The biggest mistake any chronic pain sufferer can make is to try to make their pain go away. Very often, patients will see a chiropractor, osteopath, or TCM practitioner and expect their pain to go away. When their pain does go away upon treatment, they think the treatment works. This is when the problem starts.
Why do useless treatments seem to work?
There are many treatments that seem to work because they offer immediate relief. The problem with most of these “immediate relief” treatments is that your pain tend to come back. With this in mind, do you still consider them to be an effective treatment?
The easiest way to appreciate why you need feel better after useless treatments is to conceptualise pain from the pain gate theory perspective.
In the diagram above, you can follow the nocicptive (aka threatening) pathway with the green line. It will reach the spinal cord before finally going go the brain. The purple line represents a benign (aka non-threatening) pathway. What happens, according to the pain gate theory, is that the deep touch stimulus can down modulate the nocicptive stimulus, which eventually lead to lower pain perception in the brain.
To understand this, first consider that our spinal cord can only process a fixed amount of information at any given time aka a fixed bandwidth. There’s only so much information that can pass through the spinal cord, aka the “gate”, and when there is too much incoming information, the “gate” has to choose what information to let through.
When you hit your knee against something, you will immediately experience pain. You may then proceed to rub your knee and it starts to feel better. In reality, the tissue state of your knee remains as you rub it. The symptom alleviation you experienced strictly comes from a modulation of your pain experience that happens at your spinal cord and/or brain. In that sense, your spinal cord decided to let less “pain” through to the brain*.
So, when you go for a chiropractic adjustment or tik tar treatment, you may feel better because the “cracking” event provides your brain with a rush of stimulus. This rush of stimulus effectively works the same way as you rubbing your knee. You feel better because your pain perception has changed. This is why the results don’t last. The tissue state remains the same.
You may also notice that getting cracked or adjusted feels better than a massage. This is because a spinal adjustment provides your brain with a lot more stimulus than a massage. The greater the influx of information, the more relief you experience.
The problem? They results don’t last.
*This is not entirely accurate but will work for the purpose of this article.
Do you turn the music down when you are parking?
It is a well-observed phenomenon where drivers tend to turn the music volume down or stop talking when they are parking their car. This is also when we can also see the gate theory at play.
The reason this happens is because your brain can only process a fixed amount of information at any given them. To allow better focus on the parking task, most drivers intuitively turn down the music or stop talking when they are parking. This is especially obvious when driving overseas.
The problem with useless treatments
When we look at the methodology behind chiropractors in Singapore, they are often based on the need for recurrent treatments. This means you have to always keep coming back for chiropractic adjustments. This is also why chiropractors often maintenance packages. Even when you are entirely pain-free, you are still dependent on them to maintain your pain-freeness.
If you get good relief from a chiropractic adjustment, the only way you can use it for a long-term solution is if you keep going back for more spinal adjustments. Not only is this expensive, it also takes time.
Furthermore, as your condition deteriorate, you may find the treatments less and less effective (e.g., less relief with each treatment) or find yourself needing to go back for treatments more often (e.g., more frequent pain episodes). So, even if you are willing to spend the money and time, you may not always get the same relief.
What should I do for my chronic pain?
The best thing you can do for yourself is to revert to clinical guidelines on what is the best treatment. These are treatments that are found to be most effective, and is backed by scientific data. For chronic lower back pain, exercise, cognitive behavioural therapy, advice to stay active, and education for all first-line treatment.
The choice of therapy aside, you should always choose to work with a clinician that takes into consideration the psychosocial factors that may be at play. Psychosocial factors can include things like stress, work-life balance, having good social/familial support, etc.
Why exercise alone sometimes is not enough
Just this weekend, a middle-age guy came in to seek help for his back pain. During our consultation, we learned that he works six days per week and often for 16-hour work days with a two to three hours break in the middle of the day. On top of that, he also has other comorbidities (i.e., other lifestyle diseases). He is also experienced chronic fatigue, and doesn’t have time for leisure activities during the work week.
For cases such as himself, exercise-alone is not going to be a long-term pain solution. There are other aspects of health that we will also need to work on for him to achieve good long-term results.
In cases like this, pain management is not a case of working less hours. While that will definitely help him with his recovery, such broad strokes advice are often not realistic.
What we focus on is small changes that can be made to improve his current health. This can be as easy as working on having regular meals and having a healthy diet. It could also include strategies to reduce or to recover from burnout. This can be as simple as a self-directed mindfulness practice.
The best thing you can do for your recovery
Stop chasing pain relief! It’s a trap. Instead, take a more holistic approach to your health. There is no singular, universal treatment that will work for everyone.
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
WHO, 1946
Yes, statistically we know that exercise is most likely to help you. However, the success rate of exercise is still not 100%! This means, for best recovery outcomes, you need to look beyond a singular magic cure to a whole-person approach.
What are the areas in your lifestyle that you can start working on to complement your recovery? Health is not just about an absence of disease or pain. It transcends to having complete well-being!
To find out more about how we can help you help yourself find freedom from pain, drop us a message via the form below.
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Based in Singapore, Square One Active Recovery offers treatments with a very big difference. With our evidence-based exercise approach, you can achieve your recovery goals in just 12 weeks. Not getting results from your chiropractor, TCM doctor or physiotherapist? Talk to us and find out how we can take your recovery to the next level.
Our goal? To make our own services redundant to you.
*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.
