How accumulation of stress, daily postural use and residuals of trauma create neuromuscular disequilibrium causing irritation, lesion, and eventually pain.
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...In equilibrium you conserve...
...out of equilibrium you consume... |
Under our skin it's quite complicated
The innate spontaneous neurophysiological and bio-mechanical adaptability of your locomotor system, (brain, dural sac, spinal cord, spinal nerves, muscles, fascia, bones and soft articular tissues) has the capacity to compensate for stress, trauma and continuous postural use for many, many years. At the same time, it also has an incredible ability to withstand neglect. It is normal to assume that the pleasant feeling of youth will continue forever because it is the the only sensation you have ever known. But without the proper maintenance of normal system equilibrium it eventually begins to suffer premature wear and tear, a pernicious process of chronic postural strain which leads to eventual pathology. |
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The traditional medical community does not spend the necessary time to educate us in the possibility and importance of locomotor maintenance to reduce the risk of chronic pathology. So, when the various bits of the system begin to painfully fail for the first time at 25 to 55 years of age, the phenomenon is mystifying. This system contains more than 200 bones for structure, over 300 articulations of soft tissues to allow flexibility, more than 500 muscles to synchronize sequentially for normal postural movement and 1000's of kilometers of sensory and motor neurons to coordinate movement.
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Consider any pathologic process in the body. A painful tooth, gallbladder, heart, back, painful anything .... pain is a natural warning of pathology in progress. Pain in the head, neck, shoulder, arm, back or leg are all common consequences of a loss of normal neurophysiological and bio-mechanical equilibrium... with or without a physical lesion.
Movement in asymptomatic chronic imbalance will have an effect on the soft articular tissues similar to driving a car with the tires out of alignment. And nerve tissue as if walking with a pebble in the shoe. Eventually these compromised tissues become sufficiently irritated to cause spontaneous pain close or distant to the point of compromise via the network of nerves. Over time, the irritation of the nerve tissue can become chronic, the articular lesion may become grave and the pain quite severe.
Below are photos of university studies that demonstrate articular lesion as a consequence of chronic use of the locomotor system in a state of disequilibrium.
Movement in asymptomatic chronic imbalance will have an effect on the soft articular tissues similar to driving a car with the tires out of alignment. And nerve tissue as if walking with a pebble in the shoe. Eventually these compromised tissues become sufficiently irritated to cause spontaneous pain close or distant to the point of compromise via the network of nerves. Over time, the irritation of the nerve tissue can become chronic, the articular lesion may become grave and the pain quite severe.
Below are photos of university studies that demonstrate articular lesion as a consequence of chronic use of the locomotor system in a state of disequilibrium.
Three common mechanisms of irritation and lesion of the locomotor system.
Arthropathy is lesioned articular tissue
Arthrosis, disopathy, bulging disc, protrusion, hernia, are versions of arthropathy. When the radiologist's report describes the aforementioned pathologies, what does it actually mean for you. Below you can see an open section of the lumbar spine in profile. The dark squares are the bodies of the vertebrae, the lighter horizontal lines are the intervertebral discs. Behind the vertebrae and discs vertically there is the central canal that has been cleaned of nerve tissue and behind the central canal are the ligaments between the spinous processes.
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The soft bushings of the spine...
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These common lesions (protrusion and hernia) at this point are able to irritate the nerve tissue (dural sac, spinal cord, cauda equina and spinal nerves) projecting symptoms near to or far from the lesion. The healed disc is much more resistant to daily postural wear and tear.
Below you can see an open section of the lumbar spine in profile. The dark squares are the bodies of the vertebrae, the lighter horizontal lines are the intervertebral discs. Behind the vertebrae and discs vertically there is the central canal that has been cleaned of nerve tissue and behind the central canal are the ligaments between the spinous processes.
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These photos demonstrate the progressive nature of lesion of the soft articular tissues which develop as a result of asymptomatic chronic dis-equilibrium of the locomotor system. When your family doctor or a specialist says that your x-ray or MRI reveals arthrosis, discopathy, disc bulge, protrusions or disc hernia, it means that you are suffering from a variation of the lesions seen above. When inflamed they can be as painful as any other pain you may have experienced. When the lesion dis-inflames you may even forget that the it is present. That is when you risk symptomatic relapse. Without pain to remind you to be careful, returning to full daily activity risks a symptomatic relapse. Dis-inflammation and healing of the lesion are but two of the goals of proper care. Your knowledge of how the pathology happens together with your proper self management is fundamental to your full recovery and preventing a relapse.
