Japanese author, Haruki Murakami, once wrote that “pain is inevitable; suffering is optional.” This statement often reminds me of the individuals I meet at health fairs, who say that they have been in pain for years, and that nothing can be done. Often, they have tried some form of treatment (be it medication, physical therapy, chiropractic care, cortisone injections, etc.) with limited long-term change in symptoms. They may have been diagnosed (via x-ray or MRI) with arthritis, degenerative disc disease, disc herniations, or some other “hopeless” condition. However, research shows that there is a poor correlation between finding degenerative changes on imaging and actually having pain. In fact, one study found that a disc bulge was present in nearly 40 to 50 % of the test subjects, although none of the participants actually had a history of low back pain.
While some individuals will always experience pain, I often find that some level of relief can be achieved by stepping back and looking at the larger picture. The body, as a whole, is a very complex unit; to focus on the area of pain alone would be an injustice to the patient. To effectively treat an injury it is important to consider multiple factors, including ergonomic/postural stresses, lifestyle stresses, dietary inflammation, and other areas of the body causing compensations. A prime example of this is someone experiencing chronic knee and/or low back pain.
Based on their general shape, and function, the knees and lower back are designed to be stable structures in the body. These regions are surrounded by joints of higher mobility, including the hip, ankle, and thoracic spine (mid-back). If the hips, which interconnect the lower back and knees, are tight, then the range of motion lost there must be made up elsewhere. This motion is transferred to the joints, muscles, and ligaments of the knees and lumbar spine/pelvis (lower back), over-stressing the area. The additional stress leads to joint inflammation, muscle spasms/weakness, and an associated pain response. In fact, weakness around the hip can even increase your risk of repetitive ankle sprains/strains.
It is because of this interconnection, also known as the kinetic chain, that we perform a thorough history and orthopedic examination on all of our patients. Based on the outcome of the exam, a treatment plan is created to address all of the involved areas, and specific needs of each patient. Treatment may include chiropractic adjustments (to the spine and/or extremities (e.g. hip, knee, ankle, etc.…)), therapeutic modalities, exercise/stretching instruction, soft tissue work, lifestyle advice, and nutritional suggestions. Focusing solely on the painful area, when other structures are involved, is likely to still produce positive results. However, by treating the underlying issues, as well as the primary complaint, we are more likely to achieve long term relief.