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OK, I Guess It’s On Me To Do Virtual Surgery On Back Pain

I danced around the house yesterday just like my dogs do when we bring them a new toy. Beatrice and I went to dinner and I was enamored of showing off all my new (old) moves (again). I had renewed life in oldish bones.

Did something structurally change? Did my L4-5 disc herniation go from 5mm to 4mm, and I felt an equational mathematical relief? Was I “healing,” finally, after 10 months? If so, in what precise mathematical/chemical/physical way? ‘Just the numbers, ma’am.’

…2 things happened since I posted yesterday: Hacking and Tweaking at Back Pain Day By Day. It’s in important order, this time.

  1. Doing the post itself, then reading and engaging in comments made my pain recede even more. That’s pretty amazing, wouldn’t you say—when an act that involves writing, verbalizing, thinking, etc., reduces pain—and even if you’re sitting on your ass on an iPad (see the post, sitting is a big factor)?
  2. Exuberant by #1, I had a renewed interest in how my own brain is fucking with me. I’ve already read Sarno and I hate to watch movies or read books a second time. So I looked, and found something new: The Great Pain Deception: Faulty Medical Advice Is Making Us Worse. The guy is a TOTAL unpolished geek and I love it. I’m well into chapter 2, now.

I got up this morning, Teetered, and soon got a comment on yesterday’s post from a retired surgeon.

Sorry to hear that you are still having that much trouble with your back. For what it’s worth: you have fiddled with it long enough. Get it fixed, L4-5 takes a while for the nerve root to recover. Over age 50, your chances of a repeat decrease. I wish you the very best of lucks. Been there, done that, and had that. (Retired orthopedic surgeon).

TJ has been in comments a while, and I see where he’s coming from. I respond like this.

Hi TJ:

Well, I do have the anecdotes of my dad and 2 brothers who swear by their surgeries for the exact same thing (dad and 1 bro by the same surgeon). OTOH, I have my own experience in getting over a cervical herniation (also confirmed by MRI), with months of ache in my right arm. Years later, nothing at all, and no surgery. I lafed it away, literally.

I’m reading a new book I started last night:

The Great Pain Deception: Faulty Medical Advice Is Making Us Worse

by Steven Ray Ozanich

He’s not a doc or professional practitioner, but a sufferer himself for 3 decades who’s helped a lot of others. And he seems to be on 1st name basis with Sarno and a lot of other TMS focussed docs and naturo’s.

Thing is, I find that when I laf at or apply heat to one pain area, it often goes away and comes back in another place. How does structural deficit medicine address that?

I understand fully the pain is real (oxygen depravation to an area), but I question whether it’s ALL and ONLY about some structural problem (like a herniation). If I break my femur in two, it’ll be pain free in a few weeks, healed in about six. How can a petty little disc herniation (which almost everyone over 50 has, and most with zero pain) CAUSE pain for decades? Pinched nerve? OK, then how come if I physically pinch a nerve, it goes numb, not cause excruciating, aching pain for hours upon hours?

This happened when I read Sarno and eventually got over my arm pain. I could feel the pain dancing from place to place as I read the book and simply realized there is nothing physically wrong with me, that for whatever reason, my brain is fiddling with the oxygen supply knobs to various places. Eventually, it all quieted down. Came back twice months later (did I “reinjure?” No). First time it came back I was able to mentally set it aside in 2 weeks and the 2nd time, in one week and have seen neither hide nor hair since.

In this case, I finally began to see this as exactly the same thing and not some structural problem, and I’m 70% better on average, almost perfect standing, walking, and laying. My working hypothesis is that all the standing is simply forcing increased blood flow, hence more oxygen, hence undercutting the oxygen knob futzing my brian is doing, and so I’m getting a ton of pain dancing, now, which is the sign it’s running to find new hosts.

But, interested in your take.

And I am interested.

So, I decided to do a bit of original digging. Right off the bat, via PubMed:

Is spinal surgery effective for back pain?

Abstract

There have only been a few randomized controlled trials of surgical treatment of chronic low back pain caused by degenerative disc disease. Fusion surgery has been compared primarily with nonoperative treatment, whereas disc arthroplasty has been compared with fusion surgery. The results for either of the two surgical procedures are modest in terms of pain relief and improved function.