Below is discussed another factor of the pathology that involves the loss of normal neurophysiological and biomechanical equilibrium: Neuropathy.
Below is discussed another factor of the pathology that involves the loss of normal neurophysiological and biomechanical equilibrium: Neuropathy.
Neuropathy is chronically irritated nerve tissue
Irritated nerves. The neurological equivalent to having a pebble in your shoe. It isn't grave, but will continue to until you remove the cause of irritation. There are different types of neuropathy. What follows is information about mechanical neuropathy and the domino effect of systemic dysfunction and symptoms that it causes. Mechanical neuropathy is a consequence of chronic irritation due to a loss of normal physiological and biomechanical equilibrium between the spine, with or without articular lesion, and it's contiguous nerve tissue. Once the normal physiological equilibrium is lost (due to a trauma or simple continuous postural use) each movement chronically irritates the compromised nerve tissue disturbing the normal function of the motor and sensory neurons.
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MRI of the cervical spine in profile. MRI of the lumbar spine in profile.
As the articular disease progresses from normal to extreme, notice how the degeneration impinges on the dural sac and finally on the spinal cord and spinal nerve roots. This is how a central pathology creates pain and other symptoms in the vicinity of, or very distant to the pathology.
As the articular disease progresses from normal to extreme, notice how the degeneration impinges on the dural sac and finally on the spinal cord and spinal nerve roots. This is how a central pathology creates pain and other symptoms in the vicinity of, or very distant to the pathology.
neutral - flexion - extension
This dynamic MRI demonstrates as you change posture you change contact between the cervical spine, the dural sac and the spinal cord. Imagine the increase in contact if you add torsion by turning the head. Imagine the increase in irritation to the nervous system.
Nervous system conductivity
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Video by Nishantha Jayaweera
The nervous system works like an electrical grid, this means that an irritation between the brain and the periphery can cause neurological dysfunction not only at or near a point of irritation, but also transmitted to any distant point of the body. For example, this is how a neck dysfunction or lesion can create pain, weakness or other symptoms anywhere in the body. The dural sac, the roots of the spinal nerves, the spinal cord, cauda equina are all at risk of chronic mechanical irritation from a dysfunctional or lesioned spine. For a period of time there may be no obvious suffering, but eventual symptoms will manifest. |
The human electrical grid
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Neuropathy creates two types of suffering: sensory and motor...
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Sciatica is a sensory and motor neuropathy.
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Sensory neuropathy due to mechanical irritation of the nervous tissues causes unpleasant sensations such as pain, burning, tingling, problems with balance, loss of sensation etc. in any part of the body.
Where an articular lesion tends to create pain at or near the lesion, sensory neuropathy can project pain or other symptoms anywhere along the nerves of the body. It is possible that symptoms in the head, neck, back, shoulders, arms, elbows, wrists, hands, hips, legs, knees, ankles or feet are caused by central irritation of the dural sac, the spinal nerve roots, spinal cord or cauda equina . |
Motor neuropathy due to mechanical irritation of the nervous tissues causes a slow loss of normal instantanious neuromuscular function. Its noticeable consequences are not usually immediately obvious.
Motor neuropathy causes no pain, so you will not notice until it is already quite advanced. What you may notice is an eventual lack of normal strength, coordination or stability. Your groups of muscles (agonists, antagonists, and synergists) silently coordinate to maintain each articulation precisely within its natural limits in movement and at rest. Chronic mechanical irritation of the motorneurons at the spinal level reduces their conductivity therefor their ability to coordinate muscle fiber contractibility. This decrease of your instantaneous neuromuscular coordination (adaptability) allows chronic articular overload creating an arthropathy as explained above. This loss of instantaneous motor adaptability puts your muscles, tendons and joints at risk of injury. A very common consequence of chronic motor irritation is neuromuscular pain.
Motor neuropathy causes no pain, so you will not notice until it is already quite advanced. What you may notice is an eventual lack of normal strength, coordination or stability. Your groups of muscles (agonists, antagonists, and synergists) silently coordinate to maintain each articulation precisely within its natural limits in movement and at rest. Chronic mechanical irritation of the motorneurons at the spinal level reduces their conductivity therefor their ability to coordinate muscle fiber contractibility. This decrease of your instantaneous neuromuscular coordination (adaptability) allows chronic articular overload creating an arthropathy as explained above. This loss of instantaneous motor adaptability puts your muscles, tendons and joints at risk of injury. A very common consequence of chronic motor irritation is neuromuscular pain.
