Unexplained Pain?

Making sense of your pain

How many times have you woken up in the past to find that you have a new ache or pain. Where does this pain come from?

The sensations we experience in our bodies are not random. The complexity of the human  body can make what we experience seem random.

When we experience pain in a muscle or around a joint, a common assumption is that the problem is right there with that muscle or joint. This may seem self evident but it’s not quite that simple. It could be referred pain. This is a pain that originates in one place but shows up in another.

For example a common presentation in the clinic is pain on the side of the neck and shoulder and down around the shoulder blade. Each joint in the neck has a distinct area of referred pain so patients are often surprised to find that the pain they feel in the shoulder blade is in fact from the neck and that joint problems at the top of the neck may cause tension headaches. See the diagram below by N. Bogduk

Each vertebrae in our spine has a corresponding spinal nerve, these can also give referred pain, as the diagram below shows. An example of spinal referred pain is sciatica which arises from the irritation of the spinal nerves at L4 and/or L5,S1.

Internal organs may also give referred pain. The sensory nerve supply for the heart originates from the spinal nerves at T1-4 in the upper back so the pain felt during a heart attack is in the left arm or shoulder. Pain in the right shoulder may also be referred from the liver and gallbladder

Referred pain is therefore something that needs to be considered in all patients complaining of any type of pain in order to make an accurate diagnosis. These referral patterns are something that osteopaths are highly trained in.

OSTEOPOROSIS

Osteoporosis affects many people

1 in 3 women

1 in 12 men

To understand osteoporosis it is important to know a bit about how bone is made and maintained.

Osteoblast cells build new bone

Osteoclast cells remove and recycle bone

Normally their activities are balanced

Bone mass peaks at 30 and then naturally declines. 

Many factors will effect a persons peak bone mass.

Throughout life, bone cells are constantly being removed and replaced from within your skeleton. When the rebuilding rate becomes less active than removal rate, bones are left weaker and more porous.

The biggest threat of this is the onset of the menopause in women. Oestrogen keeps the number of bone removal cells at bay. 

After the menopause when oestrogen levels decrease the cells that break down bone increase, breaking down the bone at a quicker rate than than it is being replaced. 

Bearing this in mind it is vital that in the younger years (up to 30 years old) major risk factors that reduce bone density are avoided to accommodate for this e.g 

SMOKING smoking has a toxic effect on bone by stopping the construction cell (osteoblasts) from doing their work. 

DRINKING TOO MUCH ALCOHOL, 

INACTIVITY Your skeleton grows stronger if you do regular weight-bearing    exercise.

POOR DIET

Other factors such as steroid treatment, family history and illness where malabsorbtion of nutrients is a problem.

Your Osteopath may be able to offer you some relief from your symptoms. For many patients massage and gentle movements of the affected joints will help to restore a more healthy blood supply and greater freedom of movement.

This does not in itself suggest a cure, but if you are more mobile and less uncomfortable, you will be able to do more exercise and this is a crucial part of self-help.