Family in field

Understanding Pain

Click on a topic to go directly to it's answer

What is Pain?
What is an Organ System?
Basic Neurology
Muscle Physiology
Biomechanics (How the Body Moves)
Why doesn't my doctor tell me about this?
What kinds of conditions?

 


What is Pain?

There are actually several types of pain. Most pain is designed by the body to create a warning against further injury. You feel the burning when you touch a hot iron and reflexively pull away without thinking. You feel the pain of a toothache and know there is damage (cavities) in your teeth that need repair that shouldn't be allowed to go untreated. There is the deep ache of an infection that needs to be healed. There is the pain of a leg muscle is a spasm.
(Return to top)


What is an Organ System?

The body is made up of many different kinds of cells. A group of similar cells with similar functions, pathologies or diseases and similar treatments or cures is the basic working definition of an organ system. The kidney cells and liver cells and skin cells are different and are designated as different organs. Given this definition the largest organ system in the body is the muscle organ system. It makes up about 60% of the body. It is everywhere and attached to everything except the brain, the inside of the spinal column and the insides of bones. They are even attached to all other organ systems. This is important to remember. In addition, since it is the primary system for movement, it has the greatest number of control cells going to them from the brain and pain cells coming from them back to the brain. In other words, the majority of pain actually comes from muscles. Unfortunately because it is so common and broken down into specific muscle groups most doctors forget this. That deep ache you may feel from a bladder or liver infection can be coming from that organ AND the muscles that are attached to it. You'll see how in a few moments.
(Return to top)


Basic Neurology

Pain is an electrical signal transmitted along a nerve or bundle of nerves like a telephone cable to the brain. From any point in the body there are generally only three nerves from the point on the body to the brain. The first runs from the originating point (like the big toe) to the spine. The second runs up the spine to the brain. The third connects that second nerve end in the skull to the point in the brain that interprets the signal as coming from the originating location (i.e. the big toe). Control nerves work in reverse on different nerves but on the same pattern. If you cut off the leg at the hip but stimulate the last part of the nerve as it passes into the spine the signal will go to the brain and the brain will say, "PAIN IN THE BID TOE!!!" when in reality there is no leg to have a big toe on. For control nerves in reverse, if you give an electrical charge to a nerve in the hip it can make the foot wiggle just as if the signal started in the brain.

Any injury, trauma or irritation to any part of the body causes an automatic reaction in the control nerves to the muscles in the area to tighten up. They do this for two reasons - to have the injured body part moved away from the irritation or damaging thing and to tighten up the body region to protect from further injury possible if the injury could be made worse by body movement. Think how a person will hurt their arm and immediately pull it in close and keep it tight to the body to prevent further injury. This happens everywhere in the body with any form of trauma. It's an automatic reflex.
(Return to top)


Muscle Physiology

The most important thing to remember is that a muscle is not one thing. It is made up of millions of individual muscle cells. You have to think of muscle cells instead of an individual muscle. If you pick up something very light in you hand and bend your elbow to lift it up to about waist high, you can feel your arm muscle (biceps) tighten a little but if you feel it with your other hand you will find it is still fairly soft over all. Now if you do the same thing with a very heavy thing you will find the biceps muscle very tight all over. The reason is simple. Your biceps muscle only had to activate a few of the muscle cells to lift the light weight but had to activate all of them to lift the heavy weight.

Another experiment - hold you hand and arm straight out to the side at shoulder height. That shouldn't be much of a problem. It's not too heavy or awkward. But if you hold it out for 30 minutes you'll find that it will collapse and hurt. It's not because of lifting something too heavy or some accident. It's because you tried to use the muscle cells longer than they are capable of being used. Over use, not trauma, is the leading cause of muscle pain and the basis for most common painful conditions people have.

A muscle cell (all or part of a muscle) will react to over use by using up the chemicals it has stored inside each cell to maintain the contraction. As it does so it will try to get more from the surrounding blood flow. At some point it will get very low on chemical energy and adapt to the continued order by the control nerves to stay contracted. This adaptation is usually a locking of the muscle cell in a contraction known as a spasm. It can be just a few thousand cells (smaller than the head of a pin) or the entire muscle like a cramp (a spasm) in the leg where they all go into an involuntary contraction (spasm).

