How to beat pain with a butter knife

All injuries result in some form of the body’s response. The skin, muscles, tendons, ligaments and even internal organs form scar tissue following any injury or physical stress. Normally the body forms collagen to replace damaged tissue. The key is that normal tissue is linear and parallel, but scar (fibrous tissue) looks like a basket weave.

Muscle and joints areas have aligned tissues to allow for movement. When scar tissue forms in a perpendicular pattern, the nerves can be integrated and over stimulated during partial or normal movements.

Nerves involved in the damaged tissue are usually a 1000 times more sensitive. The body can have scar tissue anywhere. On the surface or deep in the tissues and the particular nerve placement and location determines the type of pain someone may feel.

If any vascular involvement exists, the area can often have repetitive swelling, or worse it has an eventual failure which can sever micro blood supply to any region and result in local ischemic necrosis (tissue death).

A few examples of this may related to pain that is felt with the change of weather. Pressure changes in the atmosphere can drop externally, yet the body’s internal pressure remains the same. This results in an expansion of the tissues, which crushes tissue/nerves and results in pain.

The most common example is the pain that occurs when someone is at rest or in any specific movement. Since the fibrous tissue is perpendicular to the normal stretch receptors, the simple act of lying down or sitting, can result in a lack of mobility and result in pain. Nerves eventually become hypersensitive and simple movements can cause pain. Stretch receptors may fire during some particular movement or occur only at times of the day, days of the month or under specific physical conditions.

Take a second to see how this applies to common lower back pain. The fibrous tissue forms and often doesn’t align with the normal elastic properties of the natural tissue. As you bend or lift anything off the floor, the scar tissue will not move as freely as the other normal parallel tissue and often results in pain. This is why current research shows that disc herniations are not the primary source of lumbar pain.
Often chiropractic manipulation is very successful with improving the mobility of lower back pain. Exercise, therapeutic modalities and massage can help with tissue restoration and reduce pain.

Medications are usually only effective at perception pain suppression, but can be helpful in providing a window of opportunity to allow for more aggressive techniques at tissue reconditioning. Typically a multi-professional approach is the most successful. This is why the practice of epidural spinal injections and manipulation are so effective for stubborn lumbar cases.

A few professional techniques exist that are geared directly at curing cases that are more stubborn and don’t respond to typical approaches. Graston is a chiropractic technique that is gaining more acceptances, but is lacking in long term literature support. Guasha is a Chinese based massage technique based on similar principles. Both basically are using round edged instruments that are used in a protocol that results in deep tissue reconstruction and nerve desensitization.

Both of these previous techniques first warm up the tissue and then move perpendicular to a contractile direction of a tissue, then result in movement to assist the paralleling of the fibers. This is analogous to allowing the hair to be retrained by combing it repeatedly. Eventually, the lymphatic return is stimulated and the blood and toxins are pulled back towards the heart.

The first step in fixing this abnormal tissue is related to education and understanding. The patient needs to understand that: The steps needed to help with removing pain, often causes pain. It is necessary for the patient to understand what is happening, so they can better cope with the likely onset of some pain. For those that are hypersensitive, medications often need to be included.

Prepping the area can also mean warming up the area. This can be done by applying a warm moist compress, using a topical pain killer or dermal thermal agent, or by simply rubbing, exercising, massaging or manipulation of any particular joint. Once some petechial response is noted, the next issue is to position the area correctly.

Position the body part to bring the area in question to make the tissue as easily accessible as possible. Then with slow movements, a rounded stainless steel object (such as a butter knife handle) can be used to move perpendicular over the area with associated pain. The pressure is usually a little more than that used to warm the area up. Hence the skill of a trained professional is useful in this regard. The hardest pressure should be directed always towards the heart and in alignment with the contractile properties of any given area.

An example is the knee or elbow; either joint has a simple direction that is distant to the body, but in line with the extremity itself. The final stroking movements would be from the forearm towards the shoulder or from the lower leg towards the upper leg.

Always adjust for pain by slowing down the movement first, then reducing the pressure if the speed doesn’t seem to be enough of a deterrence. Repeat the procedure 1-6 times a day, each lasting approximately 5 minutes. See a professional if your pain doesn’t improve in less than a two week period of time or if your pain worsens, unexpected swelling occurs, a constant rash and/or fever is noted.

Exercise in some capacity always helps the area by increasing circulation to promote healing. Just modify the motion and the intensity to keep below a 50% maximum pain threshold. Always use high reps (30-60) and low weight, with lower speed at first, then advancing to faster speeds prior to adding more resistance.

Yours in Health!

Dr. David Ryan

Columbus Chiropractic Center Director