STATINS ATTACK MUSCLES.......
AND LIGAMENTS, AND FASCIA, AND TENDONS, AND BONES....
Image by Aquapatmedia
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"To our knowledge, this is the first study... to show that statin use is associated with an increased likelihood of diagnoses of musculoskeletal conditions, arthropathies [arthritis], and injuries" Dr. Ishak Mansi from this month's issue of JAMA Internal Medicine.
It's not news that STATIN DRUGS
(Cholesterol Lowering Drugs) cause muscle pain. In fact muscle pain is their number one side effect. It is also important to understand that referring to what is going on simply as "muscle pain
" is missing the bigger picture. The 'trust us
' side-effect warnings for Statin Drugs refers to this muscle pain as Rhabdomyolysis ----- a problem that most people have never heard of. Let's take a minute and break it down into bite-sized chunks that are easy to understand.Rhabdo means striped, Myo means
muscle, and Lysis
means rupture. So, in a nutshell, Rhabdomyolysis infers that striped muscle (skeletal muscles --- i.e. biceps, triceps, quadriceps, gluteus, etc, etc) are actually breaking apart at the cellular level and releasing their contents into the extracellular fluid, which eventually makes their way to the blood stream. The chief breakdown product of Rhabdomyolysis is something called 'myoglobin'. Myoglobin is an oxygen-carrying protein in the muscle that is analogous to hemoglobin, an oxygen-carrying protein found in the blood.
SYMPTOMS OF RHABDOMYOLYSIS
How do you know whether or not you have Rhabdomyolysis? One of the classic findings is going to be dark or "Coke-colored
" urine. But it is usually found via blood test, long before the urine ever gets to that point. The main symptom is pain. Because muscle tissue is actually being broken and destroyed at the cellular level, people suffering with this problem are going to have muscle / joint pain, weakness, point tenderness, and even swelling of the affected muscles. This means that patients / doctors can easily be fooled as I have several times over the years.
Rhabdomyolysis can look just like artrhritis, a Rotator Cuff Problem, FIBROMYALGIA
, a knee problem, or any number of other painful conditions. This is why I always find out whether or not someone is on Statin Drugs (or for that matter, other drugs) before I do anything else. By the way, certain other things like HYPOTHYROIDISM
, AUTOIMMUNE CONDITIONS
, CERTAIN ANTIBIOTICS
, ANTI-DEPRESSION DRUGS
, and drug or alcohol abuse can all contribute to the development of this problem as well.
WE ALREADY KNEW ALL OF THIS
WHAT IS THE NEW EVIDENCE FOR STATINS
DESTROYING OTHER TISSUES AS WELL?
A study was published in this month's issue of JAMA Internal Medicine
(Statins and Musculoskeletal Conditions, Arthropathies
[Arthritis], and Injuries
) showing some extremly disturbing evidence. Dr. Ishak Mansi and his team of researchers, working out of the The North Texas Health Care System (Dallas' huge VA), showed that musculoskeletal adverse events and diseases are significantly higher
in those taking Statins than in those not taking Statins (study size was over 46,000 individuals looked at). The study concluded that, "Musculoskeletal conditions, arthropathies [Arthritis], injuries, and pain are more common among statin users than among similar nonusers.
" They went even further and clarified the term "muscluloskeletal conditions
". They include, "all musculoskeletal diseases, arthropathies [Arthritis] and related diseases, injury-related diseases (dislocation, sprain, strain) and drug-associated musculoskeletal pain
". Stop and think about this for a moment. Not only are injuries
to the MUSCLES
, and LIGAMENTS
significantly greater in those taking Statins, but so are the diseases
affecting these tissues (not to mention bones), as well as adverse side effects of a wide variety of drugs. Interestingly enough, the main reason that this study was done in the first place was to "prove" that Statin Drugs had anti-inflammatory powers that could actually help people with arthritis and musculoskeletal pain. Probably why one of the authors discolosed associations with
AstraZeneca, Bristol-Myers Squibb, Elan, Forest, Ortho-McNeil Janssen, and PFIZER
. It would be safe to say that these companies are now in full "Damage Control Mode".To learn more about CHOLESTEROL, just click on the link.
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WHAT DO SCARS AND SCABS HAVE IN COMMON?
MORE THAN YOU MIGHT THINK!
I get it. My artwork above is crude. But it is adequate to show you the difference between normal Connective Tissue and Scar Tissue. Everyone knows what a scab it. They're those 'crusty' wound coverings that act as nature's band aid, keeping the wound covered while preventing it from leaking fluids and the various components the body uses to repair itself. Eventually in the process, fibrous cells with muscle-like qualities, grip the edges of the scab and begin to contract. This causes the scab to shrink and eventually fall off. Pictured below is a scab on a knee that is in the process of 'contracting'. But what happens to the tissue underneath?
Photo by ALEF7
CHARACTERISTICS OF SCAR TISSUE
Collagen, the most abundant protein in your body, has waves in it. When tension is put on healing Connective Tissues, the waves allow it to stretch and elast. As far as the healing process of the tissue underneath the scab, the COLLAGEN FIBERS
are (or should be) aligned along these same lines of mechanical stress and tension. Hopefully, the Connective Tissue fibers of the end product look more like the picture on the top left than that of the top right.
