule. When a joint is traumatized, it secretes extra fluid to fill the joint, which then becomes irritated and inflamed. This works to protect the joint structures by limiting or preventing movement on your part. Shoulders and knees often become swollen and inflamed, as well as fingers and toes.
Muscles are often injured, but they have excellent blood circulation and tend to heal very quickly. The girth of their movement usually precludes much adhesive scar tissue formation, and they usually recover spontaneously with a night or two of sleep. Although most people think that their muscles cause most of the pain in their backs, necks, shoulders, hips and thighs, this is, in fact, not true. What people are feeling is often the deception of referred pain, which means that pain is felt at a distance from where the injury is located. Therefore, the pain we think signals muscle injury may instead be referred pain from adhesive scar formation in tendons, ligaments or joints far from the site where we feel the pain.