Dr David McGrath

Spine Physician

MB BS (Hons) FAFOM, RACP, FAFMM
Master of Pain Medicine

Do I have to live with my pain?

No. Pain is an uncontrolled input. Chronic pain develops when the inputs are not recognized and obviated either by:

1.Avoiding those inputs
2.Modulating the inputs by superior and more adaptive processing

As we discussed in other essays, the musculoskeletal system is highly connected to the nervous system and therefore modifiable by other inputs such as perceptions and concepts. The error usually lies in the diagnostic formulation. As long as we view ourselves as a system of parts, which have some degree of failure we will be directed into reductionist interventions. The error rate of such manipulations is high and leaves the cause unaltered. With unabated input, structural changes follow at all levels. Skeletal elements such as muscle, tendon, blood vessel, and bone all change under the influence of uncontrolled inputs. The nervous system also changes leading observers to formulate the idea of "central pain". The longer the duration of pain, the more likely a greater number of components will be affected.

A higher magnitude of change does not imply an incurable pain, only a greater degree of difficulty.

Sometimes we have to be a detective to find all of the important inputs. This is usually not an impossible task given our knowledge of processing, and common inputs. The spine has 711 fundamental movements. Each limb has 79. Further combinations increase complexity, but not in a confusing or unmanageable way. This movement bottleneck gives us the opportunity to discover the majority of processing faults which underlie the generation of musculoskeletal pain. Correcting the faults leads to stability and pain resolution.

Article Index