Most of my day is spent debunking the myths of the causes of pain patients have been told by various authorities. Every new patient comes in with a litany of findings identified on an x-ray or MRI which is supposedly the cause of their pain. Stenosis, arthritis, bone-on-bone, mensical tear, rotator cuff tear, herniated disc, spondylothesis, and every other possible structural variation from the norm is identified and simply assumed to be the cause of pain.
The fact that most of the patients I treat can't remember a specific incident that initiated their pain is significant here.The types of structural variations that the diagnostic test found take years to develop, yet most patients decide to obtain treatment within months of the onset of their pain. The most obvious fact that seems to be missed is that if in fact these structural variations did cause pain, the areas where patients are feeling pain are in most cases not in the place where they should be feeling it if a structural abnormality was the cause.
With all of these lapses in logical analysis, it is hard to imagine that these types of diagnoses are made every day; but this is the fact. This is why I would like to explain why it is much more logical to suggest that the cause of most functional pain is muscular. Let's start with a principal that guides my entire practice. That is "Strength=Function". The principle states that a person needs a sufficient amount of strength to perform a functional activity. If there is not enough strength, there will be a breakdown in the mechanism that tries to perform the functional activity. It could present itself as swelling, pain, tingling, numbness, loss of range of motion of a joint or weakness. The breakdown could affect a muscle, tendon or even a bursae. Ultimately, the cause of the breakdown was muscle weakness. This should sound a lot more logical than a person who gardened one day felt pain in their back and they somehow created a herniated a disc or developed stenosis.
Now let's look at the tissue that is creating the pain signal. In almost every case I have treated, the tissue which was pressed and created the pain has been muscle. This is strong evidence that the cause of the pain is that this muscle strained. The reason for the strain is often that another muscle which works with the painful muscle strained first causing the painful muscle to eventually strain creating dysfunction. This is why I take a global approach to preventing pain and dysfunction. The key is to have strong, flexible, and balanced muscles.
It is important to understand that movement and function result from muscles stabilizing and moving joints. The joints simply act as pivot points to allow function to occur. The heavy load of creating functional tasks goes to the muscles. So give them credit. For me, it's more believeable that you can strain a muscle easier than herniating a disc or creating stenosis or tearing a meniscus. Finally, understand this: an MRI or xXray can not show a strained muscle, a muscle in spasm, or a tight muscle. If you believe that there is even a chance that the cause of pain is muscular and these tests are the primary method of determining cause, then a possible cause can never be identified. How it is possible to discover the cause of pain when some of the options cannot be identified? Please consider that it is more likely that your pain is the result of a muscle strain or muscle spasm and that the only mechanism for resolving your pain is through aggressive strength training.