When we end up with tissue that is more like the picture on the above right (Scar Tissue), there is potential for problems ---- big problems. This is because Scar Tissue (often referred to as "Fibrosis") has some very specific characteristics that are in direct opposition to those of normal tissue. In a nutshell, Scar Tissue is different from normal tissue because it is....
- WEAKER: Most pathology text books will tell you that Scar Tissue is at best, no more than 70% as strong as normal tissue, and in most cases, probably more like 60%. This means that Scar Tissue is much easier to re-injure. The re-injury subsequently heals with more Scar Tissue.
- LESS ELASTIC: This is a no-brainer. A second grader looking at the side-by-side pictures at the top of the page can see that Scar Tissue is less elastic than normal tissue. And be aware that during its healing process, Scar Tissue will 'shrink' ---- kind of like a scab. All of this can present a huge problem because even if the tissue itself is not painful, loss of (or abnormal) joint motion is the known cause of DEGENERATIVE ARTHRITIS --- often erroneously referred to as DJD. This is why restoring joint motion --- even in the absence of pain --- is such a big deal not only for helping you now, but as far as saving you a ton of grief down the road is concerned.
- MORE PAIN-SENSITIVE: Many people with Scar Tissue (whether seen or unseen) end up in CHRONIC PAIN because Scar Tissue is potentially far more pain-sensitive than normal tissue.
- LESS VASCULAR: Although Scar Tissue is living tissue with a blood supply, the blood supply is not as good or as organized as it is in normal tissue. This is particularly important to understand in the event that Scar Tissue forms in tissues that are poorly vascularized in the first place (SPINAL DISCS, LIGAMENTS, TENDONS, etc).
Scar Tissue is often created after SURGERIES
, CAR ACCIDENTS
, SPORTS INJURIES
, etc. But sometimes stuff just 'happens' and you never know why or when. A prime example of this is seen in Fascial Adhesions. If scarring gets into the FASCIA
, you can have a real problem on your hands. Fascia is the most pain-sensitive tissue in the body, yet does not image well with even our most advanced imaging techniques such as MRI. This sets people up for the PERFECT STORM
of Chronic Pain and dysfunction. Below you can see the progression of a surgical scar.
Photos by Kaspar1892
WHAT CAN I DO ABOUT SCAR TISSUE?
What can you really do about Scar Tissue? In a perfect world, you would simply prevent it. Unfortunately we do not live in a perfect world. So, once it is there, there are some things you can do to help deal with Scar Tissue such as avoiding INFLAMMATION
, eating a WHOLE FOOD-BASED DIET
intelligently, getting periodic CHIROPRACTIC ADJUSTMENTS
, COLD LASER THERAPY
, SPINAL DECOMPRESSION
, etc, etc, etc. However, nothing; and I do mean 'nothing
' works as well as SCAR TISSUE REMODELING
. Rather than me talk about how devastating Scar Tissue can be, I would rather let a couple of my patients speak. These videos were both shot yesterday and both cases involved the THORACOLUMBAR FASCIA
(click this link for 15 second videos showing the difference between Scar Tissue and normal tissue).
THORACOLUMBAR SPINE Image by Anatomography
The image on the left shows the diamond-shaped Thoracolumbar Fascia (arrow), with another image of a lumbar spine overlayed in red. I show you this because Mary has been coming to me for a long time with low back pain that was diagnosed via MRI as being caused by her Spinal Discs (disc-related pain).
The problem is that according to the latest scientific research, 50-70% of the adult American population is walking around with disc problems in their low backs that they are completely unaware of because they do not hurt (HERE). Think about this for a moment. The majority of us would show a HERNIATED DISC on MRI if we had one --- even if we have no pain. Not knowing this information sets people up for failure when it comes to SPINAL SURGERIES. It also means that it is always easy for a doctor to find some kind of abnormality on the MRI to blame your pain on.
As you can see from the picture below, Mary is fun to be around. She is sweet, gentle, and loves to laugh. For five years though, she has not felt like laughing due to severe chronic pain. That is until a couple of months ago when I was able to convince her that she needed to try our TISSUE REMODELING TREATMENT. She had brutal FASCIAL ADHESIONS of her THORACOLUMBAR FASCIA. Make absolutely sure you click on this link. It contains two 15 second videos of Thoracolumbar Fascia (one of a person with low back pain and one of a person with no low back pain). I'll stop and let Mary tell you the rest of her story. Thanks for the video Mary. We love you!
THORACOLUMBAR FASCIA VIDEO TESTIMONIAL
There is a diamond / triangular shaped area at the base of the spine (low back) called the Thoracolumbar Fascia
. This Fascia is impregnated and concurrent with at least three different muscle tendons, giving it three distinct layers. Although I did a post on this topic several months ago, I have revamped something important on it and included two short (15 second) videos that show how adhesions in the Thoracolumbar Fascia severely restrict joint motion. It is amazing for me to actually see
with my own eyes the model of pain and dysfunction that I have been promoting for years and years. HERE
is the link (I actually had these videos on my site previously, but could not get them to play). If nothing else, take 30 seconds to watch the videos. Amazing!