If the spasm is maintained for a sufficient time it begins to become permanent. If it is exercised while in spasm it can create even more pain and spasm. Once the control nerve stops the muscle can relax but if some or occasionally all of the cells have had to stay in spasm for too long they will continue on their own even though the stimulus of the nerve has been stopped. A trigger point is simply a small group of these cells instead of the entire muscle that stays in spasm and is usually too small to feel and doesn't show up on any x-ray or laboratory test. They can be tested and found but we will cover that later.
(Return to top)


Biomechanics (How the Body Moves)

An interesting little test I've given many hundreds of doctors is a question. "We have about 696 muscles in our body. How many of them push instead of pull?" Surprisingly the majority of them give the wrong answer. They say about half push. The answer is NONE! A muscle doesn't push. It can only contract and pull. Through the action of some muscle pulling, it can push an object along but the muscle itself only pulls. This is important because it gives an insight into some pain in the body. When we discuss specific conditions this will become clearer.

A muscle contracts for two different reasons. First to contract and pull to do some kind of movement. The second is to contract and lock to prevent movement. This is the reflex when there is trauma or irritation to any part of the body as in the hurt arm above. Another example is muscles attached to the kidney, liver or bladder that will tighten when there is an infection. Another example is the muscles between the ribs following open heart surgery. All of them react the same way. If they stay contracted for protection too long they will develop permanent micro (sometimes called trigger points) and/or larger muscle spasms.
(Return to top)


Why doesn't my doctor tell me about this?

Pain can be caused by many different situations. The true calling and responsibility of a doctor of any kind is to find the actual cause of your pain and try to heal it. A very important principle to understand is that the human body is far too complex for any one doctor to understand everything about it. Each doctor specialized in his particular field. Because of this each doctor approaches the human body from a particular viewpoint and with a particular idea of what is probably wrong and how it should be treated. I confess to doing the same thing. There have been times I've been baffled with a patient, only to find out that the problem was something simple in a different specialists field. Many times that doctor is right and the patient gets better (barring mortal wounds and disease processes). If the patient doesn't get well, it's the responsibility of the doctor to refer the patient to someone else with different training and/or perspective to find something else that may be going on in that patient.

Unfortunately for many patients, the treating doctor or physician doesn't have all the answers and has been trained to NOT confess to ignorance. After all, how can the public continue to place doctors on pedestals if they find doctors don't know everything there is to know about the healing arts? The answer is simple. Give us the respect of our training and understanding but accept that we don't have all the answers. Those answers are out there but with someone else. What I'm going to help you understand here is something that, if you like doing favors for people, you might like to discuss and show to your personal physician. It will make sense to him or her and may help other patients later.
(Return to top)


What kinds of conditions?

Please don't expect what is presented here to be the cure all for everything. It isn't. It is wonderfully effective for the vast majority of pain in just about any part of the body. The concept is applicable to everywhere in the body. It involves the muscles and their relationship to injury and their modes of pain.

Before we go any further let this be absolutely clear. SELF DIAGNOSIS CAN BE DANGEROUS. SEEK A DOCTOR'S EVALUATION OF YOUR CONDITION TO MAKE SURE YOU DO NOT HAVE SOMETHING DIFFERENT THEN WHAT IS PRESENTED HERE. BE SURE TO DISCUSS THIS TYPE OF TREATMENT WITH YOUR DOCTOR BEFORE BEGINNING.

There are many conditions which do not respond to what is presented here. Cancer, infections, cysts, fractures, many neurological conditions, advanced arthritis (pure joint - not involving muscles), plus many others not related to muscles.

The basis for this therapy is pain associated with muscles that have been affected by any other condition or are injured all by themselves. You will be taught to do a simple examination and determine if it can be beneficial for you. Please understand that even though you may have a condition like one of those described above, you may have additional associated muscle problems which can be treated. In those instances don't expect a cure for the original condition but do expect some relief from the pain associated with it. For that alone your time and money is well spent. In those cases consider this like you would any pain reliever - a help but not a cure for the underlying problem.
(Return to top)