A new vision of pain
The automatic response to pain is that we look for the source of the pain, where does it come from? In the case of an injury due to trauma, surgery or acute severe overload, this is usually clear quickly. There is tissue damage and you can see this, or if necessary, determine it with an X-ray, ultrasound or MRI. But with a lot of acute or chronic pain, there is no tissue damage at all and the imaging tests show nothing either. What now? Then it quickly falls under the cup"misunderstood or non-specific pain". Something that easily leads to a non-specific treatment or the advice to learn to live with it. A newer explanation for the pain is that it must be because the nervous system has become hypersensitive. And indeed, a hypersensitive nervous system regularly plays a role. But this does not explain why the pain is in one place but not in another. If the hypersensitive nervous system were the explanation, then it would have to hurt everywhere, right? In practice, however, this is never the case (no, not even with fibromyalgia).
Example:this lady has chronic pain in her right leg, the orthopedist has diagnosed severe cartilage damage in the knee. Extensive pain rehabilitation has shown no improvement. Walking without crutches is not possible. The advice is: learn to live with the pain and get a new knee when you're older. When I push on different spots it turns out that many spots are not sensitive but some are extremely painful. You cannot explain this very local pain with a hypersensitive nervous system. Nor is it due to the cartilage damage (I'm not pressing that). What's going on in the tissue? What is the source of the pain here?
We can only understand this if we start looking at pain in a whole new way. Pain not as a reaction to tissue damage but as a protector of the cell, life, the organism. Tissue damage is annoying but usually not life-threatening, it is more serious if the functioning and survival of the cell is threatened. We are, after all, a multicellular organism, a functional collaboration of cells. Like fish, cells can only survive in a slightly salty (read 'alkaline') humid environment. The fluid in which all cells in the body live is called the interstitial fluid or 'ground substance'. This fluid has the composition of a thin liquid gel, it is located in and around all our muscles, ligaments, bones, tendons and organs. Probably the biggest threat to the cells is acidification of this fluid in which they live. And let acidification be precisely what happens in the event of inflammation, a lack of oxygen supply (ischaemia) or overload. Three states that we often see in situations where pain occurs.
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Our body is full of nerves that constantly monitor the acidity of this gel (chemosensors). When the gel acidifies, three things happen:
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signals are sent to your emotional brain (insula) which gives you the impulse to start moving (e.g. if you have been sitting still on a hard chair for too long)
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the protective nerves (nocisensors) in that area become more sensitive, so that you are more likely to experience tension, stiffness or pain.
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the gel becomes viscous and stickier. Stiffness and movement restrictions can arise because the gel is the universal lubricating oil of the body. It no longer runs smoothly. The discharge of waste and inflammatory substances is also impeded, so that the situation can become chronic if there is not enough exercise..
Example:you have an injury, there is tissue damage, there is inflammation, the fluid acidifies, becomes viscous and sticky. If the tissue heals and you start moving as soon as you can move variedly, the gel will become liquid again and you will probably be able to move (pain) free again. But suppose you postpone that movement, for example because you are afraid to move, are in too much pain or are not allowed to move because of the healing of the tissue (e.g. in the case of a bone fracture). Then the gel can harden in such a way that it no longer becomes flexible with movement/practice. Moving more can even cause extra pain because movement restrictions and adhesions have arisen. Then the gel will first have to be liquefied again, something they call 'liquify the fascia'. This is the specific field of fascia therapy. We have developed techniques that allow you to quickly liquefy the gel again. As a result, the waste is properly disposed of, mobility increases and we often see a rapid decrease in pain, even if the complaints have existed for many years.
To understand and reduce pain we have to
Focus on Fluids!
It is now known that many people with demonstrable changes in bones, joints, cartilage and tendons, such as wear and tear, hernias, tendon tears, etc., have no pain at all. So it seems very much that it is not the bones, the muscles, the cartilage (or the brain) that are the source of pain, but the fluid that surrounds these structures, the fluid that is the environment of our cells. It really seems that we should no longer link pain to (or not) tissue damage, it is about something else. Now we can also understand that people experience a lot of pain while there is nothing to see in the photos. No, there's no tissue damage, but there's something going on, something that explains why you're in pain at that particular point. The tissue has acidified, the gel has become viscous, connective tissue layers have adhered, you experience stiffness, you experience pain. You could say that a lot of musculoskeletal pain is really a matter of a 'clogged drain'. The tissue cannot get rid of its waste products to the lymphatic system and the cells become stuffy and alarm signals are sent to the brain, which sounds the alarm "PAIN". (in English literature they call this Interstitial Lymphatic Stasis or ILS)
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Fortunately, this is often treatable. We really don't want to say that we can solve everything now, we are not (yet) that far. But we no longer have to link chronic pain to 'just learn to live with it'. Below is a snippet from the treatment of the lady's leg from the video above. Of course, the osteoarthritis has not diminished, but she is now pain-free and can function completely normally again (even mountain biking). We recorded the treatment and sent it to the orthopedist. Below you can see his response:
We are convinced that a lot of people walk around unnecessarily with pain.
The brain does not invent pain itself, the brain responds to the information (nocisensory) it receives from the body. How it responds to that information is highly variable and depends on many different factors. How sensitive the nervous system differs per person and per moment. For all pain (both acute and chronic) the following formula applies:
Pain = signals from the body x sensitivity of the nervous system
( = nociception)
By signals from the body we mean here: signals that the balance (homeostasis) is disturbed. This disturbance can be in the field of temperature, mechanical forces and/or chemical environment. There is no evidence whatsoever that there is pain in which the body is in complete balance and there is no nociception. Small disturbances of this balance occur throughout the day, but they usually do not lead to a sensation of pain (fortunately!). However, if you are very tired, you could always experience all kinds of pains, that is because fatigue makes the nervous system much more sensitive (more sensitive). For more on this click the button below.