CHRONIC PAIN'S PERFECT STORM
LEAVES SUFFERERS SHIPWRECKED
is the tough, cellophane-like membrane that adheres tightly to muscles. One of the things that I have learned after years of treating patients is that if a person has Fascial Adhesions
(Fascia whose fibers are not lined up in a neat, orderly manner but are instead clumped in a tangled, matted wad), they will never hold adjustment. And not only will they likely end up with some sort of Chronic Pain issue, when they go to the doctor for examinations and tests, there will probably not be anything to see other than a run-of-the-mill DISC BULGE
or some DEGENERATIVE OSTEOARTHRITIS
--- common scapegoats for all sorts of CHRONIC PAIN SYNDROMES
. Problems with the Fascia can create a perfect storm of Chronic Pain because.......
- Fascia is arguably the single most pain-sensitive tissue in the body. When you couple this with the fact that it is also the most abundant Connective Tissue in the body (it's literally everywhere), you can see the potential for disaster.
- Fascial Adhesions will not show up on MRI. I realize that most of you believe that your pain is severe enough to make your MRI glow red. Unfortunately, Fascia is so thin that it will not show up excepting in certain places like possibly the PLANTAR FASCIA. What happens when your MRI comes back negative? You are likely to be labeled a hypochondriac, a drug seeker, or a person trying to get on Disability (unfortunately, there are lots of these today). Once the insurance money runs out, you will be discarded like a piece of trash.
- If you have areas of Fascial Adhesions (SCAR TISSUE), these have the potential for creating things like ALLODYNIA OR HYPERALGIA. In other words, Scar Tissue has the potential to be up to 1,000 times more pain-sensitive than normal tissue. Unfortunately, few doctors are aware of this.
RECIPE FOR DISASTER:Take these four items, put them in a pot, stir them all together
- Your doctor will likely not touch you / examine you ---- which is really the only way of determining whether or not Fascial Adhesions might be present. Yesterday I treated a physician who has been dealing with progressively worsening chronic BUTTOCK PAIN. One of his big complaints about his care (one that I hear regularly), is that when he went to pain specialists, neurologists, orthopedists, etc, they did not touch him, watch him walk, check Ranges of Motion, or look at anything else that might actually provide some valuable clues as to what the problem is. Instead, tests were ordered, he was charged incredible amounts of money for injections of BOTOX or CORTICOSTEROIDS, given some meds, and told to hit the bricks.
, throw in copious amounts of drugs that the doctors have prescribed, and you have a recipe for disaster --- the "Perfect Storm
" for perpetuating Chronic Pain. Maybe it's time to step outside the box and actually address the underlying cause(s) of your pain. I do not want to insinuate for even a moment that I help each and every person I see ---- but I help a lot of you. The cool thing is that you'll know in just one treatment if what I do is going to help
. Like I always say, talk is cheap but the PROOF IS IN THE PUDDING
WHAT IS A PULLED MUSCLE?
CAN A PULLED MUSCLE LEAD TO CHRONIC PAIN?
If you have ever played sports (or even if you haven't), there is almost a 100% chance that at some time in your life, you have pulled a muscle. The medical word for a pull is 'strain'. A popular online encyclopedia refers to Muscle Pulls / Strains thusly, "A strain is an injury to a muscle or tendon in which the muscle fibres tear as a result of overstretching. A strain is also known as a pulled muscle. The equivalent injury to a ligament is a sprain
." When the Muscle Pull is severe, the muscle belly and even its TENDON
can be injured. There may be bruising as the capillary beds that supply blood to the tissue are traumatically broken. Be aware that most of the time, pulled muscles, while they may be exquisitely painful, do not present with the bruising that indicates tearing of muscle belly itself. Most of the time, the tissue that is torn is Fascia.FASCIA is the cellophane-thin, yellowish-white, membranous tissue that
is attached tightly to the outside of the muscle. The fascia acts in a similar fashion to the way that your sub sandwich comes wrapped in cellopane or paper to keep it from all falling apart. Pay attention for a couple of interesting 'fun facts' that together can lead to Chronic Pain. Fascia cannot be imaged with even the most advanced technology such as MRI. When you add this to the fact that fascia is arguably the single most pain-sensitive tissue in the body, you can see a potential recipe for disaster. But let's take it a step further.
Normal Fascia is like well-combed hair. The fibers run parallel to each other, and provide both strength and
elasticity. Due to the repetitive injuries seen in sports, weightlifting, running, dancing, etc, people can end up with layer upon layer of injured tissue. This tissue is in no ways like the tissue around it. It has poor mobility, it has a diminished blood supply, it does not oxygenate well, it is usually acidic, and it can be up to 1,000 times more pain-sensitive than the tissue around it. And remember; it cannot be seen with either of the MRI's you have done. And while an intensive stretching and strengthening protocol sounds nice, you may very well be putting the cart in front of the horse (HERE
). Trying to stretch out and strengthen scar tissue without first breaking the scar / fibrosis / adhesion, is like trying to loosen a knotted rope by pulling on both ends as hard as you can. Can you see why so many people tell me their Therapy protocol made them worse?
