Pain as a Symptom


Pain is a very personal and subjective experience. It cannot be measured like weight, strength or length (quantity measures). The patient’s own descriptions such as,  whether the pain is sharp or dull, constant or on-and-off, or burning or aching often give the best clues to the cause of the pain. Other symptoms such as numbness, weakness, blurred vision, or dizziness also help determine the underlying condition.

Acute Pain

Acute Pain. When you cut your finger or pull a muscle, pain is your body’s way of telling you something is wrong. Once the injury heals, you stop hurting. This type of pain is known as acute pain and only lasts as long as the provocative irritant is present. Low back pain of this type has resolved within six weeks

Treatment – Acute Pain

Acute pain is a signal of tissue injury, when the tissue heals the pain is gone. Often the cause of pain is due to the bodies inflammatory response to injury – due to chemical changes in the body. Inflammation is actually the first step in healing process. Pain not only lets you know something is wrong  to prevent further damage, but brings into the area of injury important cells and substrates for healing to occur. Another form of acute pain arises when sensitive tissue with lots of nerve endings are irritated through pressure –  due to mechanical cause. A careful history and physical examination can determine the cause of the pain and appropriate treatment.

As we offer an alternative to medication, injections, and surgery our approach is to address inflammation in a natural way to ensure proper healing. Mechanical causes of acute pain respond best to mechanical treatments, ie manual therapy and prescription exercises

Acute Pain episodes on a chronic condition. Often described as a “flare-up” of an old problem. Probably the commonest form of neck and back pain. As we gain a better understanding of neck and back pain, a picture of a chronic condition with intermittent periods of flare-ups is emerging.  Similar to other chronic conditions like asthma where the goal is to manage the symptoms and prevent flare-ups. Management involves not only Chiropractic treatment but addressing lifestyle habits, eliminating the bad ones and doing the good ones. Between 60-80% of patients will have a recurrence within two years.

Treatment – Flare up of chronic condition

As with Acute pain the initial management involves treatment of the pain provoking mechanisms. However, it is even more important to determine the nature of the underlying chronic condition  and develop a treatment and spinal rehab program based around either correcting or controlling the underlying chronic condition.

Chronic Pain

Chronic pain is different. Your body keeps hurting weeks, months, or even years after the injury. Chronic pain is often defined as any pain lasting more than 12 weeks. Whereas acute pain is a normal sensation that alerts us to possible injury, chronic pain is very different. Chronic pain persists. Although only 7% of patients with low back pain go on to develop chronic pain, it is this group where most expenditure on care is spent.

Chronic pain may arise from an initial “acute injury”, such as a back sprain, or there may be an ongoing cause, such as illness. However, there may also be no clear cause. Other health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain. Chronic pain may limit a person’s movements, which can reduce flexibility, strength, and stamina. This difficulty in carrying out important and enjoyable activities can lead to disability and despair. When other aspects of health and well-being are impacted on the term “Chronic Pain Syndrome” has been used.

Whereas in acute pain where the degree of pain is predominantly directly related to the degree or severity of tissue injury, In chronic pain there is often a large discrepancy in the degree of tissue injury and severity of the pain experienced. Modern science has provided reasons behind this with the use of functional MRI studies. They have found changes within the brain that occur through a process known as neuroplasticity, the same process that is central to learning (repetition like learning the times table 2 x 2=4 etc) . However in the case of pain, the constant repetition of pain signals to the brain results in these pathways being stronger and easier to fire. There is also an expansion of the area within the brain that senses pain from a particular part of the body. These changes within the brain and nervous system are known as central changes. In addition, there also occurs a deconditioning effect with loss of strength, loss of mobility and flexibility and general fitness.

Since chronic pain may occur in a variety of locations in the body and for many different reasons, the  patient and the Chiropractor need to work together to identify the causes and symptoms of the pain and how it can be relieved.

Chronic pain can range from mild to severe. It can continue day after day or come and go.  Chronic pain can interfere with your daily life, keeping you from doing things you want and need to do. It can take a toll on your self-esteem and make you feel angry, depressed, anxious, and frustrated.

Because the development of Chronic pain has such a devastating affect on a persons life, the initial management of first time acute pain is so important.

Treatment – Chronic Pain

With chronic pain, the goal of treatment is to reduce pain and improve function, so the person can resume day-to-day activities. Whatever the treatment plan, it is important to remember that chronic pain usually cannot be cured, but it can be managed. New research suggests that the best self-management programs teach people different ways of thinking about and responding to pain, making their actions to relieve it more effective. That is why here at Spine Central our approach is getting the patient actively involved in managing their condition. Our approach provides an alternative to the traditional approach of medication, nerve blocks, and surgery.