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Posted on 12-04-2013

Rethinking your joint pain…

The purpose of this article is to take into consideration the important role of posture and appropriate movement and function have in common joint dysfunction. Chiropractic physicians often look beyond just the site of your discomfort, and this article is a brief explanation of why there might be more to the cause of your joint pain than meets the eye.

Pain and stiffness in the extremities has always been a common occurrence, but seems to be on the rise.  In 2006, the CDC performed a survey across the country that asked a simple question: "During the past 30 days, have you had symptoms of pain, aching, or stiffness in or around a joint (exclude back or neck)?” The results were interesting, as 30% of adults reported having some kind of joint pain that was not in their back or neck. 18% of respondents reported having pain in their knee, 9% reported having pain in their shoulders, 7% reported having pain in their fingers, and 7% reported having pain in their hip.

 It is not uncommon for a new patient to have a primary complaint involving one of these joints, and often, they are evaluated and treated only for the primary site of the pain. The knee, shoulder and hip can be evaluated and treated, but often there is an underlying cause that may be elsewhere in the body. Karel Lewit MD is a well-known physician from Prague. He was once quoted saying “he who treats the site of pain is often lost.” When it comes to chronic musculoskeletal pain, the site of pain is rarely the actual source of the pain. What if the practitioner is so focused only on the site of your pain, that an important cause of the pain is completely over-looked, and a positive outcome missed?

Czech physician Vladimir Janda described musculoskeletal pain as a chain reaction, reassuring the importance of looking beyond the site of pain for the source and cause of the dysfunction. If one joint or muscle is not working correctly, this can be reflected in the function of other joints and muscles throughout the entire body. There is often a chain reaction, and has been researched in great detail the past 15 years. Janda realized that muscle and connective tissue work together and are common not just to one joint, but often several different joints. He concluded that pain and movement are very rarely associated with a single joint. He described “muscular slings”, or groups of functionally related muscles that work together to have one outcome (think of throwing a baseball). Muscles must disperse a load amongst different joints and provide stabilization at the same time, making no one movement isolated to one sole muscle. This means knee movement (for example) is not isolated simply to the knee, but is also dependent on the proper function of the ankle joint, the pelvis, the lumbar spine and the core/abdominal muscles. Even the way you swing your arms while you walk can have a direct effect on your knee!

Hopefully, you are starting to see that while you might have pain in a specific joint, it is not always the cause of the pain. A study in 2006 showed that 49% of athletes who had a arthroscopically diagnosed posterior superior labral tear (SLAP lesion) also had a decreased hip range of motion or hip abduction muscular weakness. This illustrates an interesting point, how often have you been treated for your shoulder pain by strengthening your hip and core?

I am often asked by patients why I do not focus solely on their primary site of pain, and my answer is simple. The body is intelligent, and it protects itself with chain reactions. Low back pain is not caused solely by one or two lumbar spine vertebrae being out of alignment, but can have contributing factors that start with something as simple as the way we walk, how healthy or knees are, how strong our abdominal muscles are, or the strength of our legs.

When you start having joint pain, your body is warning you that something is wrong, and it is up to you to find a practitioner who can look at your body as a whole, and start you on the path to wellness. At Changes Within, we look outside of the box and will look not only at the site of your pain, but beyond it to find the solution you have been looking for.

Dr. Eric

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