The topic of pain is obviously a very broad one, however we often get patients asking: “Just how can chiropractic treatment get rid of my pain?” Since this is the most common symptom our patients present with (whether it be neck or back pain, headache pain, knee pain, elbow pain, etc), here’s a quick explanation of how chiropractic treatment affects pain.
There are 2 ways that chiropractic treatment can reduce pain:
- Peripherally (ie. at the site of the injury or dysfunction, where the pain is generated)
- Centrally (ie. at the spinal cord and/or in the brain, where the pain is registered and modulated)
1. Peripheral effects on pain
The exact mechanism of pain reduction at the actual site of an injury depends on the type of injury that has taken place. Various chiropractic techniques, however, are known to create changes in joint and muscle function such as decreasing restrictions, releasing entrapped tissues, enhancing blood flow and lymphatic drainage to the area of concern, stretching tight muscles, increasing mobility and so on.
The exact treatment application is tailored for each patient and their condition, however the mechanical changes created by our treatment will decrease the generation of pain signals from that particular site.
2. Central effects on pain
It is here that our approach to the treatment of pain really has the greatest effect. All pain is registered and ‘felt’ in the brain. Even though you feel pain at various sites of your body, it’s only because a set of neurological connections are stimulating the specific part of the sensory cortex in the brain that corresponds to that area. If the function of the brain (and spinal cord) is altered, the perception of pain will also be altered.
You can probably relate to this – when you hit your thumb with a hammer, or jam your finger in a drawer, what’s the natural response? We naturally shake our hand or rub the area. When we shake our hand vigorously, we create a lot of movement and joint position change – this movement fires a whole lot of sensory signals called proprioception (joint position sense) back to the spinal cord and into the brain. Proprioceptive signals are stronger and faster than nociceptive (pain) signals, and so when we increase proprioception we actually inhibit pain. This ‘pain blocking’ reaction takes place in the spinal cord, so effectively the pain signals that are trying to get into the spinal cord to travel back up to the brain aren’t allowed in (or are at least diminished) and the brain doesn’t receive those painful signals.
When we perform a chiropractic adjustment (particularly a spinal adjustment), the large populations of proprioceptors embedded in the joints and muscles of that area fire off and enter the spinal cord. This increased proprioceptive firing into the spinal cord has the same effect as the example mentioned above (shaking your hand vigorously), only much greater. This bombardment of proprioceptive signals that occurs when we give a spinal adjustment blocks nociceptive (pain) signals and creates a strong pain killing effect, and almost immediately provides a significant decrease in pain levels from that area. It’s this understanding of pain inhibition at the spinal cord that sets chiropractic apart from many treatment modalities.
We often utilise adjustments to other parts of the body to create the same proprioceptive bombardment effect at the spinal cord – eg. adjusting the foot and increasing proprioceptive signals from this area can have a strong effect on lower back pain, as the proprioceptive signals from the foot enter the spinal cord around the same level as pain signals from the lower back region.
Furthermore, a proprioceptive bombardment provided by a chiropractic adjustment will stimulate certain parts of the brain. One of the jobs of the brain is to modulate and suppress pain. A tired, underactive and fatigued brain doesn’t do this very well (which, incidentally, is why most things hurt more when you’re tired and fatigued, often at the end of the day). Stimulating the brain in this way will help it to modulate and inhibit pain better.
The proprioceptive circuits that get switched on following an adjustment will naturally fatigue over time, and the pain signals will be allowed to slowly take over again. This is why we need to provide repeat treatments to continue to activate these circuits and keep them building up. It’s a bit like going to the gym, only each time we do an adjustment we’re building up the strength of your neurological circuits. Once they’re strong and self-sufficient, pain is usually much less of a concern than it used to be.
Regardless of the type of injury you have or the source of the pain, chiropractic has a unique ability to act upon the local site of the injury as well as the central pain regulating mechanisms.