If you are suffering from pain, you are probably wondering if it’s ever going to go away or are looking for an effective treatment. The answer is, yes, it will go away and there is effective treatment. As a chiropractic student, I was never satisfied with the paradigm that joint manipulation was all that was needed to eliminate pain and address structural dysfunction. I agree that joint misalignments negatively impact musculoskeletal health, but the exclusion of soft-tissue therapy, exercise and nutrition left me to search for answers. I read articles and textbooks, and attended seminars and conferences outside of my profession to expand my knowledge. Over time, I gained the understanding I needed to deliver the most comprehensive and holistic approach to treating musculoskeletal injuries.

What I will discuss is the treatment approach that takes into consideration the fact that the human body is not just a collection of parts needing repair, but a system requiring a holistic approach toward optimal healing, resilience and achieving a state of well-being. But first I should shed some light on the injury assessment that needs to happen before treatment begins. This is a short description of a clinical protocol. Some details may not be included, but you will get the picture.

Understanding musculoskeletal injury is critical to accurate diagnosis and treatment. It begins with gathering a complete and detailed history of the complaint. Questions pertaining to the mechanism of injury, when it occurred, quality of pain and loss of function provides valuable information regarding the current condition, direction of treatment and prognosis for recovery. Inquiries pertaining to sounds such as popping and crunching, or sensations such as instability, pulling, ripping and electric shock during the traumatic event will be noted. The examiner will ask about the intensity and quality of the pain. Is it sharp, dull, bright, boring, localized, or radiating? Is the pain associated with certain posture, activity or time of day? Other factors such as age, occupation, current medications, and past history of major illnesses, accidents or surgeries provides valuable information. Additionally, questions regarding lifestyle activities like exercise programs, sleep patterns, nutrition, work environment and stress levels will be asked. Through the inquiry, the examiner will note potential “red flags” that would indicate that the disorder may not be musculoskeletal in nature, which would then require a referral to the appropriate health care professional. These questions may seem extensive, but they are critical to making accurate prognosis to the disorder.

Evaluation starts with observation of the whole person as they enter the examination room. In reality, the evaluation begins from the minute the examiner makes first contact with the patient. At that time, the patient’s gait, posture, demeanor and level of alertness is being noted. The formal evaluation begins after the history is gathered. The evaluation process is primarily focused on the area of complaint, but it will also be geared toward uncovering how the disorder may have affected the whole musculoskeletal system. Observation for postural asymmetries, deformities (structural, functional, dynamic), tissue discoloration and trophic (nerve-related) changes provides valuable information.

The next part of evaluation is the examination. This stage will confirm or refute the suspected diagnosis. Great care must be taken as to not aggravate the condition, but in some cases the patient may feel some discomfort. Once the exam process is finished, the clinician will explain the injury, treatment plan and the expected out come of the healing process.

Now that I’ve explained the standard protocol for a doctor’s visit I can move on to the topic of treatment. Finding and knowing the appropriate care for a musculoskeletal injury can be complicated, primarily because we don’t know who to go to. Actually, most people go to their general practitioner to find relief for their pain. As a result, painkillers are prescribed to eliminate the pain. Painkillers work like magic, but don’t address the dysfunction causing the pain. Eventually the pain comes back and you run out of pills and you have to get more. This cycle repeats itself over and over again. This is an accepted and widely practiced response to treating musculoskeletal pain and injury in our culture. It is widely practiced not because of access to appropriate care, but because of ignorance and the mindset of quick fixes.

Treating musculoskeletal pain and injury involves more than pain elimination to gain optimal function. To understand this, you have to understand the reasons we feel pain. According to Guyton and Hall, pain serves as a protective signal for self-preservation from bodily damage. It is a signal to discontinue the insulting activity, even if it is a simple activity such as sitting for prolonged periods.

This activity compresses the soft tissues, reducing blood flow, causing tissue damage and leading to pain. As a result, the body weight is shifted away from the pain, or prolonged sitting is avoided. Individuals with no pain sense due to spinal cord trauma will fail to move away from the pain, resulting in complete breakdown of the anatomical region.

This definition makes it clear that pain is harmful, but how can active/competitive individuals accept this and discontinue the painful activity when the activity is their sport? They don’t. They go to chiropractors, physical therapists or massage therapists for relief. What these professionals have in common is the approach of manual therapy to eliminate pain and dysfunction, rather than pills. What I’ve personally discovered, outside of the chiropractic paradigm of the spinal adjustment being the primary mode of healing, is that soft-tissue therapy is equally important along with rehab exercises and an anti-inflammatory diet.

I believe this is due to the fact that the body is more than the sum of its parts. We are not like machines that break down and have parts replaced. We are a much more complicated system.

So, what’s the solution? The solution I have implemented and found to be very effective is the integration of chiropractic osseous (bone) adjustments, soft-tissue manipulation (i.e.; Fascial Manipulation, Graston and Active Release), exercise rehabilitation, and anti-inflammatory diet and supplementation. The reason for this approach is that it addresses all of the reactions that occur when an injury happens. When pain is experienced, several events are occurring in the body. Inflammation (causing the sensation of pain) is one of them. Antalgia is another. It results in postural deviations leading to muscular imbalance, causing more structural dysfunctions in the body. An integrated mode of the therapy addresses skeletal misalignments, tension in the fascia, inflammation, dysfunctional movement patterns and muscle weakness. Here’s my integrated approach:

• Align the skeletal frame through chiropractic adjustment
• Balance tension in the fascial suit through soft-tissue therapy
• Reduce inflammation through diet and supplementation
• Rehabilitate dysfunctional movement to strengthen muscle and propioception.

Would this approach provide you with the solution you’ve been looking for?
From my experience, it should. I would recommend that you seek a professional in your area that can understand the systemic nature of your injury and provide you with the type of comprehensive treatment I’ve described. Something to remember regarding musculoskeletal injuries is that given the right support and treatment, the body will heal. Remember, when an injury happens it’s not just the pain that needs attention. Addressing the joint restriction, soft-tissue disorder, exercise rehabilitation, and nutrition are all critical to recovery.