[The Introduction and Analysis section is a good read to assist your future endeavors in not just automatically fooling yourself. Nice statement of limitations and challenges. Nice.]

Implications for clinical practice

Surgeons and others believe that surgery is effective for back pain. They base this belief either on their own experience or on observational studies. This belief is, by and large, not vindicated by the outcomes in well-reported clinical trials. Those trials indicate that only a small proportion of patients do well from surgery. If surgeons achieve better outcomes than those reported in the controlled trial literature, the community would benefit from the publication of those outcomes. In the absence of contradicting evidence, the benefits of surgery must be regarded as small. Because improvements from surgery are small and because not all patients benefit, it becomes critically important to carefully select patients in whom fusion surgery is performed for chronic back pain. Furthermore, it is important that patients have a clear understanding of the procedure and its potential results and complications so that they can participate in the decision.

Differences in results from one study to another may be explained by the selection of patients, but the surgical procedure itself and its performance are likely to influence outcomes as well. In an editorial, Fritzell [8] posed the question: ‘is surgical treatment consistent with evidence-based medicine?’, and answered it with: ‘yes, in selected patients’. But surgeons have not yet articulated the definition of the correctly selected patient, and tested it prospectively. The reputation of surgery rests on the observation, after treatment, that some patients sometimes do well, with some procedures. That is little solace to the majority of patients who do not do well, who suffer complications, or who are rendered worse by surgery.

Yes, I understand fully that this specific literature review deals with fusion and not the ‘dectomy thingy. Feel free to make Grand Distinctions if you like.

I wish to go a WTF step further, and integrate a political/social aspect. It completely does not go unnoticed with me that reported chronic pain appears to be a disease of modern societies with their advanced geopolitical maneuvering everyone believes they’re a very important (not impotent) part of (among too many other differences to mention, of course). They wear stickers on their lapels signifying their importance in the grand scheme of things they have zero control over.

So, is modern social antagonism more likely to breed stress, or catharsis? It’s a simple question.

I read a really strangely different book in 1990: The Neo-Tech Discovery. I took many things from it, but the one most important thing, the one thing that has guided my life generally ever since—a lot of times very imperfectly, but I know where home base is—is:

The human mind is a reality integrating organ, not a reality creating organ.

Don’t gloss over that; because, when you begin to unpack, you’ll find that very, very much in the realm of human social interaction from relationships to families to states turn very much on a whole lot of mind-created “realities,” and these “realities” are in conflict with one-another, and antagonism is the result. On a geopolitical scale, war, murder and genocide is the result, and there will always be millions cheering on their mind-created “reality” if they’re on the winning side—making excuses if on the other.

Let me leave you in the lurch on that, for now. Best to see how much mind created reality comes my way in comments….

Richard Nikoley

I'm Richard Nikoley. Free The Animal began in 2003 and as of 2021, contains 5,000 posts. I blog what I wish...from health, diet, and food to travel and lifestyle; to politics, social antagonism, expat-living location and time independent—while you sleep—income. I celebrate the audacity and hubris to live by your own exclusive authority and take your own chances. Read More

28 Comments

  1. Pauline on January 15, 2015 at 01:28

    Here is short free book on Bowen therapy:
    .
    Why it works for me is that while you lie on the massage table covered in a blanket, the room is warm and the movements are very gentle. After each series of movements on different parts of the body, the person leaves the room for a few minutes, giving the body time to process what has happened. These moments actually take you deeper into a relaxed state. The anxious mind finally lets go and the body/brain relaxes more and more. I find I am almost in a sleep state at the end of the hour and half. The whole system is based on creating the environment for the body to heal itself.

  2. David Lynn on January 14, 2015 at 14:56

    Richard, Your comment from Neotech about the mind being integrative rather than creating reality is critical. More accurately, it is the BRAIN that integrates and the mind is an expression of that integration as well. Unless you’re into mysticism, which, if I recall correctly, the Neotech dudes were definitely NOT.

    I’m WAY over simplifying here, but if you want to get more technical and complete, let me know. Anyway …

    The brain does not “know” what’s going on “out there,” out there being its own body (outside the nerve system, meaning the muscles, organs, joints, bones & skin) or the reality beyond the skin (the environment we’re in, including gravity, which is a major component of what the brain is always dealing with).

