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June 25, 2018

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Chronic Pain

According to the Institute of Medicine, over 100 million Americans suffer from chronic pain. That is 75 million more than those suffering from diabetes and 88 million more than those suffering from cancer. Pain is a significant health problem with a whopping price tag of $560-635 billion annually. So what is chronic pain and why doesn’t the traditional medical model work to relieve it?

 

When we have an accident such as spraining an ankle, our nervous system sends a pain signal to alert our bodies that we have injured tissues and to stop what we are doing.  Acute pain is caused by a specific injury or disease, in contrast to chronic pain in which the pain lingers long after the event that caused it.

 

But we now know that chronic pain is much more complex than just pain that last longer than the normal time of healing. A psychiatrist and director of the pain treatment program at Johns Hopkins Hospital, Michael Clark explains the underlying neurobiology: “The disease of chronic pain is more than just acute pain that lasts longer. It has a greater intensity, causes impaired function and can migrate beyond the original pain site. The nervous system becomes distorted. Pain receptors get amplified and internal pain blockers minimized, which can make even the lightest touch be perceived as painful.”  Medications work to block the pain signals traveling from the site to the brain causing the signal over time to intensify. Higher doses of medication are then required to block the intensified signal. As time goes on our pain receptors and processors get distorted causing the medication to stop working and even the smallest stimuli to be perceived as painful. There is very good evidence that opioids do not work for chronic pain and that they can sensitize people to pain so they actually feel more pain.  Additionally, opioids are highly addictive and come with a whole list of side effects including dizziness, sedation, respiratory depression, and depressed mood.

 

The longer we experience pain the more our bodies and brains compensate and change to accommodate it. For example, chronic low back pain causes changes in posture, lack of mobility, problems with balance, and overtime muscle loss. Chronic pain affects your ability to work, affects your ability to play with your kids and grandkids, and takes away the ability to engage in activities you enjoy.

 

If the traditional medical model doesn’t work then how do we treat chronic pain?

 

Chiropractic care

As a chiropractor, I work to address the underlying problems affecting the nerves, muscles, and spine. Chiropractic care helps to improve mobility, nervous system function, relieve muscle tension, and, provides a non-invasive solution for pain relief.

 

Chiropractic adjusting is the practice of using spinal alignment to alleviate a wide variety of physical ailments, including muscle strain, neck pain, chronic back pain, and more. This is accomplished by adjusting the position of the spinal column to its proper shape thereby reducing pressure on the spinal nerves, which provides communication from our brain to all the organs, tissues and cells in our bodies.

 

Soft tissue therapy includes the assessment, treatment, and management of soft tissue injury, pain, and dysfunction of the neuromusculoskeletal system. 

 

Targeted exercises and or stretches help strengthen musculature, improve range of motion, increase flexibility, and restore proper motion.

 

Nutritional assessment

Addressing diet and doing a nutritional assessment is important to eliminate additional causes of pain such as inflammation. An anti-inflammatory diet can help relieve pain causes by inflammatory processes. I recommend a non “CRAP” diet.  This means eliminating caffeine, refined carbs, alcohol, and processed foods.

 

Psychological component

Psychologists also can help to address the psychological components of chronic pain such depression and changes in mood.

 

References

"American Academy Of Pain Medicine - Get The Facts On Pain". Painmed.org. N.p., 2017. Web. 27 Mar. 2017.

 

Benyamin R, et al. "Opioid Complications And Side Effects. - Pubmed - NCBI". Ncbi.nlm.nih.gov. N.p., 2017. Web. 27 Mar. 2017.

 

Group, Herald-Tribune. "Chronic Pain Requires Multiple Pathways Of Treatment - HT Health". Health.heraldtribune.com. N.p., 2017. Web. 27 Mar. 2017.

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