INJURED AND ADHESED FASCIA
A REAL-LIFE EXAMPLE OF FASCIAL INJURY
AND SUBSEQUENT ADHESIONS
Let me give you an example of all of this in the arena of MVA
(Motor Vehicle Accidents). You are sitting at a stoplight minding your own business, when a 16 year old high school kid plows into you with his brand new Chevy Silverado. Of course he was going about 20 mph over the speed limit, and of course he was texting, so of course he never even touched his brakes. The result is torn tissue that does not show up on the X-ray or MRI they did at the Emergency Room. The ER doctor tells you to make an appointment with your regular doctor ASAP. They give you some pain pills and muscle relaxers, tell you that you'll be just fine because nothing is broken, and they send you home. But you're not fine. I saw a woman a few days ago whose story was much worse than the generic above. She was T-boned twice --- the first time about 15 years ago and the second time about ten years ago. She was not only struggling with neck pain and headaches, she was struggling to even move her neck. Instead of being able to turn her head and put her nose over her shoulder (90 degrees), she had about 5 degrees of rotational motion bilaterally. She had been to a chiropractor.After breaking her Fascial Adhesions, she was out of pain ---- immediately. The really neat thing, though, was the fact that her Range of Motion went from almost nothing, to about 60 degrees on one side and about 50 degrees on the other ---- even before I adjusted her. I am confident that three or four more treatments will return her neck to its proper alignment and motion.
The problem is that 10 years of diminished mobility and abnormal function have left her with a case of DEGENERATIVE ARTHRITIS
TUBES WITHIN TUBES ASPECT OF MUSCLE TISSUE
In the picture below (I thought that it was too cool not to include), I want you to notice a couple of things. Firstly, notice how complex muscle tissue is. Secondly, take a look at the "Tubes Within Tubes" nature of muscle tissue (another good example is HERE
). The thing I really want you to grasp from this is that each individual tube is covered with its own layer of Fascia.
Photo from http://commons.wikimedia.org/wiki/File:Skeletal_muscle.jpg
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CHRONIC LOW BACK PAIN AND
(THE TOP TEN WAYS TO LICK CHRONIC LOW BACK PAIN)
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The Thoracolumbar Fascia is the tough Connective Tissue found in the small of the back. It's three layers get progressively thicker as you move from front to back. This tissue houses several important muscle / tendons, including the Quadratus Lumborum on the left, and the Spinal Errectors / Multifidus on the right.
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Image by Anatomist90
These are both pictures of the Thoracolumbar Fascia, which is actually a conglomerate of several muscle tendons. The drawing on the left is from the famous medical textbook, Gray's Anatomy. The diamond-shaped Fascia near the bottom is the Thoracolumbar Fascia. The picture above is a photograph instead of a drawing.
TECHNICAL VIDEO ON THE
The Thoracolumbar area is extremely important as far as biomechanics and your ability to move are concerned. This is because of its unique ability to act as a 'transfer case' or 'axle differential' and shift loads and forces from the lower extremities to the upper extremities. As you might imagine, this is critical to understand if you want to successfully deal with healing the tissue damage caused by SPORTS INJURIES, work-related injuries, repetitive injuries, injuries due to MVA's, or if you are simply wanting to improve your golf game.
This is also why lower body strength is so critical for upper body strength, and should never be neglected --- particularly if you are an athlete.
Think of the Thoracolumbar Fascia as the centerpiece of an anatomical "corset". This corset is actually made up of several corsets that are usually referred to as slings. Some of the various names of these slings include the Posterior Longitudinal Sling (pictured at right), the Anterior Oblique Sling, and the Posterior Oblique Sling. These 'slings' relate to something called "Force Closure". Force Closure pertains to the muscle's ability to compress two joint surfaces together via their ligamentous, tendinous, and fascial attachments. Although balance must be maintained, an oversimplified rule of thumb is that the stronger you can make the muscles surrounding any given joint, the better they hold the joint together, and the more stability it will have.
Biomechanical studies of the spine have taught us that mechanical loads are transferred from the hips, pelvis, and low back, across the Thoracolumbar Fascia, to the upper back, shoulders, and arms, in an "X" shaped fashion (again, see the picture above). For instance, motions that involve twisting or rotating the trunk would transfer force up the right hamstring / gluteal muscles to the opposite side latissimus dorsi / trapezius (or visea versa). If you picture this occurring, the Thoracolumbar Fascia would be at the center of the X. Here are some pictures to better help you visualize some of the muscles involved.
MUSCLES THAT ATTACH TO THE THORACOLUMBAR FASCIA
GLUTE / HAMSTRINGS
MORE ON THE THORACOLUMBAR FASCIA
Once you begin to understand the way that loads and forces are transferred through the lumbar spine (lower back), you can start to see why local pain found in a wide range of areas (low back, buttock / piriformis, sacroiliac joint, hamstring, trap etc) may very well be due to problems in the Thoracolumbar Fascia. Because the Thoracolumbar Fascia is the center of the X, and virtually all
trunk motion must be transferred through it, an injury to this particular tissue can prove to be catastrophic on many levels. Like many other injuries, the three chief components of Thoracolumbar injury are pain, loss of strength / motion, and subsequent degeneration. Let's tackle them one at a time. But before we do that, I want to talk just a moment about Fascia in general.Fascia is the tough, yellowish-clear membrane that is found underneath the skin, and tightly covers muscles. A fun-fact that most practitioners are unaware of is that Fascia has the ability to contract (slightly) similarly to muscle.
