Why Is It Taking Longer For The Pain To Go Away This Time?
Since graduating in 1984, one of the most common questions I hear from patients is: “Why is it taking longer this time to go away?” While understand the frustration in this question, the answer is not simple, truly it is as complicated as the individual’s life.
Let me give a list of reasons that alone or in combination may contribute to a slower recovery of this episode. Scroll down to see further discussion on each reason.
- 1. The cause of the pain was not allowed to heal completely or correctly the last time.
- 2. The activity that caused the problem to begin with is still being done
- 3. There is no improvement in the lifestyle that allows healing
- 4. The joints, ligaments, discs, degeneration is so bad that it can never be normal again.
Now The Details
1. Not enough care, no follow through with exercises, no change in the causative factors
a. Unfortunately, in many instances, patients discontinue care when the pain is manageable or gone. They fail to take into consideration that the underlying cause, such as a facet joint, disc issue or ligaments have not had enough time to heal or repair properly.
b. Quitting care too soon, allows a greater accumulation of scar tissue in the inflamed tissue such as ligaments or muscles. Scar tissue is less elastic than healthy tissue, has less blood supply than healthy tissue, but also has more nerve fibers than healthy tissue. This build up of scar tissue results in a stiff, sensitive joint that is easily irritated.
2. The activity that caused the problem to begin with is still being done
a. The typical cause of back or neck pain is either trauma or repetitive motion/postures.
b. A slip fall, sports injury, work injury or auto accident forcibly stretches or tears structures like the discs, ligaments, muscles or nerves and result in a complex repair process involving inflammation and scar tissue.
c. However, in most cases, it is chronic or repetitive postures or motions that cause a low-grade irritation that eventually results in this same repair process. When we repeatedly perform an action or stay in a prolonged position we eventually fatigue and irritate our ligaments, muscles and joints. Over time they slowly stretched or distort causing increased stress and irritation. Once this happens, inflammation and pain develop.
d. Common activities include, sitting at a desk with head forward all day, continually looking down at a cell phone and sitting for long periods of time.
e. Without changing our lifestyle habits, we continue to cause damage to our back and neck.
3. There is no improvement in the lifestyle that allows healing
a. This is similar to repetitive motion or actions, but takes in more of our overall lifestyle.
b. It is common for people in the US to have a sedentary lifestyle. Little or no exercise allows our muscles to slowly weaken to the point they cannot support our spine or produce smooth fluid motion when we do attempt physical activity.
c. It is interesting to note that when viewing MRI of the spine, areas that have disc degeneration typically have an increase of fat in the spinal muscles at the level of the disc degeneration
d. Unfortunately, a significant part of our population is overweight. While this may not cause your pain, additional weight on a weakened structure can continue the cycle of irritation, inflammation and pain.
e. Additionally, those who are overweight also have weakened musculature
4. The joints, ligaments, discs, degeneration is so bad that it can never be normal again.
a. Finally, there is what we were told in school, the limitation of matter. Meaning, if someone has moderate to severe disc degeneration, that can never be normal again. Unfortunately, if not treated correctly and consistently, it can continue to progress.
So, you can see there is a host of reasons why each episode of back or neck pain can take longer to recover from. The answer is not just treatment but prevention. An overall approach to health including regular adjustment, exercise, modification of daily habits and diet are the best things to do if you want to maintain a pain-free and active life.
If you are interested in improving your life, give us a call at 314-731-4383. All you have to lose is your pain!
Dr. Martin graduated from Life Chiropractic College in Atlanta GA, where he earned his Doctor of Chiropractic degree. He is one of only a few board-certified chiropractic orthopedists in the metro St Louis region. He is a Diplomate of the International Academy of Neuromusculoskeletal Medicine. He uses the latest neuroscience research to make the best diagnosis of the cause of your pain as the starting point for your recovery. Since 1984 he has helped many people find relief from chronic pain or helped those injured in accidents recover.