Pain always has a generator. The key is to find that generator and get it to heal.
There are only a few tissue types that commonly cause pain for most people. The first is muscle which heals easily within weeks since it has tremendous blood supply, even though we perceive and are constantly told we have “muscle pain”. Secondly bone, which very rarely causes pain unless fractured or inflicted with a cancerous process. Thirdly nerve, which when involved can not be ignored and produces a lightening like, burning electrical pain. The key to nerve pain is to figure out what is compressing or irritating the nerve itself and get it to heal or remove it. Actually the key is to prevent it from happening at all if possible, which brings us to its most common irritator, the ligament and/or disc. The ligament and/or tendon are by far most common tissues to cause of chronic (greater than a few weeks) or reoccurring pain.
Ligaments have very poor blood supply and heal slowly, if at all without help. Even with help you can only improve it so much due to its very limited regeneration rate. Luckily, with timely and quality physical medicine we can usually promote enough adequate healing to dramatically improve your quality of life.
We frequently use diagnostic imaging, manipulation, deep massage, specific exercises, nutrition, and hormone balancing. But by far the most impressive treatment is prolotherapy.
Prolo-therapy comes from the word “Prolo” which is short for proliferation. Proliferation means to increase new tissue growth. Prolotherapy is an injection therapy that has multiple uses by promoting healing of: chronic pain, disc injuries, ligament instability and/or ligament and tendon injuries. As discussed above this is by far the most common cause of chronic pain.
The key to changing chronic pain is finding the unhealthy tissue involved and addressing all the components contributing to it. This is an art in and of itself. Most frequently the process that underlies this chronic pain is “degeneration” which is also viewed as “aging”, even when trauma is the initiating step. Trauma is frequently the beginning of the cycle, but when occurred by ligamentous tissue, due to its poor blood supply and inadequate healing properties it becomes degenerative in nature. When a ligament is injured to the degree of instability this process is pushed even faster and further. This is important to recognize because treatment is very different. Though anti-inflammatory medication and strenuous exercise may be appropriate initially they absolutely perpetuate and feed the cycle later. Prolotherapy increases nutrients and growth factors which are critical in breaking the degenerative cycle.
Chronic pain and injuries are treatable in a meaningful way, and this usually does not, in our clinic, include chronic pain medication. We always assume “everyone has the ability to heal until proven otherwise” and we go to great effort to see that this happens.