    Our brain only deduces what it “guesstimates” is happening “out there” based on putting as much current sensory input and stored historical data together as possible, bearing in mind that something called Descending Sensory Pathways in the brain stem actually unconsciously BLOCK most incoming input anyway. So the brain is usually operating on very limited info, or sometimes magnified wrong info. Question is, “who” or what is “deciding” which info to block, and which to keep? Problem is, that’s not a high-level (cerebral cortex, higher brain) analysis being made at all, so much important info is often filtered out or incorrectly modified. (That’s more important than it might sound.)

    The brain usually does a pretty good job of integrating most of that stuff, provided the incoming & historical data are not too far apart from “reality.” But sometimes, too many inputs saying too many different things are confusing to the CNS & Brain, leading to “dis-coordinated integration” at various levels the brain.

    An example is integration of the vestibular system in the ear canals (like the bubbles in a level), visual information where the eyes are seeking horizontal and vertical, and the joint positioning info coming in from the neck & ankles and other locations in the muscular system. If those inputs get out of coordination with each other, and out of sync with “reality,” you get dizzy or vertigo.

    And resulting motor outputs (from brain & nerves to muscles) resulting from the confused or inaccurate inputs of all kinds, lead to dis-coordination of muscular function, which the sensory system picks up on, and recycles that data, often getting further and further from “reality” with each cycle, magnifying as you go. Any already tense use get even tighter than they were, to attempt to stabilize the body against real or imagined threats or instability.

    And so you get a GIGO thing: Garbage In, Garbage Out. The result is what I call psycho-neuro-musculo-fascial discombobulation — literally, confusion. The brain often reacts to any threat or excessive unfamiliarity with a pain pattern.

    Now, its true that if you just stand there and hold your arm out to the side for long enough, it will eventually get achy and sore (oxygen deprivation.) But a muscle that’s been long-term chronically contracted — with what I call C.E.M.&.N.T. or Chronic, Excess Muscle & Nerve Tension — for long enough tends to be REALLY achy & sore, but not usually the end of the world (unless severe, such as in a car accident). But combine all that with the above GIGO thing, and the negative integration & interpretation, which the brain actually experiences as DIS-integration (life or at least integrity threatening), and a resulting threat to its existence, the negative spiral starts.

    The various groups of muscle cells (both within one muscle and between muscle groups) get out of coordination with each other, sometimes drastically so, which the brain reads as a threat, and triggers a pain pattern. Combine them with Sarno’s well-known point about tense muscles depriving the area of oxygen, and things can get way out of whack. And because the inner and outer environments are constantly changing, the inputs to the brain are changing too, so that accounts for why things can move around and fluctuate so much.

    The good news there is if it DOES move around, it is almost certainly a product of psycho-neuro-musculo-fascial discombobulation, and not some “tear” to the fibers or truly damaged nerve or broken bone or joint.

    Part of the solution is to figure out how to bring the various muscle cells back into coordination with each other, which give the brain cleaner & clearer messages, allowing the brain to go OUT of emergency or garbage mode, back to more normal activity. Facilitating that process is, in my mind, done by getting specific groups of Golgi tendon organs within the muscles to activate, and they talk to the CNS & brain to reduce excess & dis-coordinated firing & irritation, the neurological root of all the trouble in the first place.

    I know that might have been too much at one swipe, but I thought I’d try to cover the spectrum a bit and see if it catches your attention.

    Thanks for Reading, Richard,
    David Scott Lynn

    • Richard Nikoley on January 14, 2015 at 15:50

      David

      That may be the 1st Best Comment in about 4,000 posts. Too much to even comment on, but 2 things and one quote from you.

      1- you impress me that you made an immediate distinction between this and NT, specifically mentioning mysticism (woo woo). Glad I mentioned that because it seemed to give you sway to go total physiology. Good move.

      2 – Everything you wrote makes sense to me, and you layed it out pretty hierarchical logical for a comment on a blog. You might have just said: ‘it’s complicated. We’re dealing with a mess of primordial soup, reptile, hominiod and Kim Kardashian brain, all in one. 🙂

      You said big:

      “The good news there is if it DOES move around, it is almost certainly a product of psycho-neuro-musculo-fascial discombobulation, and not some “tear” to the fibers or truly damaged nerve or broken bone or joint.”

