New clients come in for all sorts of reasons. Some have a severe pain issue – one that is keeping them from their jobs or performing activities of daily living. Some have been receiving care and are looking to continue maintenance, but they’ve just moved, or the practice they’ve been using is no longer available. Some come in for minor pain or discomfort issues that have been bothering them for a while, or they just feel they should “start taking care of [their] bod[ies].” It is this last group of people who often have the most difficulty with some mentality shifts early on in care.
It is easy to see why though. Pain is a strong motivator. People coming in with severe pain are highly motivated to get out of pain. Adopting new mentalities as a way to avoid future pain is easily embraced. Those who have been under consistent chiropractic or massage care don’t have as many of the paradigm-shifting experiences. They may have had them previously, but they’ve been maintaining wellness for a while now, so they are already past most of the “body realization” moments.
The last group – the ones who are coming in for minor issues, or simply general wellness – often have lower motivation to endure moments which may be viewed as “set-backs.” They understandably just want to go from some discomfort to feeling well. We all would, right? Unfortunately, this group often comes in with long term issues that have accumulated from some combination of unbalanced movement patterns, overuse/underuse, and poor body maintenance practices for years or even decades. Maybe nothing has set off the “alarm” in the body yet, but an accumulation of minor issues is sitting there, dormant, setting them up for a rude awakening when they have a fall or more significant injury that “didn’t seem bad enough” to cause a resulting slew of issues. More on that phenomenon another time. For now, we want to take a look at some of these paradigm shifts that must be contended with when treating more chronic or long-lasting musculoskeletal issues that have yet to rear their painful heads.
Ok, not really. But the metaphor can be useful when trying to make sense of the different stages that can be experienced during treatment.
It is not uncommon to experience pain that “jumps” to a different part of the body early in treatment. This experience may seem like a negative set-back, but there are a couple of reasons that this “jumping” or moving pain can be a good thing.
Scenario 1: The brain was overwhelmed. Sometimes, patients come in with several problem areas, but the brain is mostly just paying attention to pain signals from one specific area. As dysfunction in that area is addressed and improved, the brain is free to pay (more) attention to other dysfunctional areas.
Scenario 2: We’ve disrupted a balance. The body is super adaptable, so it will start compensating for something dysfunctional almost immediately. That is useful in the short-term, but if not addressed, those compensations can create their own issues in the long run. As we treat whatever the body is presenting with initially, it can disrupt the balance that the body has negotiated to deal with the root issue. This process can feel like addressing “layers” of an issue. As things shift, we have more information and can better address root issues.
These descriptions are simplified, but they work. What both of these scenarios have in common is that they mean progress. Pain is never fun, but if we can create change, that is a good thing!
The other common scenario that occurs is clients may find themselves experiencing pain more frequently, more easily, or in new areas. We’ll hear “it never used to take this much to aggravate [insert original pain issue]!” But they’ve been in care for all this time, so why does it seem like things are getting worse??
The brain is extremely adaptable and is great at mitigating how many pain signals it sends you at any given time. This is awesome for those of us experiencing a LOT of chronic issues, but not so great for actually knowing what is going on in your body.
When experiencing chronic pain, many people find that their awareness of other areas of chronic pain “shutting off” most of the time. There’s a few different theories about why this happens, but for our purposes, it’s the brain’s way of protecting us so we can function – at least somewhat – in day-to-day life. This ‘gate theory’ is one reason why you can feel completely fine, and then suddenly, when receiving a massage, everything is more tender or sensitive than you expected.
Even some athletes never develop strong mind-body connections, which is something that is required to be able to self-assess and start feeling when dysfunction is coming on.
Because of either of these things we often allow issues to build up without realizing it’s happening. We don’t feel or notice the little signs of discomfort, and only notice when all of the sudden we randomly throw out our back trying to perform a simple task such as grabbing toast out of the toaster.
Regular manual therapy (chiropractic or massage) helps to increase the mind-body connection partly by increasing the communication with your proprioceptors. Proprioceptors not only allow us to know where our body is in space, but they also give us awareness of unhealthy muscle length or tone (i.e. dysfunction).
The result is that after a few weeks of care, it may feel like you are suddenly becoming much more sensitive to pain or having new pains you’ve never had before. Understandably, the concern is that care is not working (or may even be making it worse!). There is a very good chance it is best to keep persevering. What is often actually happening is that you are developing a super power to recognize when something is only a little off, before it becomes a full blown problem or injury. You are becoming more sensitive to recognizing dysfunction. The benefit is that this allows you to address minor issues through self-care or in-office care, which means you can start preventing problems before they become larger and really disrupt your life.
So how can you tell when to persevere? Objective information becomes the best point of reference, and this is when it matters having a team of professionals you can trust to help guide you. While your body is learning to assess itself, we can provide objective feedback. We pay attention to misalignments and what the soft tissue feels like at the start of each session. We also pay attention to how quickly you respond to treatment during a session and how well changes hold following a session. Responding more quickly and holding longer (adjusting for daily activities) are signs of health. We can compare this objective information weeks into your treatment to the start of care as a way to evaluate body health when you’re feeling more “sensitive.”
Depending on your previous experiences, fully addressing the root problem of a pain issue that has been building for years or decades can involve some mental and emotional hurdles. Recovery is not always linear, and feeling disheartened during new pain moments is understandable and a perfectly normal response. It is our experience that when you stick with the recommended in-office and at-home care, you will achieve not only addressing the pain issues, but also creating a healthier foundation for your body.