Fascia can be responsible for all sorts of PAIN SYNDROMES
, even though it cannot normally be seen with an MRI (excepting certain cases such as the PLANTAR FASCIA
, or maybe at times the Thoracolumbar Fascia). A 2009 study from the medical journal Spine
shed some additional light on this specific topic. After trying to determine if problems of the Thoracolumbar Fascia could be seen using MRI, researchers at Philadelphia's Rothman Institute at Thomas Jefferson University Hospital concluded that, "The sensitivity and specificity of MRI for diagnosing injury of the PLC [Thoracolumbar Fasica] are lower than previously reported in the literature. The integrity of the PLC [Thoracolumbar Fascia] as determined by MRI should not be used in isolation to determine treatment.
" In other words, you might see it, but the image is not good enough to be considered 'diagnostic'.Stop and think about the gravity of this situation for a moment. The single most pain-sensitive tissue in your body is poorly imaged with current MRI technology. Furthermore, Scar Tissue in this area is a recipe for disaster anyway because it can become hyper-sensitized to the point that some researchers say it is up to 1,000 times more painful than normal tissue (HERE). To better understand what I am talking about when I talk about scar tissue or fibrosis in the Thoracolumbar Fascia, you need to take a couple of minutes and read this piece on FASCIAL ADHESIONS.
Now that you have an improved understanding of Fascia in general, we can cover the three chief components of injuries to the Thoracolumbar Fascia.
- PAIN: As many of you have discovered, low back pain, buttock pain (PIRIFORMIS SYNDROME), and SACROILIAC JOINT PAIN do not always respond to repeated Chiropractic Adjustments. Don't get me wrong; Chiropractic Adjustments are going to rapidly help many if not most people struggling with pain in these areas. But if there is one thing that I have learned over the past two decades of practice, it is that if it is present, you had better deal with any underlying scar tissue of the Fascia if you want any sort of chance at achieving long-lasting pain relief. It is also important to understand that the Thoracolumbar Fascia is continuous with the CERVICAL (NECK) FASICA, which is continuous with SKULL FASCIA. In other words, it's all attached to each other into a continuous sheath. This means that problems in one area of the body have the potential to cause pain in distant areas of the body --- one of several reasons that the most well known whiplash researchers on the planet stated almost two decades ago that the injuries seen in whiplash accidents are likely to, "cause bizarre and seemingly unrelated symptoms". HEADACHES are just one of many common results of injury to the Thoracolumbar Fascia (you'll see why momentarily).
- LOSS OF FUNCTION: As you will see in a moment, loss of motion / function (Functio Leasa --- the fifth component of Inflammation) is a huge component of a Fascial Injury and the subsequent Scar Tissue and Fibrosis that forms as a result. It also goes hand in hand with loss of strength. Both of these lead to that vicious cycle of pain and re-injury, which in turn, leads us to our next bullet point. In the video clips below, I want you to take note of the results of a study that was published just over a year ago. NIH's National Center for Complementary and Alternative Medicine funded this study that was published in BMC Musculoskeletal Disorders in 2011. The 15 second video clips are Diagnostic Ultrasounds of Thoracolumbar Fascia --- healthy (no low back pain) -vs- injured (low back pain). The difference is almost shocking. It is refreshing to see that the model I have been describing to patients for the better part of the past decade and a half is absolutely accurate. It is also no wonder that Fascial Adhesions as seen in the video on the right can cause Chronic Pain.
NO LOW BACK PAIN
LOW BACK PAIN
Langevin H, Fox J, Koptiuch C, Badger G, Greenan- Naumann A, Bouffard N, Konofagou E, Lee W, Triano J, Henry S (2011). "Reduced Thoracolumbar Fascia Shear Strain in Human Chronic Low Back Pain". BMC Musculoskeletal Disorders.
- DEGENERATION: The end product of loss of normal joint function (strength and motion) is degeneration. Yes, it's true. If we live long enough, this becomes part of the normal aging process. However, because bony degeneration is so easily imaged with X-rays, MRI's, or CT, it is a convenient scape goat for pain --- whatever kind of pain you may be having. In other words, it is easy to blame pain on SPINAL DEGENERATION when the reality is that according to study after study, it probably has little or nothing to do with your pain (HERE). To really understand Spinal Degeneration, you have to have a cursory understanding of the neurological component of this whole process ---- MECHANORECEPTION / PROPRIOCEPTION. One more important fact to remember while we are on this topic. Not only do the bones, discs, and cartilages in the area of a restricted Thoracolumbar Fascia degenerate, the Fascia itself degenerates. This is easy to understand when you realize that the Thoracolumbar Fascia is really an APONEUROSIS that is made up of several muscle tendons. In other words, the degeneration of the Thoracolumbar Fascia might almost be better understood in terms of TENDINOSIS rather than Fascial Adhesion.
TOP TEN WAYS TO EFFECTIVELY DEAL WITH CHRONIC LOW BACK PAIN
As always, do not start an exercise program or diet without first getting the express written consent of you Medical Doctor
The truth is, almost anyone, no matter what you have been through, or what you are currently going through, can help improve the health and biomechanical integrity of their spine. It is not only a matter of know-how
, it is a matter of want-to
. The truth is, it can be tough --- at least at first --- to do what it takes to heal your back. This is because to truly heal your back, you have to address your entire body. It's not just a matter of doing the 'magic' exercises, stretches, and therapy, while continuing to live a self-destructive lifestyle.