      This is critical. If you break your leg, your leg is what’s going to hurt like hell until it doesn’t a few weeks out.

      But if you have a herniated disk confirmed by an MRI, how is it that some days the back hurts. Others days, the hip. Still other days the hamstring, the quad, the calf, tomorrow the shin and when toes hurt, how come the big one and not the pinky?

      And then, how come once you begin running interference with all of that as I’ve been doing, it shifts over to my right leg (though not my right foot…Bwaaahahahahah).

      Anyway, best 1st comment to a post ever in my memory.



    • David Lynn on January 14, 2015 at 17:38

      WOW, Richard! Best Comment, huh? Out of 4,000?

      From what I hear about You, THAT is a REAL compliment. Thank You Very Much!

      If you want to continue the discussion about your pain, please let me know. I’ve just scratched the surface here.

      Thanks & Take Care,
      David



    • Richard Nikoley on January 14, 2015 at 18:17

      Best FIRST comment. Still a big deal. I couldn’t even guess best comment ever. I’d have to go throught all my comments. 🙂



    • David Lynn on January 15, 2015 at 13:05

      Sorry Richard, I actually thought it was best for a first time commenter, but I phrased it wrong and I see my error. … No Matter. Glad you found it interesting.

      I’m trying to read through your blog over next few days. Looks VERY interesting, with similar tracks to me. (Who ELSE knows about Neotech any longer?) Your Manifesto looks good, but I have to re-read it, was in too much of a hurry.

      One of your readers told me about you, and he knows something about my track record with your kinds of issues, so he thought I should send you a Comment. So I did.

      Take Care,
      David



  3. Krism on January 14, 2015 at 18:02

    Pretty fascinating discussion.. and gives a lot of credo to why mind-body techniques work so well. I know anecdotally of herniation reversals through functional movement practices, especially yoga (key: moving spine in all six directions). I corrected a moderate scoliosis in the 3+ years since I first began.. pretty modestly at first. I was seeing a chiro for wellness and adjustments (“rack and crack”) with good results though still would tweak/pull a back muscle on occasion when stressed (especially lack of sleep i.e. recovery). When I started focusing on movement, spinal twists, back extensions.. chiro wasn’t even necessary. Foundation training has a lot of potential, especially for the non yoga-inclined, to strengthen the posterior chain of muscles (glutes to hamstring group) and correct the woes of chronic ass-sitting. Weak lower back and the house of cards will fall. If hammies are tight, chances are there’s overcompensation in that muscle chain–and a weak back. Stretch and strengthen and the knive may be avoided. Standing desks, fancy pneumatic ones or monitors on phonebooks are fantastic too.

  4. Dr. Curmudgeon Gee on January 14, 2015 at 22:56

    herniated structure != pain

    pinched nerve != pain

    isn’t walking also “movement”? so movement does help, just have to find the right type. have yoga? Pilates? Feldenkrais? chi-kung? Tai-Ji.

    can you talk to your back or pain?

    remodel rooms by getting rid of chairs. just do everything on the floor, like Japanese or ancient Chinese. it makes one feel very grounded & relaxed.

    • Richard Nikoley on January 15, 2015 at 07:22

      Actually Curmudgeon, it’s not true that herniated discs and “pinched nerves” = pain. If that were true, then everyone with them would have pain, just like everyone with a cut finger or broken bone has pain within some similar range.

      But the fact is, the vast majority with disc issues have no pain. This is documented. Kurt Harris once told me that when he looks at images, he can find such disc issues in almost everyone over 50, and there’s no direct correlation with actual pain. Most people have none. He also said that it’s quite common for people with absolutely crushed vertebrae to have mild pain that heals quickly, like a broken bone, but the person with the little herniation would be pacing his office talking suicide, and the pain never heals.

      This is the whole rub.



    • Thomas on January 15, 2015 at 09:49

      “it’s not true that herniated discs and “pinched nerves” = pain. If that were true, then everyone with them would have pain, just like everyone with a cut finger or broken bone has pain within some similar range.”
      Quite true. Several months ago I got a nerve pinch in my C-spine that resulted in a severely weakened right hand. Extreme weakness but no pain. The strength is very gradually returning, but there’s no guarantee that it’ll ever be 100%.



