If acid builds up in your tissues it sets off an alarm system. This alarm system is working all the time. For example, if you sit motionless, after a while it starts to hurt. Movement is important to keep your system flushed.
Lack of movement or a physical obstruction, like sitting on a rock, leads to a fluid build-up in your muscles and joints creating by products of cell activity, including acid. The acid build-up in muscles and other soft tissues activates sensors in your nervous system, which fires impulses through your nerves and up your spinal cord, which is the messaging motorway of the body. When they reach the brain, they cause the sensation of pain. If your brain concludes that your muscles are in danger and that you should do something about the problem, it will make them ache. The solution would be for you to move. Any kind of movement, particularly random movement, is best.
The thought of acid in our tissues should make us all get up. We are designed for movement.
Inflammation in the tissues is something else that causes us pain. Anything ending in ‘itis’ refers to inflammation, for example tonsillitis is the inflammation of the tonsils.
Inflammation is designed to create discomfort. Remember when you last sprained an ankle, experienced toothache or appendicitis? Inflammation is a primitive form of defence that is essential to the tissue repair process. Think of the swelling, redness and pain after an injury as part of your own internal repair system. Without it, you would not get better. Inflammation occurs because something has been injured or stressed to the point where chemicals are released, which set off inflammation. The body then sends in more blood to the area (hence the redness). The blood carries injury repair cells that begin to clear up and heal the area, which creates the swelling. Nerve sensors are sensitive to this and cause the pain. Inflammation makes the joints stiff in the morning and produces sharp pains, redness and warmth.
Joint pains are often described as grinding, stabbing, gnawing and aching. However, these words are our brain-derived interpretations based on the input from the joint, plus a whole lot of other inputs. Part of the reason we describe joints as grinding is because that makes sense mechanically.
An important factor related to joints and pain seems to be the speed at which joints are damaged – if the changes are slow, the brain probably concludes that there is no real danger. The pain of dislocation, inflammation and fracture is undeniable, but most people with worn joints never know about it.
Our bones and joints are not attractive when X-rayed, especially if you are a bit older. We all have worn joints, surfaces and little boney outgrowths! X-ray findings do not necessarily match pain. Changes are likely to be age-related.
Joints require movement and regular compression, which are essential for their health. Movement distributes a synovial fluid (lubricant), and cartilage requires the pumping compression to help with blood flow. The brain eagerly welcomes the sensory input of the joints, as it wants to know what is happening so it can construct the best responses for you (for instance it tells you to alter your balance or position).
Smashed bones can heal, sometimes stronger than before. The repair process is very powerful.
Some joints in your back or neck can get injured, for example in car accidents, but the injuries can be too small to see on X-rays and scans. Your brain may recognise the threat however and ring alarm bells, which may, or may not, result in pain.
Bones and joints are often blamed for deep movement-related pain. This may make people fearful of movement because they are afraid it will injure their joints. We have all grown up with the concept of pain ‘deep in the joint’ and ‘in the bones’. Many a patient has said “I need to get a bit of oil into my joints!”
In total, there are 206 bones in the body and many more joints. Bones are not normally brittle. They absorb pressures well and will adapt and change their shape in response to the body’s needs. Bones are living, healing structures. They are full of danger sensors and so are joints. Bones are covered in the very sensitive outer layer (called ‘periostium’), which acts as an extra protection system; no one likes getting kicked in the shins!
The outer layers of a disc have a nerve supply, so danger sensors can be activated if those layers are in any way in danger. If the disc is injured, the surrounding structures (which are also full of danger and sensor nerve endings) are probably affected as well.
An injured disc may not necessarily cause instant pain. A ‘slow pain’, perhaps eight to ten hours after the injury, may occur as the disc re-inflames. Frequently, a disc injury will result in pain and stiffness the day after it is injured.
It is natural for discs to degenerate. Degeneration is a normal part of the ageing of all tissues but it need not contribute to a painful experience. The discs are attached to the bones around it, and they stick and age together. At least 30% of people who have no lower back pain have discs bulging into their spinal canal, sometimes markedly. This fact has been known for many years but it is still not common knowledge among the general public.
Discs never slip. They age, bulge, sometimes herniate, and sometimes squeeze onto a nerve or release chemicals that irritate a nerve. Despite these dramatic sounding changes, this does not necessarily alarm the nervous system.
The word ‘disc’ is an unfortunate name for a remarkable structure that sits between the vertebrae. It is not, at any stage of life, actually anything like a disc! In anatomy and medical books they are usually drawn in shapes recognisable as a disc, but such drawings bear no resemblance to the real thing. Discs are firmly attached between adjacent vertebrae and are made of the same material as your ear, along with some super-strong ligament.
In 1934, a famous study showed that a disc could swell and impinge upon a nerve in the lumber spine. Since then, all sorts of therapies have been aimed at the disc. Current approaches include manual techniques of manipulation, surgical techniques that include removal or snipping pieces off, injecting or superheating/burning it. Practitioners of the various techniques may have reported some positive outcomes, but nothing has been overly successful for the actual treatment of the disc. The main objective of chiropractic treatment for a disc prolapse is to maintain as much normal function of the affected area as possible whilst symptoms persist. Avoiding movement is probably one of the worst things a sufferer can do.
Disc injuries attract alarming adjectives like ‘ruptured, grumbling, degenerated, herniated and slipped’. It is now widely accepted that most adults have disc degeneration in their spine that would previously have been described in this way, yet they have absolutely no symptoms whatsoever. Even quite marked degeneration of the disc is not always the source of the pain.
Muscles are given the blame for much of our pain, but we think these six key facts below about our muscles go a long way to putting muscle pain into perspective:
Muscles have many sensors in them, so they can easily be a significant part of a pain experience.
Muscles can become unhealthy and weak, especially if they are underused, static for long periods or used in ways to which they are not suited, such as being kept tight for long periods.
Muscles are actually quite hard to injure. They bruise a bit and sometimes receive ‘micro tears’, which are small injuries to the lining of muscles. However, it is difficult to injure a muscle severely. The pain may stem from a build-up of acid, which will make alarm bells ring. New exercises can sometimes trigger muscle soreness some hours later, particularly after eccentric movements where muscles contract as they lengthen.
Muscles have a great blood supply, so when they are injured, they heal quickly. After all, movement and protection are critical to our survival. If you have ever hurt your tongue, you will know how quickly it heals. Tongue is made of muscle; and let’s face it, eating and speaking are pretty important to our existence and survival!
Altered muscle activity is part of your response to injury and threat. Changes in muscle activity can occur in the short term to assist escape or to protect you; but in the long term there can be a cost.
Muscle activity is about making sense of the world and how to cope with it. In this way, muscles are windows to the brain. So if your muscles are working differently, or not functioning properly, you really must ask yourself why.