- LOSE THE WEIGHT: If you are struggling with low back pain, but are not willing to do what it takes to get rid of excess weight (especially belly fat, which puts additional torque on the low back), you will likely fail. I cannot tell you you how many patients tell me that if they gain just 10 extra pounds, their back hurts. The best ways to lose weight is found HERE. By the way, I already know what you are thinking. You want me to know that you cannot lose the weight because the pain keeps you from exercising. This is nothing more than an excuse. Read the link above. Weight loss is about 80-90% diet, which means it is only 10-20% exercise. If you follow my advice, you can accomplish weight loss without exercise. Be aware though, that losing weight will mean an increased emphasis on Gut Health.
- HEAL YOUR GUT: Because virtually all health problems have a UNIVERSAL CAUSE, it would be in your best interest to learn about it and understand it. GUT HEALTH is critical for overall health, whether we are talking about your back, your THYROID, or your, ADRENAL GLANDS, or anything else.
- CONTROL INFLAMMATION: The first thing you have to understand is that INFLAMMATION is probably not what you think it is (swelling). HERE is great information on eating an Anti-inflammatory Diet. HERE is the link to highly Anti-inflammatory Pharmaceutical Grade Fish Oil. Oh; and if you are not drinking enough water, there is no way you are going to heal your back. Drink lots of water, and only water. This will help with many things, including decreasing inflammation. And if you are still smoking; stop! Smoking is not only highly Inflammatory, it literally starves every cell in your body for OXYGEN.
- CONTROL YOUR BLOOD SUGAR: How many health problems are being tied back to UNCONTROLLED BLOOD SUGAR? Just about all of them. If you fail to understand this point (even if your blood sugar is 'normal'), your ability to heal your spine will be severely hampered.
- MAKE SURE THERE IS NO SCAR TISSUE PRESENT: No need for expensive diagnostic testing as far as this is concerned. It is crucial to understand that the things mentioned in the previous bullet point will not work if the Thoracolumbar Fascia is ADHEASED, SCARRED, OR FIBROSED. If you are having Chronic Low Back Pain, make sure you try a couple of TISSUE REMODELING TREATMENTS! Re-watch the two videos above if you need to understand this concept better,
- WATCH YOUR POSTURE: Posture used to be a big deal. It used to be taught in school. Now it is all but ignored. Posture is not difficult, but you'll have to strengthen your core (more to come on this shortly).
- DO NOT SIT TOO MUCH: When you sit down, you take the load off your feet and put it on your spine --- most particularly your low back. In fact, sitting puts four times the amount of mechanical pressure / stress on your back as does standing. If you have a desk job, you may want to consider a stand up desk of some sort.
- MAKE SURE TO MOVE EARLY AND OFTEN: Walk, swim, bike, get on an elliptical. I don't really care what you do, just move. We discussed earlier how loss of joint motion creates all sorts of problems in the low back. Do not neglect adding a STRENGTH PROTOCOL to your program.
- STRENGTHEN YOUR SPINE AS WELL AS YOUR ENTIRE BODY: I would suggest a regimen of CORE STRENGTHENING TECHNIQUES to start with. Talk to me before proceeding from there.
- GET AN INVERSION TABLE: This helps a lot of people struggling with low back pain. HERE is a blog post on the topic.
- TRY SPINAL DECOMPRESSION THERAPY: There is great evidence that SPINAL DECOMPRESSION THERAPY can help about 70% of you who are struggling with severe back issues such as Disc Problems, Spinal Stenosis, Facet Syndrome, or Spinal Degeneration. Be aware that it will most likely require Scar Tissue Mobilization to effectively deal with the Thoracolumbar Fascia. The cool thing is that our Spinal Decompression Therapy protocols are ALL-INCLUSIVE.
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SCAR TISSUE REMODELING
What have I always said about our TISSUE REMODELING
? I tell patients that if you are going to see positive changes, you'll see them after just one treatment. This is true no matter how long you may have had the problem (HERE
). I never really know how many treatments it will take to resolve one of the numerous PAIN SYNDROMES
we deal with daily, but let me reiterate; we will know after just one treatment whether or not we are on the target with our treatment
. If a person sees significant change after their first visit, but but additional treatment is required because the problem has not totally resolved, the patient will go through a situation that I have coined, "Bullseying
". Bullseying is the process of me getting on target, narrowing down our focus, and finding the very specific root cause of your problem.If you have ever sighted in a rifle, you know exactly what I am talking about.
