Pain is a Progressive Disorder

In order for the body to optimally heal, people need to change. The health care providers need to change their thinking from providing “band-aid” approaches that actually worsen the degenerative process; and patients need to change their thinking to focus on what the body needs to heal itself. I summarize this point in what we call the Hauser Corollary: “If nothing changes, nothing changes.” If patients with injuries continue through the traditional cascade of treatments starting with RICE, then NSAIDs, graduating to steroid shots, and finally getting promoted to arthroscopies and ending up with knee, hip, or other joint replacements, then, yes, nothing will change!

We encourage you to take health matters into your own hands. Make decisions based on what is best for your body. If a treatment prescription does not make sense to you or does not seem to focus on healing, we encourage you to ask more questions. Do not receive treatments based solely on what your insurance company will cover or what the so-called “expert” health care provider tells you. Realize that there are other options available. You do not have to accept “surgery is your only option” or “you need a cortisone shot” or “take these anti-inflammatory medications, you’ll feel much better.”

The other part of the Hauser Corollary that is vitally important to optimal health and healing from injuries is related to the part that you play in taking responsibility for your own health, particularly as it relates to avoiding things in your life that could be hurting the healing process.

FACTORS AFFECTING HEALING

Generally, by the time people are seen at our Caring Medical office, they have seen 10 prior health care clinicians and often none of them have considered any of the potential causes as to why they don’t heal.

By definition, pain means something is weak or injured, assuming a musculoskeletal cause for the pain. Most people can tell the date and time when their pain started. “I was in a car accident…I fell down the stairs…I was playing a lot of golf when…” Most people with pain know what started the pain— they just want to find out how to end it!

TOP TEN REASONS WHY YOU DON’T HEAL

Nutrition: Deficiencies and eating the wrong food.
Hormone deficiency or imbalance.
Medications such as anti-inflammatories or narcotics.
Over-manipulation by self or a practitioner.
Inadequate Treatments
Sleep and inadequate rest.
Food sensitivities.
Chronic infection.
Melancholy temperament or negative attitude.
God’s will for your life and 7 deadly stresses.

Eating the wrong foods

Nutritional testing is recommended for those pain patients who are not healing properly. Sometimes the sole reason for inadequate healing is because the patient does not eat correctly. We recommend that the diet consist primarily of vegetables, proteins, and some complex carbohydrates, in the form of fresh foods, organic and non-processed as much as possible. Leave the white flour, chips, snacks, sugary foods, and sodas on the store shelves. Consuming too many simple carbohydrates is one of the primary reasons people are overweight. The joints and ligaments are strained when they have to carry so much more weight. Weight loss is, therefore, a part of curing chronic pain. You may not realize that one sugar load hampers immune function for four hours! So the person who consumes a soda every few hours is suppressing the immune system all day. This is the same immune system that heals your connective tissues. If you want to heal, cut out the sugar, and take control of your diet.

This can include a high-grade multi-vitamin in addition to specific herbs that help collagen growth and proteolytic enzymes for tissue recovery. While many herbal products and enzymes are referred to as “anti-inflammatory” in the media or even their own marketing materials, the mechanisms are actually more pro-healing. They tend to speed the body through reparative processes faster, but from clinical experience, we have seen that these are much different than taking NSAIDs.

Here are some articles on our website on specific food choices

Healing and immunity are driven by hormones

The engines driving your immune system are your hormones. Everything cannot be blamed on your chronic pain. The person who experiences thinning hair, loss of sex drive, decreased muscle tone, dry skin, menstrual cramping, irregular menses, chronic fatigue, decreased body temperature, and a feeling of coldness has a hormone deficiency until proven otherwise. Like everything else in our bodies, hormone levels need to be balanced. The “correct balance” can change, based on our gender and age, but everyone needs their hormones balanced in order for their bodies to function the way they were meant to function. When your hormones are off-balance, it is a sign that the body is not working correctly.

When the body does not function optimally, it cannot heal the way it is supposed to heal. For instance, having high estradiol levels can decrease the ability of the body to make fibroblasts, the cells needed to make connective tissue. This is a consideration for women who are on birth control, as it can hamper healing ability. Low hormone levels can most definitely alter your ability to heal, let alone make you feel sluggish and unhealthy. This should be addressed with natural hormone replacement therapy regimens.

Here are some articles on our website on hormonal disorders

Narcotic medication side effects on the immune system

In our article: How opioids can increase chronic pain

“not only are the patients non-compliant with the use of pharmacological pain relief, but their doctors themselves are confused as to how to medicate them.”

These are the side effects of painkillers:

Suppression of the cytotoxic activity of natural killer cells.
Enhanced growth of implanted tumors.
Depressed T-lymphocyte responsiveness to stimulation.
Ablate delayed hypersensitive skin response.
Spleen atrophy.
Thymus atrophy.
Decreased T-lymphocyte numbers.
Decreased T-cell function.
Inhibition of antibody production.
Inhibition of B-cell activity.
Decreased levels of interferon.
Increased incidence of infections.
Depressed function of all cells of the immune system.

