Horrifying typos! Before we dig-in - I apologize for the volume of typos in previous newsletters. I have now figured out how to copy and paste to my ‘read aloud’ Word Editor prior to pushing the publish button! - so this one and all future newsletters should read much better! As always, if you don’t wish to get these you can unsubscribe at the bottom.

Chronic Pain - why we get it, and how to make it go away.

Chronic pain is a type of pain that lasts beyond the duration of the normal healing process and can persist indefinitely. It is a complex subject that I will try to make simple for you here.

Pain will persist for as long as it has a purpose related to your survival. In our childhood years, pain helps to teach us how to avoid things that can damage us. If we have a physical injury pain will persist during the healing process to inhibit us from doing further damage to a part of the body that needs to be protected. Once healed, the pain goes away, and we are left with a memory of what may have caused it, helping us to avoid doing damaging things again.

For the above reason, pain is one of our most important survival sensations. There is always a reason for pain, and if our pain is not going away, and becomes chronic, something is causing it to continue calling attention to what is going on inside us.

Pain is purely a phenomenon of the mind. It has no physical reality. It is a sensation produced by the brain in response to feedback about damage to the body. Injured/damaged/diseased tissues send signals to the brain along the pathways of the nervous system, and when these signals arrive, the brain makes us hurt accordingly - for our own good. If pain seems to go on indefinitely, something is signaling the brain to continuously produce it.

In this newsletter I will focus on the kind of signaling I’m most familiar with as a chiropractor. It is also at the root of the most common of all chronic pain complaints - back and joint pain.

Causes of Chronic Back (spinal) Pain

Chronic lower back and other forms of spinal pain are an epidemic in the western world. Here are the main causes:

• Postural stress (sitting at a desk all day for example)

• Overweight (another epidemic)

• Lack of adequate physical conditioning (weak core, poor flexibility)

• Psychosomatic/psycho-emotional (examples - job dissatisfaction, PTSD)

• Chronic Inflammation (this will be an ongoing concern in my newsletters)

The first three on the list are forms of physical causation and are the simplest to address. The 4th is a function of the mind and the 5th, a matter of body chemistry - each a bit more complex. And of course, a person can suffer the effect of any combination of the above - even all 5. In this newsletter, to keep you from being overloaded with info I will focus only on the physical causes of chronic back pain. I will definitely cover the other causes for you in the next edition.

Subluxation

The stress on the lower back from things like prolonged sitting, carrying extra pounds, and being generally weak in the core muscles can cause what in chiropractic we call SUBLUXATIONS. Subluxations are persistent mal-positions or misalignments of the vertebrae (spinal bones) that negatively affect the way these bones move and connect to each other, leading to wear and tear on the soft tissues that connect them, like discs and ligaments. This misalignment can also cause tension or pressure on the nerves that pass between each spinal bone. And because these three forms of physical stress are generally ongoing in the sufferer’s life, so are the subluxations, the damage to soft tissues, and the continuous signaling of this tissue damage to the brain. This is a very common formula for lower back chronic pain.

The illustration above gives us detail on the source of 90% of chronic lower back pain from physical causation. This opinion is based on my near 40 years of clinical experience with thousands of patients with chronic lower back pain.

You are looking at an x-ray side view of two lower back vertebrae. The soft tissue disc between them is colored for you in yellow. The misalignment between the two spinal bones (subluxation) shown is causing a continual compressive over-loading of the disc (see arrows). Note how much thinner the disc is at the back because of this. This thinning is due to ongoing damage to the soft tissue cartilage. The back portion of the disc is full of pain signaling nerve fibers that will send an ongoing damage report to the brain - and there my friends, we have the most common physical mechanism for chronic lower back pain.

Again - this type of subluxation is almost always caused by the ongoing abnormal physical stress of prolonged sitting, or extra body weight, or physical deconditioning, or some combination of the three.

What Can We Do?

If you have stuck with me so far, you might agree that the solutions are not rocket science, though some may be easier said than done!

Prolonged sitting

• Set a timer to 20 minutes where you work (on your cell phone or download one from YouTube.)

• When it goes ping get up and walk around. Take some deep breaths, stretch your torso backward and look up at the ceiling a few times. You need only do this for a minute (this is called a micro-break).

• Sit back down. Re-set the timer. Repeat for as long as you have seated tasking.

If you look at my prior newsletter archive (click READ ONLINE at the top) this is also addressed in a prior posting.

Overweight

Big can of worms here. So many opinions on how to do this. My opinion on the fastest, easiest and most effective method?

• Intermittent fasting (delay first meal late as possible, no more eating after sunset.)

• Paleo food choices

• Make this your standard eating behavior for life.

In a prior email I cover this in some detail. Greater detail to come in an edition devoted to healthy weight loss.

Out of Shape?

• Low impact cardio - stationary recumbent bike, elliptical glider.

• Abdominal strengthening (sit-ups etc.)

• Weight training (All of the above available to you at Planet Fitness for 10 bucks/month. No excuses!!!)

• Swimming - excellent non-weight bearing exercise for your back.

• Yoga for flexibility

Professional Help?

Sometimes we need more than what we can do for ourselves. Chiropractic adjustments address the misalignment of subluxations directly. In my office we also use a spinal decompression table that effectively addresses the compression effect on chronically painful discs (as shown in the x-ray illustration above.)

Chronic back pain doesn’t have to be a forever thing, but it will require some lifestyle changes like those suggested above… and perhaps some help from us here in the office. Let us know if we can help.

Until next time, blessings to you!

Dr. Seiler