Neuromuscular pain anywhere in the body due to chronic motor neuropathy
The muscles are not only a mirror of abnormal tension in the nervous system, but they also accumulate postural fatigue and the residuals of trauma. Therefore another factor of the domino effect in the evolution of the pathology is that the involved muscles begin to form "trigger points" as a consequence of chronic mechanicalirritation of their motor neurons as they course through the spine from the neck to the tailbone.
What are “trigger points”?
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Some common trigger points associated with irritation of the motor neurons and their area of symptoms. A more central pathology can project symptoms at a distance.
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A trigger point is a small knot, a micro tension, located in a muscle. Not a whole muscle spasm like a cramp, but a small point capable of creating spontaneous pain. A trigger point in addition to causing local pain of neuromuscular origin, reduces muscle performance and disturbs the coordination of the muscle complex, agonist, antagonist and synergist which in turn creates a cascade of other locomotive dysfunctions and therefore eventually more suffering. It is a unique phenomenon caused above all by motor neuropathy of the locomotor system secondary to normal wear and tear of everyday life, chronic fatigue posture, trauma (recent or past), cold, metabolic problems, stress and other factors. Muscle pain of a trigger point can creep slowly a little at a time, or explode spontaneously from nothing. Sometimes a trigger point can cause symptoms so severe as to believe it is a medical emergency.
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Video by Michiel Akkerman
Neuromuscular pain is important: it is a common problem...
The musculoskeletal system is about 40% of the body by weight. Aches and pains are very common medical complaints, (about 85% of medical complaints are caused by neuromusculoskeletal problems) and trigger points appear to be a factor in many of these. They are also key factors in headache, pain in the neck, pain in the back,
pain in the arms and legs and in many other areas of the body. What makes trigger points clinically important are their triple threat.
They can:
CAUSE DIRECT PAIN. Trigger points are a "natural" part of muscle tissue. Sooner or later almost everyone has accumulated these points of micro muscle tension and can feel the spontaneous pain with no reasonable explanation for the pain.
COMPLICATE AN INJURY. Trigger points do occur in most traumas. No matter what happens, the trigger points will complicate the situation. In many cases they can overshadow the original problem and at the least impede recovery.
MIMICS OTHER PROBLEMS. Many symptoms of trigger points appear to be other health problems. It is very easy for an uninformed patient or clinician to misinterpret a painful trigger point for almost anything but a trigger point.
The musculoskeletal system is about 40% of the body by weight. Aches and pains are very common medical complaints, (about 85% of medical complaints are caused by neuromusculoskeletal problems) and trigger points appear to be a factor in many of these. They are also key factors in headache, pain in the neck, pain in the back,
pain in the arms and legs and in many other areas of the body. What makes trigger points clinically important are their triple threat.
They can:
CAUSE DIRECT PAIN. Trigger points are a "natural" part of muscle tissue. Sooner or later almost everyone has accumulated these points of micro muscle tension and can feel the spontaneous pain with no reasonable explanation for the pain.
COMPLICATE AN INJURY. Trigger points do occur in most traumas. No matter what happens, the trigger points will complicate the situation. In many cases they can overshadow the original problem and at the least impede recovery.
MIMICS OTHER PROBLEMS. Many symptoms of trigger points appear to be other health problems. It is very easy for an uninformed patient or clinician to misinterpret a painful trigger point for almost anything but a trigger point.
...It's not easy to become a classic biological machine…
What you have just read is a brief introduction on the complex interplay between artropathy and neuropathy, the pathologies of articular lesion, mechanical irritation of the nerve tissue, neuromuscular dysfunction, painful trigger points, and loss of balance caused by neurophysiological and biomechanical disequilibrium. Regardless of whether the problem is acute or chronic, and the symptoms are severe or mild, recovery of lost locomotor equilibrium is critical to the disinflammation of irritated tissue, the healing of lesioned tissue and proper neuromusculoskeletal function. By resolving the cause of the symptoms, you resolve the symptoms. Medications can hide a pathology by eliminating the symptoms for a period of time, but they can not resolve the pathology. To recover lost locomotor equilibrium requires personalized care including specific manipulations where needed, when needed. Once asymptomatic it is possible to carry out an occasional periodic check-up to maintain equilibrium and reduce the risk of symptomatic relapse.
To better understand the significance of neglect / proper care of these neurophysiological and biomechanical dysfunctions and pathologies click here.