You look through your scope, take a shot, and then walk downrange to look to see if it hit the target --- and if so, where. You then adjust your scope your accordingly. My 14 year old son is particularly good at this (the proof is a freezer full of deer meat). Sometimes the rifle does not take much sighting. Sometimes it takes a fair bit. You never know for sure until you put some lead downrange and then go check your target.When I break the FASCIAL ADHESIONS that cause of so many cases of PIRIFORMIS SYNDROME, CHRONIC NECK PAIN / HEADACHES, BURSITIS, and other common health problems, we will typically see the problem focalize (narrow down to a Bullseye) as it improves. A perfect example of this is a person I treated yesterday that we'll call "Joe". About six years ago, Joe went through a botched hip replacement surgery. He then suffered through three more surgeries as doctors attempted to repair their original screw up. An active vibrant man; Joe soon found himself unable to do very much of anything without going through excruciating pain. As is the case of many people that I treat, it was ruining his life. I was the 20th (twentieth) doctor that Joe had seen in an attempt to find someone to help him with his problem. The cool thing is that "Joe" is dramatically better. But the thing that amazed me about his problem was the way that it so dramatically "Bullseyed". Although at his initial visit he had tremendous amounts of scar tissue on and around his SURGICAL SCAR, most of that was gone yesterday. What I found instead was a small "Bullseye" of restrictive adhesion accumulated around his FLEXOR TENDON. We worked this area and BAM! An instant and total relief of his pain. Joe; if you're reading this, I sincerely hope that your pain never returns!
CHRONIC NECK PAIN
THEIR RELATIONSHIP TO SCAR TISSUE
According to scientific studies done by both the government and private sector, between a quarter and a third of the adult American population suffer with regular severe neck pain and / or headaches. If you have never had chronic pain, you cannot fathom what it can do to you. It drains the energy and life right out of those struggling with it, and becomes the predominant thought in one's mind ---- what can I do to relieve my pain
? Far too often the medical community, instead of attempting to get to the source of this chronic pain, prescribes drugs ---- lots of drugs. Although there are many different and varying causes of chronic neck pain and headache, they often have a common origin --- biomechanical dysfunction of the neck.
Fortunately, many of these common biomechanical issues can be effectively dealt with. Chiropractors have understood the importance of proper biomechanical function for well over a century (the profession of "Chiropractic
" began in 1895 even though manipulation has been around for thousands of years). Incredible numbers of cases of individuals struggling with chronic or acute neck pain, and headaches have been resolved by chiropractors. But what about those who do not resolve so easily.I frequently run into a class of patients who
have chronic neck pain and / or headaches that is resolved by chiropractic adjustments. But the adjustments never seem to hold for more than a few days before the symptoms return. No matter how many adjustments these patients receive, their symptoms always seem to return. And one of the biggest problems we find in individuals who never really understand the importance of having underlying biomechanical dysfunctions corrected, is degeneration. The known cause of DEGENERATIVE ARTHRITIS in any joint is abnormal motion / function of that joint over time. Although doctors love to tell patients that they have "arthritis" because they just aren't as young as they used to be, or better yet, they have DJD (Degenerative Joint Disease); the truth is often times much less complicated.
Fascial Adhesion could very well be at the root of your pain and dysfunction!If you have FASCIAL ADHESIONS in your neck, upper back, or even your SKULL, there is a high probability that it is a big part of your pain. I know, I know, I know. You want to know why if these "Fascial Adhesions are so stinkin bad, why haven't you heard about them before. Why hasn't your doctor talked about them with you. It's really quite simple. The vast majority of Fascial Adhesions and Scar Tissue will not show up on any tests ---- even the most advanced imaging tests such as MRI. For more information on this topic, please read our FASCIAL ADHESION PAGE, our HEADACHES PAGE, and our CHRONIC NECK PAIN PAGE. In fact, you may be interested in just how many different health problems that Tissue Remodeling can help with (HERE). And in case you think that this is just a bunch of hot air, I want you to take one minute and let Bonita tell you about being virtually "cured" of Chronic Migraine Headaches after just a single treatment with our SCAR TISSUE REMODELING. Just check out www.DestroyMigraineHeadaches.com to see her amazing story of 70 years of daily Migraine Headaches essentially cured in one treatment.
Fascia is one of the most prevalent Connective Tissues in the human body. You hunters out there know it as "striffin" or "silver skin". I was recently explaining to a gentleman what fascia was, and how I believed it was the culprit behind his chronic hip pain. As I showed him a picture, I could see the light come on as he exclaimed, "Oh; that's the stuff that's hell on a meat grinder". Yeah; fascia is that tough!
Notice the Fascia as Judy Field-Dresses her Elk
Photo of Judy Eastman Field Dressing an Elk, Courtesy of Greg Eastman
Fascia is a unique tissue in that it is both incredibly elastic as well as being incredibly strong / tough. It is a tissue that is able to resist great amounts of tension and still retain its elasticity. But what happens when the Fascia is over-stretched and injured / torn?
The truth is that it can and often does create a Perfect Storm
of Chronic Pain. According to Wikipedia, a "Perfect Storm
" is a confluence of events that drastically aggravates a situation. In other words, it is a whole host of things that happen at the same time, or one right after the other, to create a disaster. Far too many of you reading this post know exactly what I am talking about!I just got an email this morning from an individual who had a joint replacement that failed to heal properly. Every subsequent medical "fix" failed to work as well. The result? Chronic Pain caused by massive amounts of Scar Tissue. But this begs the question as to why Fascia is the perfect tissue for creating Chronic Pain's Perfect Storm. Here are some of the main reasons that Fascia is the tissue in the body that seems to cause Chronic Pain that tends to stump so much of the medical profession so often.
- Fascia is Arguably the most Pain-Sensitive Tissue in the Body ----- In and of itself, this is a huge deal. But a Perfect Storm is brewing on the horizon when you couple this with the fact that..........
