3 min|Dr. Jam Caleda
Treatment of Chronic Pain in Naturopathic MedicineHealth
From my last blog, 'Pain: Learning The Language of the Brain', I discussed the three different generators of pain, nociceptive, peripheral sensitization, and central sensitization. Recall that nociceptive pain is normally due to an injury to a tissue. With proper rehabilitation and time, this pain heals quite nicely and easily.
What most people come into our clinic for is chronic pain. This is usually due to peripheral sensitization. Peripheral sensitization normally occurs from a past injury, and can manifest as years of chronic pain. The injury itself may have healed however because it was a traumatic experience it has emblazoned an imprint on the nervous system, which in turn responds by alerting the person with pain so as not to recreate the injury in the future. We experience this as chronic sciatica, painful knees or ankles, and stiff necks to name a few.
How Do We Treat Something Like This?
The issue is in the nerves. What happens is that the nerve or nerves at the site of injury to the brain have changed and lowered their threshold to send that signal of pain. Think of it as a river with a dam that is slowly leaking over time. When the dam is working it allows for a very controlled flow of water through the river, but as it begins to deteriorate more water uncontrollably breaks through. To fix this, we need to fix the dam.
In the analogy, the dam represents receptors along the nerve tract. We must change the way these receptors act so as to reduce the amount of signals it sends along the nerve. This is done through multiple ways. Short prescriptions of pharmacological approaches can be helpful to some extent but rarely provide lasting or permanent relief.
Some of the least invasive and effective ways is through movement, particularly novel movement. Allowing the segments that are experiencing pain to move in ways it normally doesn’t can reduce this constant pain signaling. For example: hula hooping movements, or yoga practices can help reduce low back pain. At times, novel movements by themselves aren’t enough.
This is where chiropractic adjustments, or ‘manipulations’ can help facilitate healing further. There are small proprioceptive nerves around joints that signal the body where it is in space, when these are activated they can help override the same pain signals that are sent to the brain. A small adjustment can go a long way. For many, adjustments and novel movements are very helpful, but when they don’t provide lasting effects then injection therapies may be the next mode of approach.
Neural prolotherapy is a procedure that involves injecting dextrose (a sugar solution) along the nerve tract that is affected. This is done in areas that the doctor determines where nerves are restricted by surrounding tissue. The solution immediately blocks the receptors in the nerve, which are the principal regulators of pain and inflammation.
Prolotherapy is another procedure that involves a similar dextrose solution injection into ligamentous and tendinous areas. This is done with the intention to regenerate and strengthen these tissues to add stability around a joint. Modern pain science has shown that there is much more to pain than just the physical components of the body.
We are understanding that biochemical, emotional, and even social factors are large role players in the way that pain can manifest in someone’s lives. It is imperative to approach pain management in a truly holistic and integrative manner to get lasting effects.
Are you looking for support with improving your health and longevity?