IS MINE REAL OR ALL IN MY HEAD?
“There are some clinicians who feel that the only approach to identify the true nature of pain is to demonstrate physical or chemical pathology. The reasoning behind this approach is based on the faulty assumption that physical findings are directly related to the pain experience.
Unfortunately, biomedical research has not been able to confirm that the existence of physical pathology and pain are directly related. In fact, a number of studies have found that significant pathology can exist in individuals who report little or no pain, and conversely, studies have found significant levels of pain with little or no physical pathology. Turk and Melzack have written that “the association between physical abnormalities and patient’s reports of pain is often ambiguous or weak.”
Despite these findings, there are still many clinicians who feel that if pain is not associated with physical pathology, then by simple deduction, pain must be psychogenic in origin. Again, as I have pointed out previously, there is no creditable empirical research to support this position.”
PATHOLOGY:According to Webster’s Dictionary, pathology is, “the study of diseases and of the changes that they cause: changes in a person, an animal, or a plant that are caused by disease“. Because of our increasing reliance on 3rd party payers who want hard evidence in the form of objective findings of a person’s illness before they pay the doctor for treatment, they do not like “Functional Diagnoses”. A great example of a Functional Diagnosis would be FIBROMYALGIA. Despite the myriad of symptoms, there are no definitive standardized medical tests that reveal a diagnosis. And here’s the rub; Functional Problems are more common than Pathology — far more common. This is partially why such a huge percentage of chronically ill people are being misdiagnosed (HERE). Which of these two problems would the average doctor rather see, diagnose, and treat? That one is easy to answer —- patients with outright Pathology.
What are some of today’s common health problems that used to be Functional, but because of advances in technology and testing procedures, are starting to be seen for what they are? Here are four that go hand in hand with each other and are often times seen in unison.
- GLUTEN SENSITIVITY / GLUTEN CROSS-REACTIVITY: HERE
- LEAKY GUT SYNDROME: HERE
- AUTOIMMUNITY: HERE
- DYSBIOSIS: HERE
But the differences between Functional Problems -vs- Pathology do not stop there. What about some of the musculoskeletal problems that I see each and every day in my clinic that are caused by ADHESIONS OF THE FASCIA? I’ve said for a very long time that the microscopic scar tissue that makes up Fascial Adhesions sets the stage for a “PERFECT STORM” of Chronic Pain. Think about it like this for a moment. Do you think it’s potentially problematic that Fascia; which is not only the single most pain-sensitive Connective Tissue in the body, but also the most abundant connective tissue as well, cannot be imaged with MRI? This scenario sets the stage for a wide range of musculoskeletal problems that can be painful to the point of debilitating, yet do not present with a definite set of objective findings and frequently don’t show up with even the most advanced imaging techniques.
How about PIRIFORMIS SYNDROME? What about CHRONIC NECK PAIN or HEADACHES as mentioned above (especially in people with NORMAL RANGES OF MOTION)? What about kids who have OSGOOD SCHLATTERS but have not yet developed the classic “Tibial Tubercle” even though there is pain blow their knee? How about SKULL PAIN? The truth is, almost anything on THIS LIST could be considered worthy of being included in this paragraph. For those looking for some resolution, HERE is a good place to start.