Pain Cycle And Muscle Spasms
Today we are going to talk about pain spasm cycle and how it relates to a kind of holistic care.
Basically, a lot of patients come in and ask the same questions every time. How come this keeps coming back? Why am I having pain? What can I do about it?
So, there are such a few things we can do about it and I'll show you those as we get through this.
It is called a pain spasm cycle. We have pain, whatever kind of some kind of injury. Pain is going to cause ischemia, which is decreased blood flow and increased toxin flow. Ishcemia causes spasm. And spasm is going to cause misalignment, which is going to cause more pain. So, it's this big cycle.
We are going to go through some other parts of it. There is a lot more to it - an emotional component, chemical component and, of course, there's a physical component.
Physical Component of Pain
Let's go through a physical component first. This is a really easy way to understand this. Let's say we have tissue injury. For instance, you have sprained your ankle, you hurt your back lifting something, you get hit. There's some kind of initial injury.
This initial injury causes a few things. It causes tissue damage and maybe bruising, which is bleeding inside the tissues. We've all had a bruise. So, what this does cause though is this causes a reaction with the tissue damage so there's bits of cells that should be on the insides of cells on the outside. It acts as what's called an antigen, which is the bad guy. It just means that there's something that shouldn't be there.
Your body will react to it through inflammation. Inflammation will lead to pain.
Once again, we have tissue damage, inflammation because of the stuff that's been released from that tissue damage - this is the chemical component now.
It is going to cause pain. So, the pain is a information from your brain and to your brain that something has gone wrong - tissue damage. It tells us to stop messing with it and stop moving. You hold it, you don't want to move it as much, because it causes more tissue ischemia.
Tissue ischemia is just a decrease in oxygen and an increase of CO2. Therefore we have a decrease of pH. So, you become more acidic. We don't like to be acidic, that causes more problems. We are getting carbonic acid because of the carbon dioxide that can get out of the area. We are also getting lactic acid and a whole bunch of other acids because of the metabolic processes. A body is trying to a get rid of the bad stuff and work without oxygen properly.
That could lead to spasm. Spasm is a natural reaction to guarding or pain. As it tightens up, it can cause misalignment. Misalignment is when the joints out of place and you go to the chiropractor to get adjusted.
If the misalignment and the spasms continue for too long we get scar tissue, stasis and adhesions.
Scar tissue is whe antigens and acids couldn't get out and your body basically says: "fine! we'll just keep it there". The body can't put blood flow through in order to clean it up.
How To Get Rid Of Misalignment?
The main things we want to do to stop misalignment is getting your adjustments realign yourself whatever way it is. Sometimes it can be done through yoga, sometimes through muscle movement, massage therapy, mobilization, chiropractic, whatever.
How do we get rid of spasms?
Well, you can take drugs, but it is the fake way to do it. The drugs will reduce the spasm and, hopefully, increase the blood flow reducing the ischemia. That would reduce the pain and we can come back to the beginning of the pain cycle.
This is just the main basis of the pain-spasm cycle. So, we have to take into consideration some other points.
Above we had a physical injury example. What if we have a chemical injury?
Chemical injury would be either lactic acid buildup from overuse or misuse. Lactic acid is the normal buildup of an acid because you used your sugars in the mitochondria and the muscles for too long without oxygen. It is called anaerobic buildup of lactic acid.
That lactic acid, fortunately, is recyclable. It just gets sent to the liver eventually if we can increase the blood flow through massage, heat, motion, manipulation, adjustments, through whatever. Then we can get the acid to go back to the liver, get recycled gluconeogenesis and turn back into glucose.
That seems easy, but there's a whole bunch of other chemical things that can happen here. We have histamines, heparins and other chemicals that are related to pain and injury.
It causes us to become guarding and stiff, we don't want to move. It is a fear reaction. Who wants to move something that hurts? You think you are going to hurt it again.
Sometimes, we get stuck in this or like put yourself in a brace, put yourself in a cast for too long. Usually, what we should do on this kind of things is as soon as possible get this moving in the comfortable range of motion. The more you move it a little bit, the less you'll build up those adhesions and scar tissue, because you're promoting blood flow through that area.
What else can increase the blood flow to the area? Dry needling, trigger point therapy, massage therapy, mobilization which is movement therapy, yoga, exercise and other things you can do to increase blood flow. This will increase oxygen and decrease CO2.
When tissue ischemia goes away, spasm should go away, naturally. When spasms go away, misalignment can stay, unfortunately. This is why you want to get adjusted and want to have the mobilization. If you get the mobilizations of the stuff in place where it should be stacked on top of each other, reduce the misalignments, these muscles have no reason to spasm. There is also no reason to have ischemia, gardening and pain.
Your body can naturally heal the tissues because you can get better blood flow. Better blood flow brings more healing materials and gets rid of all the toxins. So, we would get rid of our injury and eventually heal.
If you have misalignment and you just left it, you took a bunch of pain pills, they didn't really do anything but the misalignment stays. And then you go off, you start working out and exercising, you start doing stuff, you are going maintain this and longer. It takes you many many times longer to heal misalignment and even get these to stay or get these even happen if your body has been set up to keep this misalignment in place.
What are we mean by misalignment is two bones that should be stacked on top of each other off kilter. Not in juxtaposition on improper alignment.
How do you determine proper alignment? Of course, through observation. You check the muscles on either side and you see that one is tight and one is too loose. Or one is to loosen and the other is tight. Or this one is normal and the other is loose. You can feel through palpation using your hands. Of course, you can see it on x-ray occasionally, but you could feel it much better. You got to find somebody who does actual palpation, hands on. Not trying to find lumpy bumps that are bones, but actually, find a lumpy box which are the spasms - trigger points. Work on those and then you can get the alignment back into place and then your body can relax.
Emotional Side of Pain
We can talk about emotional stress as well emotional stress. We feel the tension and get stiff lin the neck and upper back when we get into a defensive posture or a surprise posterior. It is called the alert response and those can cause tissue ischemia, which can cause spasms, which can cause misalignments, which eventually cause pain. It then causes a tissue damage. Tissue damage over time builds up scar tissue, which is not good.
This is where dry needling comes in, by the way. Acupuncture helps you deal with pain by increasing the chemicals like endorphins, serotonin and things like that to help you reduce your own pain. It helps the guarding and stiffness, because you start to actually relax. These muscles will start to detense.
Maybe we'll work with tissue ischemia, because we're coming back to histamine and heparin response, trying to get those guys to come in and clean up.
Imagine if you're doing the acupuncture many times. It's like no one has paid attention to the area before and it is considered a normal pain. So, what happens is like going into your kid's room saying "I thought you cleaned your room, but the place is a mess!" This is what the needles do. They really your body-mind to go back and clean it up.