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What if the Pain is Not the Problem?

Let me ask you a serious question:  What if your pain is not the PROBLEM?

Many people begin chiropractic care because of an ache or pain. Pain can be distracting, debilitating, irritating, or annoying. Pain can be chronic, acute, intense, or intermittent.

Pain may be painful, but the pain is not the problem!

Pain Is Just A Symptom.

Pain is a symptom. A signal. Pain is no more a problem than a traffic light or your alarm clock jarring you awake. Pain is just an innocent messenger. Pain may be present to alert you to a developing problem.  Pain may be your warning about a long term problem that has just become more serious.  Pain can also be a normal ‘side effect’ of a current condition or even a nutrient deficiency

When I meet patients who are in pain, I have a lot of questions.  If they have not suffered any kind of recent trauma to explain why they might have the pain, my first thought is that they must have exceeded some physical, chemical, or emotional limit to which they can no longer adapt.  So, I’m interested in what is the underlying cause of the pain. I begin my investigation by asking a lot of questions.   Did it just happen for the first time? Has it been present a long time and worsening or does it come and go? What circumstances brought it on? What exactly does it feel like and where is it located?  These questions, along with a proper physical exam will lead me to the cause.  Once I uncover the cause, I can determine how to fix it and what change(s) should be made to avoid the problem again in the future?

Did you know that a person’s pain level is not necessarily a determining factor in how severe a condition is?  Pain is relative to each individual and can be fickle.  It is sometimes the last symptom to show up when there is a long-standing problem and sometimes it is the first symptom to disappear once treatment is sought – even if the problem isn’t really resolved.  

What Do Pain and Brake Pads Have in Common?

Imagine you are driving your car and you begin to hear a lot of squeaking and squealing when you apply the brakes (this represents pain).  As you continue to drive your car over the next few months, you notice the sounds are really getting a lot louder.  With Google at your fingertips, have input the symptoms and have come up with your diagnosis.  You then take your car to a mechanic and you tell the mechanic, “I think my brake pads are bad.  I read that when brake pads need to be replaced they cause squeaking.”  (The new brake pads represent pain medication or some quick and temporary fix.) The mechanic looks at your vehicle and upon initial inspection, he agrees with you that the brake pads need to be changed.  But, he also wants to do a more in-depth examination to check the rotors, alignment, and even the brake fluid.  Oh boy, you weren’t ready for this and decide you are in a hurry and can’t really afford the examination fee, so you consent to have him change the brake pads but nothing else.  The mechanic warns you that if your brake fluid is the problem you may have an accident because your brakes may fail, despite the new brake pads.  Additionally, he tells you that your new brake pads may wear out prematurely if the car is out of alignment or the rotors are bad.  You thank him for his concern and drive away.  It seems the new brake pads did the trick, your brakes are no longer squeaking.  Soon you forget all about those other issues you should look into.  As the weeks go by, the squeaking and squealing return.  This is cause for another trip to the mechanic to check the brake pads again.  Your mechanic tells you the brake pads are wearing prematurely and you ask him if there are better brake pads – ones that are more substantial and will hold up longer (a better or stronger medication).  The mechanic again explains that there may be a more serious problem causing the brake pads to fail, but again you only have so much time and so much money earmarked for this problem, so you insist he simply replace the pads again, but this time with better ones.  He obliges you and once again, you drive off happy that the squeaking is gone.  Within weeks the problem is back and it is getting worse (louder)….  This time, you decide to go to a new mechanic….maybe a new mechanic will have better brake pads that will last longer, you think to yourself.  The visit to the new mechanic starts off the same as the previous mechanic.  He feels, based on his experience and expertise, that he needs to take a better look at your car.  He needs to perform a thorough examination.  In fact, this new mechanic refuses to do any work on your car until he is satisfied that the real problem is identified and corrected.  He is concerned for your well-being (and his reputation) if he doesn’t fix the real problem correctly.  In my book, he is a good mechanic.

Hire a Good Mechanic, Follow The Directions & Give it Time

In my office, I represent that second mechanic, the good mechanic.  Uncovering the real cause of a patient’s problem may take a longer or more in-depth exam.  It may require me to ask an awful lot of questions.  It may require x-rays (I don’t have x-ray vision, by the way.) or other imaging.  Most importantly, it may require time.  Time to peel back the layers and learn more about you:  what previous accidents or injuries you’ve had, what your daily activities consist of, what your postural habits are when you work, play, and sleep.  I have to consider any and all medications you are taking and disease processes and your diet as well.

Once I have a solid diagnosis, as your Chiropractor, I will come up with a care plan.  Your care plan may be similar to someone else who has a similar condition as you, or it may be very different…because you are different.  I take into consideration my patient’s primary diagnosis, secondary diagnoses if they exist.  I also consider their level of dysfunction or disability, age and the findings on the x-rays to determine what I will physically do to the patient to help the situation.  I also take into account what they do for a living:  does this patient sit all day or lift heavy packages as a regular part of their work.  I rely on my nearly 30 years of experience helping countless patients in this same or similar situation.  I’m interested in their perceived level of stress and dozens of other factoids about their life and activities of daily living to come up with a plan that will quickly and safely address and correct (if possible) the problem.

What if you were like the car in this scenario?  And, what if,  the real issue was the car’s alignment…which caused the rotors to get worn down…which caused the brake pads to wear out (we aren’t even going to talk about tire wear)?  Would you just want the brake pads replaced again?  I know it worked for a short time in the past, but is that really what you want?

How is Healing Like Learning to Play the Piano or a Sport?

Learning to play the piano, type 60 words per minute without mistakes, or learning a new sport have a lot in common with how the body heals.  All of these things (and countless others) require consistent repetition to create muscle memory.  This muscle memory helps your hands to find the keys on the keyboard without looking.  Muscle memory is responsible for allowing you to ride a bike, hit a tennis ball, or learn the footwork for a new dance.

Muscle memory is also needed in Chiropractic healing.  We chiropractors can’t simply realign a spinal or pelvic joint one time and assume that it is fixed.  Our spinal joints, ligaments, tendons, muscles, and all the connective tissues will have to be retrained to hold the new corrected position.  This takes repetition.  This takes stretching and strengthening exercises to be done by the patient with repetition.   This takes changing some bad habits or improving work conditions or posture.  This takes time.  The repetition is built into your care plan, that’s how frequently you will need to be treated each week, and this tapers off as your problem shows signs of healing and improved function.  It is not based on pain.  The duration of the care plan has been determined to be how long it will take for your body to adapt to the changes and embrace them. It is not based on pain, because pain is a symptom, not the problem.

Do you know someone who thinks pain is a problem? Please send them our way. Because in my practice, pain is never a problem!  When we get to the deeper cause, this pain will be alleviated, but so eventually is the cause itself.

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