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I have observed over the years that when patients are in chronic pain for a long time and seek help repeatedly from their medical provider, eventually, they will be diagnosed with fibromyalgia. Providers often diagnose patients with fibromyalgia as a way to encourage the patient to stop seeking care. The reality is that most of the time the provider does not have an adequate answer as to why a person has pain nor do they have any way to help. They label it, generically, as fibromyalgia. I empathize with these patients and their providers.

Fibromyalgia, one can argue, is not really a diagnosis but a description of symptoms. Etymologically, it means pain in the fibrous and muscle tissues. Most providers act like there is no real cause. Many providers assume the patient is either a symptom magnifier seeking drugs or just emotionally unstable. In my experience, more often than not, the real issue is chronic pain and can be traced back to a source with enough work. Finding the right professional to diagnose and then to treat can be daunting, however.

The causes and treatments for chronic pain are vast. Hope can be easy to sell but is often difficult to deliver. Possible causes can be osteoarthritis (wear and tear due to time or injury), auto-immune arthritis, chronic subluxations or joint dysfunction, poor posture, stress, muscle knots, referred pain from internal organs, hormone imbalances, etc., or a combination of all of the above. When I treat someone with chronic pain, I am not always successful. Sometimes, when I am successful, it may not be long-lasting. Most people I can ease some of their discomforts, at worst, or help them heal altogether. Patience and paying attention to subtle changes is the key to figuring out what is causing the pain.

It can be daunting to figure out a path to improvement. Chiropractic is a great place to start. If improving joint function and nerve flow helps, then keep going. If the help is only very temporary, like less than a couple of days of relief after months of care, then you may need to add massage or some other muscle or fascia work. After that, you will need to explore various internal issues. I would refer you to a good Naturopath or Functional Medical Specialist. Now you have to consider internal organ dysfunction. Gut issues are the most common. In addition, assessing hormone function is very important. Finally, do not rule out the psycho-somatic component. PTSD (Post Traumatic Stress Disorder) can make it so that healed physical pain lingers. The pain is no less real but one must manage their emotional issues before complete recovery is achieved. Temporal care along the way is still beneficial.

If you are suffering from chronic pain or have been diagnosed with Fibromyalgia, don’t be afraid to try a host of treatments. Start conservatively and work from there. Be wary of embellished claims of immediate or permanent relief but, also, don’t lose hope. At the very least, I am positive there is someone who can help you manage your pain.

***Photo by Jesper Aggergaard on Unsplash

It could be the late cold season or a rampant allergy season, but I have had several patients come  in with vertigo this month. If you do not know what vertigo is, lucky you! If you have experienced the nauseating feeling of being on solid ground while your brain is telling you that the tilt-a-whirl is in full force, then you know that vertigo can seriously affect your life. Vertigo is described as a feeling of being stable while objects around you are spinning. The three systems that can cause vertigo, in order of most common to least, are the inner ear, the neck, and the brain stem.

1. The Inner Ear has a complex system of tiny hairlike sensors, called cilia, that send information to the brain based on the movement of fluid through a maze of canals. When there is in an increase of fluid in the inner ear or the fluid gets too thick and mucousy, it affects the movement of the cilia, and can cause vertigo. This is common with inner ear infections, colds, flus, hay fever, and sinus infections. Drainage is critical to success in treating vertigo caused by inner ear congestion. Chiropractic adjustments help loosen the muscles in the neck which allows for freer lymph flow and better drainage. In addition, cranial adjustments can help pump the congested sinus and promote drainage. Drinking plenty of water will also help to thin the mucous which will help is drain.
2. The Neck, especially the top two vertebrae called the atlas and the axis, respectively, have sensors in the joints called proprioceptors. Proprioceptors relay position to the brain.  They are found in all joints but the nerves in the neck are particularly sensitive to head movement. When these vertebrae do not move as they should, they send a mixed signal which can make the brain feel like the body is moving when it is not. Again, chiropractic adjustments will help reset proprioceptors which will restore the proper flow of position sense, thereby halting the vertigo.
3. Brain Stem Dysfunction is by far the least treatable of the three. In general, brain injuries are extremely slow to heal. Depending on the nature of the injury, there is little hope of treatment save time and prayer. I have no empirical evidence, but I would imagine that hyperbaric therapy could be helpful. Chiropractic adjustments will not directly help but keeping the body and nervous system functioning well is always beneficial.