Joint instability: the true diagnosis in most chronic pain discussions

Most chronic pain is a result of joint instability. Yet, most of the time this never enters the conversation between a patient and his/her pain management doctor who is only prescribing medication, exercise, or surgical referrals. Who wants to “manage” pain anyway? Trying to manage pain is like trying to find ways to drive on a precarious bridge. So, let’s talk about how joint instability happens and why it should be dealt with right away versus developing an unnecessary chronic problem that will only lead to a more difficult life.

Ligaments attach bone to bone and tendons attach muscle to bone. When a ligament or tendon becomes injured, it weakens and becomes lax. Then the other ligaments and tendons of the joint become lax as well due to overcompensation. Therefore, pain is a progressive disorder. When the ligaments and tendons become lax, the whole joint eventually becomes unstable causing destructive joint forces because the ligaments and tendons aren’t holding strong. If one area of the joint is injured, the adjacent joint can then become affected if the original injury is never properly dealt with.

Chronic pain will eventually progress to adjacent joints

Say a knee joint is unstable and the person continues to walk on it. Because of the force of body weight and the lax ligament(s), there becomes a slight rotational motion which then puts more pressure on the other joint components such as meniscus and cartilage. This is called destructive joint forces. As this goes on, cells start to die leading to arthritis or tears. As the knee joint becomes more and more unstable, the forces will begin to shift and now the femur or fibula starts to move too much eventually resulting in joint instability of the hip and/or ankle.

Think of a cabinet door with three hinges. The top hinge is the hip, the middle hinge is the knee, and the bottom hinge is the ankle. Say each of the hinges has three screws. If two of the screws (ligaments) are loose in the middle hinge and you continue to use the door, eventually the third screw and then the hinge will become loose. Now imagine that the middle hinge (knee joint) is completely loose and you still continue to use the door. The force is eventually going to go up and/or down the door, loosening the screws of the top hinge (hip) or bottom hinge (ankle). Eventually, as the door keeps getting moved, both hinges will become loose. Joints affect one another during movement. This is the kinetic chain.

Severe nerve pain and many other consequences of joint instability

After the short window in which ligaments can repair on their own after an injury (only a few weeks), there are limited mechanisms that the body has to protect a joint. It can inflame the joint, which leads to chronically swollen/stiff joints; it can recruit surrounding muscles to stabilize the joint, which leads to muscle fatigue, spasms, and tenderness; and it can overgrow bone, leading to bone spurs.

There are also many other painful manifestations of progressive joint instability. As the joint tissue becomes more damaged, swollen, and unstable, it will begin to pinch nerves and produce symptoms that refer to other areas of the body. A feeling of tingling or numbness or burning pain down a limb are good examples of this. The pain can generally be traced back to untreated ligament damage from the spine or nerve entrapment in the joint. Pain that comes and goes is a good sign that there is ligament damage causing joint instability. Once that ligament is repaired, the progression stops and the pain is eliminated!

The only treatment for ligaments is Prolotherapy

This is where ligament restoration is key to stopping pain from progressing into more advanced arthritic conditions or requiring joint replacement. Regenerative Injection Treatments such as H3 Prolotherapy, including the use of stem cells or PRP, is the only treatment available that is geared to stimulate your own body to repair and tighten ligaments. It is like sending back the full crew of workers to complete a job that was left undone. If the project is big enough, they may need to work for a few days, just like with Prolotherapy, the ligament repair happens over a few treatments. Prolotherapy is the ideal alternative to surgery for spine and joint pain, and can be used on nearly every joint.

Prolotherapy stimulates long-lasting repair, not just helps symptoms

Prolotherapy sends the signal to your body that the ligaments (screws) at the joint (hinge) need to be tightened (repaired). Just as pain is a progressive disorder, it can also be turned around! Once ligament repair begins, symptoms abate, including pain, swelling, muscle spasms, etc. The cartilage will have a chance to regrow as well.

In summary, you need to take chronic pain seriously. It can actually have tragic life-altering consequences. We see patients in our office every day who regret not receiving comprehensive treatment sooner because they became unable to work or care for themselves and their household without excruciating pain, or took so many pain medications that they are addicted. Receiving H3 Prolotherapy sooner rather than later can help prevent further degeneration and cartilage cell death. The looser a joint becomes the more likely an injury will occur to other joint components, such as the meniscus, cartilage, or labrum. Considering the kinetic chain, treating sooner rather than later can also prevent one inured area from becoming two injured areas. It is also easier to regenerate a mildly degenerated area compared to a severely degenerated area which should result in fewer visits and a quicker return to full activity happy and pain-free!