tissue remodeling and central sensitization

TISSUE REMODELING AND CENTRAL SENSITIZATION

Central Sensitization

At least 100 million adult Americans have common chronic pain conditions, a conservative estimate because it does not include acute pain or childrenThe costs of unrelieved pain can result in longer hospital stays, increased rates of re-hospitalization, increased outpatient visits, and decreased ability to function fully leading to lost income and insurance coverage. As such, patient’s unrelieved chronic pain problems often result in an inability to work and maintain health insurance. According to a recent Institute of Medicine Report: Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, pain is a significant public health problem that costs society at least $560-$635 billion annually, an amount equal to about $2,000.00 for everyone living in the U.S.  From the website of the American Academy of Pain Medicine (AAPM Facts and Figures on Pain)

Chronic, Undertreated Pain Affects 116 Million Americans. Yet the report’s authors said they believed that they had actually underestimated the incidence of chronic pain.”  From Time Magazine’s Jun 29, 2011 “Healthland” column

“The results of this cross-sectional Internet-based survey (27,035 individuals) suggest a considerable burden of chronic pain in US adults. Chronic pain is experienced by about a third of the population.”  From the abstract of the November, 2010 study in the Journal of Pain (The Prevalence of Chronic Pain in United States Adults…)

“Musculoskeletal conditions are prevalent and their impact is pervasive. They are the most common cause of severe long term pain and physical disability, and they affect hundreds of millions of people around the world. They significantly affect the psychosocial status of affected people as well as their families and carers. At any one time, 30% of American adults are affected by joint pain, swelling, or limitation of movement.”  From a Bulletin of the World Health Organization (WHO) called Burden of Major Musculoskeletal Conditions by Doctors Anthony D.Woolf & Bruce Pfleger

As you should gather from reading the statistics above, CHRONIC PAIN is an epidemic in America, with most studies saying that one in three citizens is dealing with this issue to some degree.  On top of this, studies show that the most prevalent sort of Chronic Pain is musculoskeletal (if you want an idea of what this entails, HERE is a list).  Another hot area of study as far as Chronic Pain is concerned has to do with the BRAIN — most particularly a malfunction of the brain that causes something called CENTRAL SENSITIZATION (HERE is a post on whiplash-induced CS).

Recently there have been a number of articles (not studies, but articles) with authors expressing their opinion that people with suspected CS should not do anything that might “provoke” or aggravate their condition.  In other words, any exercise, stretching, or body work (massage, therapy, Tissue Remodeling, etc) should be extremely gentle so as not to rile the situation up and make the pain worse.  But is that necessarily the best approach — at least for the long term?

Firstly, most people — even those with FIBROMYALGIA — can’t really tell if a specific chronically painful area is part of their global “Centralization” (HERE), or a local phenomenon.  In other words, even if people are knowledgeable about CS, they cannot tell you whether their pain (or at least a specifically painful area) has become Centralized to their brain or not.  This situation is made even more confusing if the area in question was ever injured or overused.  Secondly, because ADHESED FASCIA is the cause of so much Chronic Pain (HERE), this itself presents its own unique problem.  How so?

  • LIKE CS, FASCIA IS PAIN-SENSITIVE:  FASCIA is arguably the single most pain-sensitive tissue in the body (HERE).  CS generates pain as well.
  • LIKE CS, FASCIA CAN’T BE IMAGED WELL ON STANDARD TESTS:  As I’ve shown you in the past (HERE), Fascia does not image on standard tests such as MRI.  But then again, neither does CS.  Bear in mind that there are new technologies that can image both (HERE for fascia and certain kinds of functional MRI for CS), but neither are used commonly.
  • NEITHER FASCIA OR CS ARE REALLY ON DOCTOR’S RADARS:  Doctors don’t give fascia a second thought.  And although CS is at least starting to cause some buzz in the medical community, the real question is what are they doing about it?   Unfortunately for their patients, for the most part they are prescribing more drugs — or sending them to ‘Pain Clinics’ that; you guessed it, prescribe more drugs, mostly from the “BIG FIVE” category.

As you can imagine, this presents it’s own set of unique problems.  One of the more interesting is that I am starting to see is people who used to be called malingerers and drug seekers, now being diagnosed with Central Sensitization.  While this is certainly true in some — maybe even many cases, it’s not true in all of them — maybe even the majority of them (HERE is the criteria for determining).  Because fascia is increasingly thought to play a prime role in your overall health (HERE, HERE, and HERE), it’s important to deal with problems thereof.  Here’s the question that must be answered: Is there any real downside to someone who potentially has CS doing something as POTENTIALLY HARSH as Tissue Remodeling?   Not that I have seen in my clinic or in the peer-reviewed literature.

Rather than putting a patient through months of three times a week therapy, you’ll know in one treatment if this approach is going to help (HERE).  Not that one treatment is “the cure,” but you’ll know if we are on the right track.  Bear in mind also that just because it does not work for you, does not mean your problem is necessarily CS — there are any number of other things it could be.   The cherry on top is that a single Tissue Remodeling treatment is not going to somehow cause CS.

As you CAN SEE, we help a lot of people who have dealt with their pain for years — in many cases, for decades.  Unfortunately, we don’t help everyone.  I have had a few people get seemingly miracle results, only to slide back into pain.  I’ve had others that simply did not respond at all.  To the best of my knowledge, however, no one has gotten worse due to Tissue Remodeling treatment in my clinic. Some people have certainly had their condition temporarily fired up (or occasionally popped a HERX), but that’s a different animal altogether.  As is always the case, no matter what your problem is, you need to understand what INFLAMMATION is, and figure out how to deal with it sans drugs (HERE).

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