Treating Chronic Pain With Chiropractic Adjustment
It is not unusual for our clinic to encounter patients with chronic recurring episodes of pain with no history of trauma or injury. Obviously, everyone wants an explanation of why they are hurting. Most patients struggle to understand how they could hurt if there has not been an injury. Many of us are the same way. We are walking around and our knee starts hurting, the first thing we wonder is “What have I done to my knee?”
There is a condition of the nervous system called Central Sensitization that is associated with the development and maintenance of chronic pain. With central sensitization, the nervous system goes through a process that keeps it in a persistent state of high reactivity. This persistent state of high reactivity lowers the threshold for what causes pain and subsequently comes to maintain pain even after the original injury if there was one might have healed.
Central sensitization has two main characteristics. Both involve a heightened sensitivity to pain and the sensation of touch. Heightened sensitivity occurs when a person experiences pain with things that are normally not painful. For example, patients with this condition often experience pain even with things as simple as touch or massage. Because the nervous system is in a state of heightened reactivity the brain produces a sensation of pain and discomfort that is not appropriate for the stimulus. The pain level is not consistent with the provocative activity. The pain is amplified.
Chronic pain patients can sometimes think they must be going crazy because they know intellectually that touch or simple bumps shouldn’t be as uncomfortable or painful as they experience them. Other times it’s not the patients themselves who think they are crazy, but their friends and loved ones.
Friends and loved ones can witness the chronic pain patient grimacing at the slightest touch or crying out at the simplest bump and they likely think that the chronic pain patient must be a hypochondriac or something. After all that minor bump should not have hurt that bad, why are they reacting that way? The difference, though is that the friends and loved ones don’t have a nervous system that is stuck in this persistent state of heightened reactivity called central sensitization.
In addition to heightened pain awareness central sensitization has some other characteristics. It’s possible to have heightened sensitivity to light, sounds and odors. Central Sensitization is also associated with cognitive defects, such as poor concentration and poor short-term memory. When the nervous system is stuck in a persistent state of reactivity, patients are going to be literally nervous or anxious. Lastly sensitization is also associated with sick role behaviors, such as resting malaise, and pain behavior.
While usually not considered to target the central nervous system, chiropractic adjustment with spinal manipulation does affect pain responses at the dorsal horn of the spinal cord. Regular mild aerobic exercise is also considered effective in supporting the central nervous system.