How does Chiropractic Treatment help pain?
Warning, the below information can be dense and nerdy. We are going to talk about two aspects of chronic pain, Organ Pain and Wide Dynamic Range Neurons (WDRN).
Organ Pain
The organs of your body, as precious as they are, have no pain receptors. Wild right?! This means they can only indirectly give feedback when the damage has been done to them. This feedback must piggyback off of existing pain receptors and that can only happen at the level of the spinal cord itself. Once a signal from the organ has reached the spinal cord it can upregulate other pain signals in hopes of getting the message across. Often times the message is subtle and not really clear to most individuals until it is a huge problem. A classic example of this is left arm pain from a heart attack. The arm is completely fine but the organ of the heart is in crisis and the body is trying to signal a serious issue, but it can not make the heart hurt. The nerves from the heart go in to the same spinal level as the left arm, so the body creates a pain signal associated with left arm pain. This is a good example of this process happening in an emergency state but it can also happen in a chronic state. The most notable example is chronic irritation of the bowels either due to a disease process (ulcerative colitis or Crohn’s) or just repetitive poor life choices. Eating a whole pizza and drinking copious amounts of beer might be fine once a year, but if you do this every Friday night, there can be significant health effects. In either scenario, the irritation to the gut lining will create low back pain. The more I pay attention to my food choices, the more I see that up to 50% of any low back discomfort I have is really due to poor food choices (like having copious amounts of pizza and beer on a Friday night).
Wide Dynamic Range Neurons (WDRN)
This brings us to WDRNs. WDRNs are how organs and the rest of your body communicate with the spinal cord. They can respond to a light touch on the skin just as well as burning your thumb. WDRNs also respond to non painful stimulus, like walking on fresh cut grass. In fact, non-painful stimuli actually block painful stimuli at the WDRN. WDRNs serve as a data hub that summarize all the information they have before sending a signal to the brain. Without the protection of this data summary, the brain would be overwhelmed with sensory stimulus. WDRNs differ from other neurons because they can increase both frequency and magnitude of their output. Most neurons can only send the same magnitude of signal but faster. This would be like a person repeating the same phrase to you over and over again, but not any louder, but faster. With WDRNs, however, this same person can repeat the phrase faster and louder. If a signal is received over and over again, the WDRNs will send more and louder messages to the brain.
The problem here is that these neurons receive input from several sources. For example, one neuron can share input from your leg, your hip, and your intestines. So if one of those areas is irritated, the signal sent to the brain is that all of those areas are injured. If that pain signal continues long enough, the neuron will actually become over sensitized and begin to send a signal of pain for a stimulus that would not previously have done so. You could equate this to getting a paper cut. It can hurt a good bit at first, then the pain will dull. Now imagine some lemon juice got in that cut. Not only does it hurt but you are very aware of anything that touches that cut because it is now so sensitive.
Chiropractic Manipulation and Chronic Pain
Chiropractic treatment is able to directly affect Wide Dynamic Range Neurons. High velocity, low amplitude chiropractic adjustments are able to neutralize the hypersensitive state of the WDRNs allowing it to function as normal and provide more accurate data to the brain. This can be an especially powerful alternative to pharmaceutical intervention and can function as long-term palliative treatment for the pain of chronic diseases. This is also especially exciting for chronic pain treatment. Chiropractic manipulation can literally reset pain sensitivity which can create significant opportunity for our patients to experience movements without pain to begin to change the brain’s faulty protection output with many of the new movements we are doing with patients.