Physiotherapists, massage therapists, chiropractors and osteopaths all do it. They are taught to focus their work on a group of muscles or a joint or even section of the body like the back, spine or neck as the correct way to take away someone’s pain symptoms.
In reality treating the body as a sum of parts rather than as one integrated system doesn’t work and in this article I will try to explain why, using some simple logic.
What is Pain?Firstly let me clarify my definition of pain so you understand what I am talking about. Pain is an area of the body, usually a joint, which is affected by pressure to the point where any movement causes irritation and inflammation. It many cases it can also be set off by just weight bearing on that joint or area.
Pains come and go for everyone but chronic pain, which is the main focus of our discussion here, is defined as pain that persists, either continually or on and off, for six months or more.
An important concept you need to consider when it comes to pain, is that while in the sitting or standing position our muscle system is under load carrying the weight of gravity. That means our muscles are ‘working’ continually while we are upright.
Joint PainIf someone experiencing pain in an upright position suddenly had the weight of gravity lifted from them, there’s a good chance their pain would disappear, or at least reduce considerably, much the same as happens when you lie down and get relief.
So the downward force of gravity and its affect on the ‘whole’ body needs to be considered when treating pain.
Another consideration is that nearly all chronic occurs in a joint. It is always knee, ankle, shoulder, neck or hip pain. Or an issue with a joint along the spine being displaced or compressed affecting a disc or nerve.
Pain resulting from a muscle spasm happens, but typically a chronic ongoing condition settles in a joint.
So we are talking about chronic pain resulting from pressure that has built up in a joint over time, largely due to the load the body is under from gravity weighing it down when in the upright position.
Understanding PainTo understand more about why this pressure builds up in a joint let me use the analogy of a building.
In a building it is very important that the foundations are strong and level, in order to carry the weight of the structure above. We have all seen reports on TV of a buildings foundations that have shifted resulting in cracks in the wall and roof.
In reality the body is no different with our lower body being the foundation that supports the weight of our upper body and more importantly our spine. If that foundation is not strong and balanced, it causes pressure spots to develop in the spine or joints.
Over time, as the supporting muscles try to compensate for any imbalance in this foundation they tighten up. It is this muscle tightening that causes the pressure to build up until it eventually distorts the alignment of the joint, affecting its movement and causing irritation, inflammation and pain.
Weak FoundationsLet me explain how easy it is for the lower body or ‘foundation’ to become weakened or unbalanced.
The structure of our lower body is basically a pelvis sitting on two legs being held together by groups of muscles that work together to orchestrate our movement.
Unlike the house, the body has to move around, bend, twist and turn. So not only does this foundation need to be strong and balanced but it also has to be able to adjust to our movement and to all the positions we can get ourselves into - as well as counter balance the movement of the upper body – and then return to a balanced position.
This is a pretty big call because it only takes a muscle(s) in one leg to shorten up more than its equivalent in the other leg and the pelvis will be pulled out of that balanced position. This can happen as easily as from an injury, bad posture, fatigue, or even deterioration from an old injury many years earlier.
This distortion to the balanced position of the pelvis could cause the pressure to build up in the hip, along the spine or in the neck or shoulder, even the knee or ankle. But the problem muscle that is causing it all is nowhere near those joints where most therapists are taught to focus on and apply their treatment.
The Body as OneThe body is NOT a series of independently moving parts, rather the whole body moves as one. Everything is co-ordinated so that when one muscle switches on, another muscle relaxes.
It may be a muscle in the shoulder co-ordinating with a muscle in the opposite hip or the hamstring co-ordinating its movements with muscles in the back.
If muscles on one side of the body are dysfunctional, over tight or weak and therefore acting on the spine or pelvis differently to their counterparts on the other side, the whole structure will tilt, twist or sag.
It is this sagging, exaggerated by the weight of gravity, that builds pressure on a joint that with movement, eventually leads to inflammation and pain.
Taking this logic into account, it should be very obvious to you that working on any one area and not the whole body as one system will have a very limited effect on providing lasting relief from chronic pain.
It is therefore my conclusion that chronic pain is not difficult to fix for most people – provided you take a co-ordinated full body approach that balances the muscle system and removes the twisting, tilting or sagging from the structure.