    • Richard Nikoley on January 15, 2015 at 10:08

      Thomas,

      Yep, back in 2010 when I got a cervical herniation from whatever in the weight room, I had both pain and weakness in my right arm. However, once I got my mind wrapped around the pain (Sarno) and got rid of that, I still had weakness in the right arm that took some months to go away. That was the real, physical manifestation of the injury and it didn’t produce pain. The pain was from oxygen deprivation to tissues my reptile brain was causing, think it’s doing me a favor by diverting away from a bunch of stress, most likely to do with my business at the time.



    • bob r on January 15, 2015 at 12:13

      Richard, the “!=” symbol combination means “not equal to”.
      In some programming languages the “!” symbol is used for negation.



    • Dr. Curmudgeon Gee on January 15, 2015 at 13:22

      sorry i’m a C/C++ programmer so

      != means “not equal to”

      in other words, i do not disagree with you

      Todd Hardgrove says similar things about MRI, xray of structural imbalance cause no pain in some)

      it’s all in your mind.
      (but i do not mean iit in a “mean way” that normal MDs imply) the pain is very real.

      i have had few back injuries. & one gave me numbness of one leg (hamstring all the way down to ankle)
      so i agree that “pinched nerve” may not cause pain.



    • Richard Nikoley on January 15, 2015 at 13:33

      Ha, learn something new every day. I thought /= is the negation.



    • David Lynn on January 15, 2015 at 14:17

      I think “they” have it backwards. Except “they” have been reporting in their own medical journals since the 1980s (at very least) that there is no real correlation between structural degeneration and pain or dysfunction.

      My take on the herniated disc, for example, is that the psoas muscle, a deep muscle in the abdomen, runs exactly parallel to and long side the lumbar spine (one on each side, and with multiple layers). When that muscle gets over-contracted and shortened, it pressurizes the discs, which then begin to dehydrate and thin, then with more pressure degenerate, then herniate.

      By itself, that does NOT cause pain, mainly because there are few or no pain sensitive nerves within the joint or disc capsules. (Otherwise every move you make would cause SOME kind of discomfort.) And the over-contracted psoas muscle does not YET cause the pain either, UNLESS it has developed the discombobulation I mentioned above, either between muscle fibers within the muscle, or in contrast with other muscles on the same neural circuit.

      Some dysfunction MIGHT start without pain, because as the muscle gets chronically contracted, it will over-shorten and reduce the available range-of-motion. That’s one reason people feel stiffer as they get without necessarily having pain, and cannot bend over or whatever. … Increased Resting Tonus is a BIG problem after a while.

      So, when a disc is herniated, if there is pain, it is because (assuming no traumatic event) the over-shortened muscle has caused the herniation AND dysfunction within the MUSCLE and triggers one or more pain patterns. That also explains why you can have pain with no herniation, because the pain is originating in the muscle, not the joint or disc.



    • Thomas on January 15, 2015 at 21:06

      Radiculopathy. Peripheral neuropathy, yes?



    • Thomas on January 15, 2015 at 21:10

      I meant to reply to the comment “i have had few back injuries. & one gave me numbness of one leg (hamstring all the way down to ankle)
      so i agree that “pinched nerve” may not cause pain.”



  5. Steve on January 14, 2015 at 23:29

    Go check out the Starting Strength web site. One of the coaches just posted a long article detailing his own recovery from severe back pain. Maybe his story will give you more ideas about your own situation.

    • Richard Nikoley on January 16, 2015 at 10:14

      “Go check out the Starting Strength web site. One of the coaches just posted a long article detailing his own recovery from severe back pain. Maybe his story will give you more ideas about your own situation.”

      Interesting. In his case, from what I can tell, it was a real injury (foot drop, can’t walk on heals: this is real no-shit nerve stuff Sarno would screen out of his particular treatment plan) accompanied by some pain, but not debilitating and not chronic (severe acutely). In other words, not a TMS situation.

      In fact, it lends credence to TMS as a real thing that’s different. Check out how badly messed up his back was from the MRIs, but look what he was still able to do in the gym. Someone with TMS often has a mere pimple of a herniation (or nothing at all) and pain 24/7 that’s so intense they can’t sit.



