The Pain Tunnel: Part 2

Being in unending chronic pain is like falling down a dark well. You feel alone in the darkness, hurting, terrified, and you don’t know if you will ever get out. You can’t see the walls of the well so climbing out seems impossible. You just feel hopeless.

In Part 1 of this series, I deepened your understanding of the nature of chronic pain and I introduced you to The Pain Tunnel. If you haven’t read that you can do it here. Understanding The Pain Tunnel gives you a map of the well. Now I want to give you a flashlight so you can begin to see how to navigate your way out. To do this, you need to gain a better understand of the layers that make up The Pain Tunnel.

The Pain Tunnel Overview

Layer 1 – The Central Nervous System aka the brain and the spinal cord. The part of you trying to understand everything you are sensing in order to keep you alive.

Layer 2 – The Peripheral Nervous System aka the nerves in your body that enable you to feel temperature, pressure, and pain.

Layer 3 – Inflammatory Responses – aka the bodies process of fighting against things that harm it in order to heal itself.

Layer 4 – Muscle & Joint Dysfunction – aka when the parts of you that allow you to bend, reach, and walk don’t work like they are supposed to.

Layer 5 – Muscle & Joint Degeneration – aka how the body breaks down when you let your muscles and joints not work like they are supposed to for long periods of time.

Let’s shine some light here and deepen your understanding of what each layer is, some issues that can occur, and the health care professionals that can help address those issues.

Layer 1 - The Central Nervous System aka the brain and the spinal cord.

Your brain is the interpreter and the regulator. It is the judge and jury. If your brain decides there is a problem, there is a problem. When it comes to chronic pain, the feedback loop between your emotions and your physical pain (and back again) is a tight one. People who are depressed get physical pain. People who have physical pain get depressed. That’s not a coincidence. That’s how the human machine works. Your mental health, mindset, and brain chemistry are fundamental building blocks to the experience of pain.

Issues to look for in Layer 1:

Emotional and mental health issues such as; unhealthy relationship with the self, unhealthy intimate relationships, unhealthy community relationships, unhealthy mindsets.

• Sleep issues.
• Unhealthy dopamine altering behaviors such as opiates, alcohol, gambling, pornography, and sex addiction.
• Unhealthy stress levels.

Health Care Professionals That Address Layer 1:

• Pastors
• Counselors
• Medical professionals that specialize in hormones.
• Psychiatrists
• Nutritionists
• Pain Management Doctors to alter medications.

Layer 2 - Peripheral Nervous System aka the nerves in your body that enable you to feel temperature, pressure, and pain.

Your sensory nerves act as your brain’s sensors. They gather information about what’s going on around you, mostly heat, pressure, and chemicals. They send that information back to the brain. If there is enough heat, pressure, or certain chemicals present, your pain sensors send a signal to your brain that bodily damage is about to happen. That’s a good thing. You want to know if your hand is resting on a hot skillet. A healthy pain sensing system is a beautiful thing. But what about when it stops working properly? When this system stops working properly even the slightest touch can send off pain signals, even the refrigerated aisle as the grocery store can send off terrible pain signals, and sometimes literally nothing can be wrong but your pain sensors are just set to ON and you will be experiencing very real pain for no real reason whatsoever.

Issues To Look For In Layer 2:

Central Sensitization aka dysfunctional pain signal systems - caused by autoimmune disorders, time in pain, heightened inflammatory levels in your blood, dopamine altering behaviors/drugs, inadequate sleep.

Health Care Professionals That Address Layer 2:

• Rheumatologists
• Personal Trainers (cardiovascular training helps re-regulate this system)
• Pain Management Doctors to alter medications
• Mental Health Professionals
• Nutritionists

Layer 3 - Inflammatory Responses – aka the bodies process of fighting against things that harm it in order to heal itself.

When you damage your body, the damaged components send out signals for help asking for vital blood flow and fluids to assist in healing. If you roll your ankle and damage tissues, you want it to swell. If your hand touches a hot skillet, you want it to turn red, blister, and swell. That’s what a healthy inflammatory response looks like. What happens when our inflammation systems overreact or are constantly turned on because of an unhealthy lifestyle? Our pain sensors ring the alarm to tell us something is wrong, even when the part of the body that hurts is completely fine. More inflammation means more pain signals being sent off. High levels of inflammation are like a firework show of pain signals lighting up your life, or in this case destroying it.

Issues to Look for in Layer 3:

• Dehydration
• Refined sugar
• Excessive salt
• Food intolerances and allergies like dairy and gluten.
• Auto-immune disorders

Health Care Professionals That Address Layer 3:

• Nutritionists
• Rheumatologists

Layer 4 - Muscle & Joint Dysfunction – aka when the parts of you that allow you to bend, reach, and walk don’t work like they are supposed to.

Now I am getting squarely into my field of expertise, biomechanics and how the body carries and adapts to loads and stresses. The first thing you have to understand is the difference between DYSFUNCTION AND DEGENERATION.