If you are suffering with vertigo, there are some easy, non-invasive tests to figure out which system is causing the symptoms. Treatment is effective and we usually see results pretty quickly in most cases.

I see it every day. For some patients, it is a major concern. They tell me their previous chiropractor diagnosed them with it. I tighten my lips and lower my eyebrows with an empathetic look. On the inside, my eyes are rolling. I can tell the patient needs me to understand that this is a serious chronic issue. This is obviously learned behavior from their previous doctors. I wonder if I am the only one that thinks this is no big deal. I try not to be condescending and to acknowledge their concern. The truth is that it is another temporary sign. I am talking, of course, about having a “short leg.”

Symmetry in nature is rare. I am sure everyone has one leg a little shorter than the other if you start measuring in millimeters. This begs the question as to why one leg can look so much longer than the other? The answer is found in the mechanics of the body.

Most movements in the body have a coupled movement to help maintain balance and flexibility. Side to side bending and rotation go together. In the low back, when a disc bulges and causes the vertebrae to bend to one side, it is accompanied by rotation. Rotation, in turn, contracts the muscles on the same side pulling the leg toward the trunk of the body. When lying face down, this leg will appear short because it contracts up.

I will not get into the mechanics and how it looks when standing up but think of standing with one shoe on. In addition, if the pelvis is rotated it can cause a different scenario. Suffice it to say that no matter what, a “short leg” is usually temporary and correctable, if not very manageable. No reason to get alarmed and go out to find the perfect sized lift or to change all of your shoes. After one chiropractic adjustment, balance can be restored. Now, how long that balance will last is anyone’s guess. It may take a series of adjustments before the legs become or stay relatively the same length. However long it takes, just remember, a “short leg” is not the end of the world.

In Jack London’s Call of the Wild, the main character, a dog named Buck, finds himself face to face with a man who has a club in his hand. Buck attacks that man in an attempt to escape his abduction, only to be hit painfully on the head nearly unconscious. He attacks again with the same result. Buck is a large and powerful dog and honestly feels he can beat this man. However, after several more attempts, he finally submits believing that if he continues, he will end up dead. He reasons that the man with the club in his hand is too persistent and strong and therefore must be obeyed.

Switching perspectives to the man with the club, there has to be some trepidation when confronted by a large animal with sharp teeth. Safety only comes from using the club effectively. Not using the club at the right time or the right way can be disastrous. It is likely there is a fear that the dog may be to big or too fast. Finally, not being prepared or ready to use the club again, at all times around the dog could also be fatal. Each animal has a different temperament. Some are more predictable than others but none are truly controlled.

This scenario is like an injury. Sometimes, after one or two adjustments the injury heals and is never a problem again. Other times it is good for a while but comes back again. Some injuries take several adjustments before healing and some never heal completely and need continuous work. There are injuries that will never get better. The best we can hope for, sometimes, is that we slow down the progression of an injury. The worst are injuries for which we cannot help.

Often times, in the healing process, we believe we have healed and disontinue care too early. When this happens, healing momentum is lost and can prolong the overall healing time. The question I get more often than not is how many adjustments it will take. As much as I would love to give an answer, I do not know. I can give general outlines and recommendations. Average injuries generally take about three months to heal with consistent treatment. There are so many factors that can decrease or increase the healing time. Factors such as age, degenerative change, weight, etc. can significantly change a prognosis.

The healing plan for chiropractic is the same as the law of the club. We keep hitting or adjusting the incoopertive joint until it decides to submit to the proper movement and heal appropriately. Some joints and injuries are going to respond quicker and easier than others and some are not going to respond at all. We do not always know how the healing process is going to respond without consistent care over a significant period of time.