  6. cunty on January 15, 2015 at 00:53

    What’s your current weight Richard?

  7. Andy on January 15, 2015 at 01:51

    Thomas Hanna’s approach is interesting. Sensory amnesia is where we lose the ability to consciously control muscle groups. His exercises (somatics) help regain this ability through slow contractions and relaxation. This resets the muscle tone to the optimum.

    The key understanding in this method is that the nervous system controls muscle tone. It may be that muscle is tight because of an old injury or overuse etc. and if the muscle is massaged or stretched it quickly reverts back, via the nervous system, to its high muscle tone.

    As a body worker I’ve found Hanna somatics to be safe and extremely effective in normalising muscle tone. Theres plenty to try for free on youtube. Martha, Peterson, somatics is worth a search.

    • David Lynn on January 15, 2015 at 14:01

      RE: Hanna Somatics…

      The mechanism by which Sensory Motor Amnesia works is the Descending Sensory nerve pathway in the lower brain I mentioned in my first post above.

      Hanna’s work was/is excellent, and I use a lot of his concepts when teaching, except a few I believe are somewhat backwards. (But that does not mean I’m right!)

      Many years ago, some of my students were also in his programs and ironically, they said his manual technique is the opposite of what I do, yet often equally as effective. Yet we use many of the same principles to get to the result.

      The Big Key in MY view is getting the psycho-neuro-musculo-fascial system to RELAX and for the muscles to loosen or release their grip on the pain sensitive nerves, and/or stop interfering with metabolic processes, such as proper oxygen delivery. There are MANY ways to relax, and people need to discover the way to do that.

      One problem is, however, when a person lies down and just “relaxes,” they can often gain a generalized relaxation, but not sufficient relaxation of the SPECIFIC muscle fibers WITHIN a muscle that MIGHT be directly causing their problems. That is in part because of the Sensory Motor Amnesia. …

      Can’t feel it, can’t relax it.

      That is why very specific stretching, or specific manual pressure in specific muscle fibers (not “rubbing” the muscles back and forth) is necessary to activate the sensory nerves which will selectively relax the very most contracted muscle fibers within the specific muscle(s) that are usually the cure of the issue. However if the specific muscle fibers develop too much Resting (chronically increased nerve) Tonus, then the stretch will not be able to trigger sufficient relaxation. Manual pressure in the muscle belly will usually be necessary.



  8. Matt on January 15, 2015 at 08:07

    Richard,

    In november of 2013 I fell down a staircase 8 weeks before my wife gave birth to twins. The pain was incredible. MRI showed same L4/L5 herniation. I tried PT, 3 chiropractors, acupuncture and massage. Nothing helped until she went into labor and then the pain went away.

    This was kind of strange since as soon as the babies were home the pain came back. Dr.’s told me to lose weight and get surgery. Two friends recommended Sarno. In March, I finally read the book and it was still difficult to believe. I was disabled for the most part from the pain.

    In May I started seeing a shrink who worked with Sarno for a long time. He recommended I see Dr. Rashbaum who took over Sarno’s clients at NYU.

    It’s been a lot of work but I’m 100% pain free. I believe the surgery is just a placebo. Chronic pain that doesn’t go away in a month or two is probably not structural.

  9. John on January 15, 2015 at 08:19

    I’ve been really interested in these back pain posts, and the various things that have worked for you. Been interesting timing too, cause I just started standing more again, along with being more active. Odd thing is, I started having very minor, but persistent, back pain when I started standing and being more active. Seemed to last a week or so, and it’s pretty much faded now. And overall, I am feeling better now than a month ago, before I made these changes.

    Another thing I wonder about is if ANY change would have an effect. For example, the only time in my life where I had serious, chronic back pain for a month or two, it cleared up as soon as I started using shoe inserts, and it seemed to be triggered by a job where I was forced to stand. And yet, your back pain this time was helped by going with more minimalist footwear, and standing more.

    I also wonder if, when people have back surgery and it seems to work, if it’s something other in the process that stops the pain. Like if you are forced to take six weeks off work and rest in bed during for recovery, for example, maybe THAT is what gets rid of the pain. It might even be that if someone mimicked the recovery process without actually doing surgery, it might be more effective, since you don’t have someone cutting into your spine and everything.