Dysfunction is when your muscles and joints aren’t working optimally. Dysfunction creates hyper-loaded areas that are compensating for other areas weaknesses. Examples include forward shoulders, forward head, gait issues, unstable spine, and other movement disorders.

Degeneration is what happens when you leave a muscle or joint in a hyper-loaded, compensating state and it adapts and/or breaks down. Examples include rotator cuff tears, degenerative disc disease, spinal stenosis, osteoarthritis/bone on bone joints, disc bulges, carpal tunnel syndrome, etc.

I want to be very clear on this point.

Dysfunction CREATES degeneration.

They are two different things.

The former causes the latter.

Now that we got that cleared up, we can move on.

Layer 4 – Muscle & Joint Dysfunction

The muscles, bones, and joints are an incredibly complex structure designed to keep us upright and mobile against the force of gravity and to evenly distribute that force beautifully into areas capable of handling it. Think of an athletic body that moves with grace and ease. It looks effortless. That’s because it is. That’s the way the body is SUPPOSED to work. What happens when the muscles and joints don’t work the way they should? Movement is hard, painful, and awkward. When muscles and joints don’t work the way they should you feel lumbering, uncoordinated, and stiff. The vast majority of dysfunctions are inherently correctable with intelligent therapeutic movement. Most chronic pain issues have muscle and joint dysfunction as their root cause and then that issue begins creating secondary issues like nervous system issues, unhealthy food choices, depression, and joint degeneration. Can you see how a small seed can grow into a big problem?

Issues to look for in Layer 4 -

There are endless possibilities, but I will just name a few.

• Tight, spasmed muscles.
• Forward head and shoulders
• Forwardly tilted shoulder blades
• Internally rotated hands
• Loss of shoulder range of motion
• Loss of movement through the spine

Health Care Professionals That Address Layer 4 Issues –

• Your brilliant and fearless leaders at Align! We specifically focus on walking people out of the darkness of chronic pain and our main focus is addressing Muscle & Joint Dysfunctions! (Cue the shameless plug)
• Personal Trainers – Be careful here, most are woefully underprepared and can cause more harm than good.
• Physical Therapists – Again, be careful here. This is a complicated topic, but most physical therapists are ill-equipped to walk you all the way out of your chronic pain journey, both from an educational and a medical billing perspective.
• Chiropractors
• Massage Therapists

Layer 5 - Muscle & Joint Degeneration – aka how the body breaks down when you let your muscles and joints not work like they are supposed to for long periods of time.

Once a dysfunction has hyper-loaded an area for long enough, degeneration takes place. Another way of saying that is, if an area compensates for long enough it will break down and degenerate. Discs and cartilage are lost. Tendons and fascia are calcified, fray, and tear. Bones grow spurs. Some degeneration can be reversed without surgery, but some cannot. If you let your body be dysfunctional for a long time, there are consequences. Sometimes those consequences can’t be reversed without surgery. I want to be very clear here though. YOU CAN HAVE JOINT DEGENERATION WITHOUT PAIN. I’ll say it a different way. The muscle and joint degeneration that you found on that MRI is NOT always the cause of your pain. In fact, most of the time people with NO PAIN have the same amount of joint degeneration as people WITH PAIN. That tells us that the degeneration is not the PAIN GENERATOR.

Issues to look for in Layer 5:

• Bone on bone shoulders, hips, and knees
• Degenerative disc disease
• Bulging Discs
• Spinal stenosis
• Fraying or torn tendons and fascia

Health Care Professionals That Address Layer 5 Issues:

• Your brilliant and fearless leaders at Align! We specifically focus on walking people out of the darkness of chronic pain and our main focus is addressing Muscle & Joint Dysfunctions! (Cue the shameless plug)
• Physical Therapists – I already gave you the scoop here.
• Orthopedic Surgeons
• Pain Management Doctors

Remember this wisdom before you go to your surgeon for the first time, the quickest way to a useless surgery is to get an MRI.

You now understand that your experience of pain is combination of issues, not just a single issue. You now understand that how your muscles and joints work, or don’t work, is usually the seed that branches out into issues in every layer of The Pain Tunnel. You now understand that what you found on your MRI is usually not the source of your pain and is usually caused by your muscles and joints not working the way they should over long periods of time. You now understand that any “fix” that doesn’t involve addressing the root cause of your pain, aka your muscle and joints not working like they should, is doomed to fail from the start and will only create more issues later down the road.

Congratulations! Now that we’ve shined a light into the darkness, you now understand the nature of chronic pain better than 99% of the medical establishment! That will be necessary if you are going to lead yourself out of chronic pain.

In Part 3 of the Understanding Neck Pain Series, we are going to deepen your understanding of how the neck is supposed to exist and function and what most commonly goes wrong.

I hope this helps you on your journey,
Matthew Lister - Founder of Align