According to the CDC, 20.4% of the US adult population (about 50 million people) or 1 in 5 Americans suffer from chronic pain. And about 8% or 19.6 million Americans suffer from debilitating pain that interfere with activities of daily living.
Trigger points are often a cause of pain. They are very painful nodules within a muscle and connective tissue that develop because of trauma, injury, prolonged stress, reoccurring posture positions, etc. They often form when a muscle becomes overloaded or strained either by an acute injury such as car whiplash or other trauma, or by long-term chronic overuse or constriction.
After a trauma, the affected muscle contracts, and certain groups of fibers stay in a contracted, locked state and fail to relax. The trigger point becomes very painful and restricts body motion. When stimulated, the muscle is triggered into spasm, radiating pain often to another area of the body. Once a muscle forms a trigger point, the muscle is more likely to go into spasm again and again. The muscle becomes irritable, and even the slightest provocation can cause muscle spasm. For example, getting chilled from the air-conditioning after being outside in 90-degree temperature can cause the trigger to fire, setting off muscle spasms. Chronic overuse often occurs when the neck, or facial muscles are strained due to repeated postures or bad bite or clenching at night. Mental stress and emotions can also trigger spasms.
Comparison of muscle tissues, under a microscope, of normal tissue and trigger point muscle fibers shows a remarkable difference. It is almost as though the trigger point has a bit of scar tissue within it that remains.
Once a trigger forms, it remains in either an active or passive (latent) state. Active trigger points are painful and can refer to another part of the body when pressure is applied. Latent or passive trigger points are ‘‘ quiet’’ triggers that are not producing pain. But latent trigger points can become active with muscle overload, stress or cumulative injuries. Passive trigger points cause the muscle to shorten in length so motion restriction results.
Natural approach to pain reduction can be very beneficial. Many medications have a negative effect on the body, and can be especially hard on the kidneys and liver. According to the US Department of Agriculture, 66% of the US population are deficient in magnesium. Magnesium is involved in over 300 enzyme reactions in the body. It is a powerful mineral in helping to maintain a healthy body. It is especially beneficial for people who experience chronic pain. The mineral is nature’s muscle relaxant and it is vital for sleep.
One may also consider anti-inflammatories such as curcumin, ginger, boswellia and omega 3 fish oil. Boswellia is a powerful anti-inflammatory herb that is also commonly used in osteoarthritis, rheumatoid arthritis. And in contrast to NSAIDs, long term use does not lead to irritation or ulceration of the stomach. Curcumin and ginger are natural COX-2 inhibitors (an enzyme that contributes to pain, inflammation and fever). It is commonly used for tendonitis, bursitis, bruises, sprains, pain and inflamed joints in general.
There are also many adaptogenic herbs that help one manage stress such as passionflower, lemon balm, rhodiola and ashwagandha.
It is very important to reduce and manage stress. Some methods include exercising, journaling, and meditating. Exercise produces endorphins, the body’s morphine. Getting enough exercise plays a key role in pain management. A few studies have shown that how people think about their pain rather than the level of experienced pain can have a significant effect on whether they get enough physical activity or if they spend more time being sedentary. One study found that participants with knee osteoarthritis that experienced exaggerated feelings of helplessness or hopelessness about their pain were less likely to be physically active later in the day, contributing to a domino effect of sedentary behavior followed by even more perceived pain. Thought patterns like “the pain is terrible and is never going to get any better” or “I can’t stand the pain anymore” may lead some older adults to avoid exercise in an effort to also avoid pain. But if exercise is put off for too long, it can lead to spirals of depression and even worse pain. Many chronic pain patients avoid physical activities that they are actually capable of doing, however, staying physically active is one of the most important self-management strategies for chronic pain patients.
Dr. Horne and Dr. Chan are here to help you manage your pain and achieve optimal health at their clinic in Cranberry Township.