    • Richard Nikoley on January 15, 2015 at 09:01

      Yep, Matt and John both. I’ll cover this and more from my personal perspective in the next post on the topic, probably tomorrow.



    • David Lynn on January 15, 2015 at 14:04

      One key is the pattern interrupt. Sometimes, ANY thing you can to to change what the body is used to feeling, especially if it is foundational like foot positioning through orthotics, lifts, etc., will give the nervous system the change it needs to initiate it’s own self generation process.



  10. Greg Venning on January 22, 2015 at 13:16

    Hi all, from a practicing Chiropractor my experience (emphasised) is thus:

    Pain of many sorts is indeed a psycho-neuro-somatic thing, very complex and neurophysiologically closer to an emotion than a physical sensation.

    Nerve signals of pain from the body are knows as nociception in the body and lower parts of the nervous system before they are make it up to the conscious levels in the brain and become “pain.” Even when these pre-pain, nociceptive signals don’t become pain they can still set off our stress pathways and negatively affect our physiology and psychology in subtle but cumulative ways. you don’t have to feel pain to have a problem.

    Most nociceptive nerve signals don’t ever make it to the pain level and there are a few players in the game that decide what makes it up to the conscious floor and what doesn’t:

    State of mind – (i.e. current sum total of thoughts and emotions both conscious and unconscious) would be prime among them. This can also be read as lower centres of the brain – monkey, reptilian and Kim Kardashian – filtering information.

    Garbage In = Garbage Out – The degree of clarity of what’s really going on “out there” as David Lynn put it is incredibly important. The messages that come from the body to the brain are called afferent signals. If they come in loud and clear then brain has reasonably clear image of what’s going on and can respond appropriately with efferent signals to muscles and organs to tell us to run, digest or fart at appropriate times. If they are distorted or discombobulated then in any way then the brain reacts inappropriately or as David said “dis-coordinated integration” this is called dysafferentation. This is wonderfully described here: http://www.ncbi.nlm.nih.gov/pubmed/9608382

    For a great read for professionals and lay people on how this works the book Reality Check by Heidi Haavik is great. http://heidihaavik.com

    A lot of that ‘Degree of Clarity’ is dependant on the structural state of the rest of the body. In my experience the body can make subtle but significant structural compensations to shift pressure or tension from one area to another. Thought these shifts might reduce pain they usually result in worse mechanical function over time. This become evident as our posture suffers but we ‘feel ok’.

    So you can still have nociception, triggering all sorts of stress signals in the subcortical areas of the brain and lead to stress physiology without pain. This becomes a health problem, not a back/body problem.

    These shifts also work on the nervous system because as the body moves differently, it will send different messages to the brain and so might kick it out of it’s “pain creating” mode. That’s a mechanical form of pattern interrupt.

    Many forms of body work can address this structural thing on some people, some of the time and that’s why chiro, physio, osteo, orthotics etc all seem to work on some people some of the time. This might also explain why back surgery is effective some of the time. By putting someone under anaesthetic and forcing all the muscles to relax and then messing around with the structure you can inadvertently alter the structure enough to shift the tension/pressure just enough to relieve the pain. Problem is, you might not have addressed the dysafferentation or reprogrammed the brain. So while the pain might be gone then nociception and stress physiology is still there in a sub-threshold level.

    Movement, especially of the spine, sends signals called proprioception that can block the nociception at many levels in the nervous system from the spinal cord to the sub-cortical ares of the brain like the thalamus and the cerebellum. Movement, especially of the spine, is medicine.

    The heuristic or rule of thumb here is posture. It’s one of the best indicators of how all of this is working. Good posture = good movement = brain/body clarity. Posture is NOT about how YOU hold your BODY up. Posture IS about how the structure of your BODY holds YOU up.

    In a standing position, breathe in, breathe out and let your body relax. Really let your body relax. If your head slumps forward, your shoulders round your body folds or your pelvis sticks forward you have structural problems no matter how much or how little pain you feel. If health = optimum function and not just the absence of disease or infirmity then this fundamental component of body function needs to be addressed and corrected.

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