Chronic Muscle Pain and Chiropractic Treatment

I’ve been getting a lot of patients lately complaining of  “non-specific” pain in various parts of the body.  One complains of pain around the shoulder blade ranging all the way down to the latissimus (lats) muscle along the ribcage.  Another complains of pain around the axilla (armpit).  Neither patient could clearly explain what caused it; only saying that the pain just appeared over time.

After 15 years seeing patients in my downtown San Francisco office I’ve been able to compare and contrast these types of cases.  What is the common denominator?  Does it affect males or females mostly?  What does the pain respond to?

To this day, the diagnosis of such types of presentations remain elusive.  These patients typically have ran the gamut of health care providers.  They’ve seen their primary care MD, orthopedic specialists; sometimes neurologists; had physical therapy, massage, chiropractic, acupuncture; over the counter anti-inflammatories like Ibuprofen; and prescription muscle relaxants.  Yet in most cases, the pain doesn’t completely go away.  What can it be?

Well, the most important thing to know is that despite the similarities, the origin of the pain differs from case to case.  Based on my clinical experience, here are the things that can cause “non-specific” muscle pain:

1.  Old injuries resurfacing.  I have a patient who used to snowboard.  He took a hard fall on his back over ten years ago.  It went away for a long time.  Now older, he is experiencing pain in the same area after standing too long.  You see, as we age, our connective tissue (ligaments, tendons, muscle) gradually lose their strength and allow an old joint injury to “come back to life” in the form of abnormal joint movement.

2.  Fibromyalgia.  This is a syndrome that many health professionals originally rejected, but now accept as a legitimate health condition.  The reason for the controversy is there are currently no diagnostic tests available to confirm fibromyalgia– it  is diagnosed based on how the patient describes her pain (widespread, constant, no apparent cause).  A person suffering from fibromyalgia will report extremely sensitive areas all over her body, like over the sternum, the side of her hips and legs, arms, etc.   Some studies attribute it to a virus; others suggest it is a metabolic disorder.  It is usually accompanied by another condition called chronic fatigue syndrome.

3.  Prescription Drug Side Effects.  Many types of prescription drugs cause muscle pain as a side effect.  You see, your muscles rely on a steady flow of electrolytes (calcium, sodium, potassium) in order to contract and relax properly.  Some drugs alter this electrolytic flow and cause muscle pain.  If you are on some type of prescription drug, try Googling (your drug name)(side effects) and see what comes up, or ask your doctor.

4.  RSD- Reflex Sympathetic Dystrophy.  Similar to the old injury resurfacing, but more serious.  RSD is basically neurogenic pain.  It is believed to be an over-reaction of the sympathetic nervous system following an injury– the nerve pain fails to “shut off”, and the RSD patient is plagued with pain long after the injury is healed.  For example, you can fracture your wrist, have the  bones heal, but be plagued with RSD pain.  It’s not clear why some people develop it, and others don’t.

5.  Psychosomatic.    This word, loosely translated means “mind affecting body”.  It is widely believed that psychological factors can play a role in the body’s pain levels.  The saying “it’s all in your head” originated from the diagnosis of psychosomatic disorders.

So, how can chiropractic help non-specific pain?  I would first determine which category the pain falls under.  If I think  it is a #5, I refer out to a professional in the mental health field.   A #4 would probably be referred to a pain management specialist for consultation and possible co-treatment (pain management specialists use drugs, injections,  and special surgical  implants to reduce pain).  I would still attempt to treat categories 1-4.

Chiropractic adjustments to various parts of the spine and extremities can do a number of beneficial things; such as increase the range of motion of a joint; break up adhesions (scar fibers that restrict movement), fire off nerves that help with posture, and improve circulation.

I employ phototherapy (therapeutic light) to the areas, which helps stimulate ATP production (cell energy units)  in the muscle cells.  This stimulates protein synthesis and cellular waste removal.   InterX Muscle stim can help block the pain, and also stimulate fibroblasts– the cells that repair damaged tissue.

Active Release Therapy is great for category #1 cases.  It’s a special, active form of massage that involves moving your limbs in a certain pattern as the therapist works on you.   And then there’s nutritional supplements.  I use supplements based on fibrinolytic constituents like bromelain and papain enzyme.  These are substances that can  safely dissolve scar tissue/ debris, and are known to help reduce non-specific muscle pain.  Although you can find them in your basic vitamin store, I use a proprietary, extra-strength blend, made only for health care providers.

So if you are suffering from muscle pain and you aren’t sure what is causing it, this information hopefully can provide you with some answers.

Dan Perez, DC

San Francisco Chiropractors

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