- Fascia Cannot be Imaged with even the Most Advanced Imaging Techniques, Including MRI ----- Contrary to what you might hear from your doctor, most fascia (other than the thick TENDON-LIKE fascia of the PLANTAR FASCIA) will not show up on diagnostic imaging. People are led to believe that even though X-rays will not show scar tissue, MRI will show anything and everything that is wrong with you. Those of you who have dealt with Soft Tissue-Based Chronic Pain Syndromes (HERE) know that this is simply not true. It's a huge myth (HERE). And furthermore...........
- Scar Tissue in and of itself it up to One Thousand Times more Pain Sensitive than Normal Tissue ----- This is the final straw. We take a tissue that cannot be seen with even the most Advanced Diagnostic Imaging technologies, yet is the most pain-sensitive tissue in the body; and now injure it causing microscopic adhesion and Scar Tissue. This scar tissue is incredibly pain sensitive ---- up to 1,000 times more pain sensitive than normal tissue (HERE).
- Too many doctors do not really understand the problems they are dealing with, or stay current with the most up-to-date scientific research ----- I am not trying to nitpick here. Correctly diagnosing a person's problem is not always easy. In fact, sometimes it can be all but impossible. And it takes a significant amount of time to stay up on what the latest medical research is saying. But when common problems such as PIRIFORMIS SYNDROME or TENDINOSIS are either completely misunderstood, or all but totally ignored; rest assured that effective treatment cannot be rendered.
WHAT DO THESE SORTS OF THINGS LEAD TO DURING YOUR DOCTOR VISIT?
The following is a medical "grab bag" of flimsy excuses and absurd explanations that those of you experiencing the Perfect Storm understand all too well.
- Deer-in-the-headlights looks, and "made up" explanations: When the cause of your complaint is a Connective Tissue-Based problem, you will garner all sorts of odd responses from the medical profession. I have heard an array of "made up" answers that would be comical if the situation weren't so downright desperate. Or you may just get that blank look like you were an alien from the planet Neptune. Both are common. So is throwing it in that bucket labeled "FIBROMYALGIA" and moving on to the next patient.
- Your doctor blaming your problem on your age, or on arthritis: "After all Mr. Jones; you just aren't as young as you used to be ---- your bones are old and arthritic, and that's why you hurt." This is possibly the single most common response to these sorts of problems. Blame it on your age, whether you are 30 or 90. I see this every single day in practice. The truth is, I have seen thousands of patients over the years with aches and pains that are far less than you would expect to see based on the severity of their X-rays / MRI's. Trust me when I tell you that scientific study after scientific study tells us that it is impossible to gauge what a person's pain level will be based solely on diagnostic imaging.
- It's all in your head: This is one of the most sickening aspects of the medical community's attempting to explain the sequelae of the "Perfect Storm". It's all in your head. Instead of just saying, sorry, I'm not sure what's going on here, it's far easier to put all of the blame back on the patient. Truthfully, there are some days that I feel I spend far too much time telling patients that I am not sure why they are hurting like they are. Just don't use this excuse with your patients ----- it's rarely true!
- You are treated like a drug seeker: My brother and sister in law are both E.R. Physicians. They, along with anyone in the medical profession, can tell you that this is a real problem here in America. Although many doctors want to throw drugs at you just to get you out of their offices, a large group will simply tell you to take Ibuprofen --- no matter how bad your pain is. Neither is a good solution. The first is covering up symptoms without ever addressing the underlying cause of those symptoms. The second means that your doctor does not believe your pain is nearly as bad as you are telling them it is. Oh sure Mrs Jones, you have pain, but it just cannot be all that bad, can it?
- You are one of those folks clambering to get on Social Security Disability: Unfortunately, the size of this group is rapidly increasing as well. However, it becomes far too easy to blow folks off and assume that they are scam artists --- just because they are complaining about Chronic Pain that your doctor(s) cannot find the source of.
WHAT IT ALL MEANSThe reality of this situation is that patients are not always guiltless in the process of helping to create the Perfect Storm. Far too many Americans are not careful about the foods they eat or the amount of daily activity they get ---- they are not taking an active role in their own health. And the truth is; there are fakers, drug seekers, and psycho-somatics running around out there and eventually making their way to the doctor's office.
- You have bad genetics: This is sort of like lawyers who play the race card. Instead, just play the "genetics Card". Tell people that all of their problem are due to bad genes and they have nothing to do with it.
But every time I treat someone like PAM
(a woman who spent years being accused of every single one of the excuses above), or I am reminded by someone like BONITA,
that doctoring requires some detective work that goes beyond the usual diagnostic tests. It also requires that you know and understand FUNCTIONAL PROBLEMS -vs- PATHOLOGY
.If you are one of those people who think their problem might be related to FASCIAL ADHESIONS or other problems of the Elastic, Collagen-Based Connective Tissues, just send me a detailed history via EMAIL, or give Tracy a call at (417) 934-5800. If I think that I can help you, I will
. If I think that you might be better served by seeing another healthcare provider, I will tell you that as well. My reputation has been built not only on helping people with difficult-to-solve cases, but by figuring out when people have something that is not treatable in this clinic (HERE