Origins of our Aches and Pains

Origins of our Aches & Pains

Fundamentally and very simply, pain is the single-most reported complaint in a doctors' office.  The focus of this BLOG Post is to discuss benign, uncomplicated muscle and bone-related origins of pain.

In my own experience as Clinician, an hour in a day does not go by without the discussion of pain emerging.  "Pain is a pain" for many and in many cases, a Chief Complaint of "Pain" will be received with a Clinical History that is absent of any one reason or recollection for the symptom of pain.  In many cases, most of us are simply unaware that a close relationship exists between a previous injury or an exposure to long-past traumas and current or future aches and pain syndromes.

This is where we dig for clues and answers to the origins of most pain symptoms and where we find relief.

Muscle and Bone Pain over time

As our body endures the effects of time, (some call this "aging"), including its exposure to minor and major injuries; micro and repetitive traumas, and the constant effects of gravity - it also undergoes a beautiful and natural healing process as result of those "injuries", to maintain the high functioning operation of the body.

"Degeneration is natural; cumulative; exponential; and absolute"

The injury-healing mechanism is a normal and natural process that is cumulative in nature (injuries add up) and impacts the physical functioning of the body, exponentially over time.  The more injuries that have been healed, the more degeneration of the physical body at that area. The more areas affected, the more rapid and greater the degeneration. Additionally, the more time (i.e. "aging") we are exposed to this physical degeneration, and the more incidents we are exposed to, the more this process is compounded and the more its effects are felt on the many related parts of the body.  Degeneration is natural; cumulative; exponential; and absolute.

The type of injury or trauma, and the extent of the physical damage per incident dictates the amount of healing that is originally required.  It is common for us to forget and some of us may not even know about some of the early slips and falls we took during our first several years; like falls from bicycles; from skates; falls from trees; down stairs; or collisions on the football field or hockey rink, and baseball diamond.  Many of us have fallen from ladders; off roofs; have conducted years of heavy work; have been exposed to repetitive light or heavy duty in factories, at home or via a hobby; and some have been exposed to violent and big forces within auto-accidents, sporting collisions and major slips or falls. 

Fact is, we have all been exposed to "something" in our lifetime that has injured our physical body and not necessarily to a point that we required medical attention - but the "event", however big or small, has happened. Over time and as the body weakens, the effects of gravity and aging itself wreak constant havoc on our musculo-skeletal system and when we add all this to the cumulative traumas we have been exposed to, the result is often irritation and in the form of inflammation.

Inflammation: As a root of Pain

Aches and Pains are often related to inflammation of the areas where our muscles attach to bones and where the ends of the muscles weaken and start to naturally micro-tear over time. Inflammation at the joints of the body (where bones attach to bones) also occurs, where ligaments or cartilagenous surfaces start to break down, due to constant and often disproportionate physical stress put onto that area of the body. 

The amount of this type of inflammation is often directly related and proportionate to the amount of previous exposure to minor or major injuries; the types of exposures and the forces at play during the injury exposure (e.g. Car accidents produce huge forces (exposure) whereas a fall off a chair produces small forces which in both cases, (the "forces") get absorbed in some amount, by the physical bodies involved in the collisions).  

The number of exposures one experiences is a factor in the amount of degeneration and related future inflammation (root of pain), as is the length of time away from the original injuries. In fact, paradoxically the further away from the time of the original injury (i.e. the older we get), the more time that original injury has had to degenerate the area of the body that was previously injured and healed. It's curious and most patients who come into the clinic, think the opposite is true - and commonly think that the older the injury, the less of a bearing that old injury should have on the current state of health or level of pain.  The opposite is in fact true.

Simply put: A fall from a park bench that scrapes a knee of a 9yo boy will have minimal impact on the same person at age 80.  Whereas a 9yo's fall onto his back (spine) from a height of 20 ft off a barn beam onto a non-sharp and large, oddly shaped blunt metal implement below, will have a far different and significantly greater physical degenerative impact, on this person when he is age 80.  

Bigger injury = Bigger future pain from degeneration and related inflammation

The fact is, we all know our bodies histories better than our physicians do, and we certainly know our minor and major injury exposures more than we share with our doctors.  So if you are experiencing aches and pains related to your own "physical-checkered-past" (exposure to minor and major injury or trauma), as mentioned above, you can start to better understand and maybe even accept your pain complaints to a different degree. Small consolation I am sure.

As our body endures time, it also "wears out" through time when we essentially 'spend" our body.  Our muscles often get stronger up to a point in our lives, as they are exposed to normal "strengthening" type activities - as do our bones. However, when the load of our lives intentional of unintentional say from a trauma or simple wear and tear on our bodies is greater than our physical body's strength, it is then that the body starts to break down.  This breakdown leads to natural healing and if repeated (which is the norm), it becomes a vicious cycle of an "injury & healing process", because we continue to expose ourselves to normal and not-so-normal wear and tear events that life delivers.

While this healing process is considered "normal", in this scenario, it falls under a medical condition many are familiar with called Osteoarthritis or simply Arthritis, which is degenerative by definition.

Arthritis can be a natural aging process and it can be started as result of trauma. Arthritis is not necessarily an older persons' disease or affliction, rather it is a condition that takes time to develop so the older we get the more likely the effects of Arthritis will become real and realized.  Traumatic-onset arthritis is a part of a healing process that STARTS at the time of injury, regardless of age.  The more we are broken down from injury, weakness, fatigue, stress or illness the greater the degeneration is felt, at that stage of our lives. Aches and pain affect us all.  The colloquial term "arthritis" is often reserved for the aged and in the Pain Clinic setting where I work, we observe this process to be normal and, very common at all ages.

Clinical Observation: Human survival through and over time requires willpower and inner strength to withstand the rigours of normal life.  In many cases as we age, this same inner fortitude programs our brains to write cheques that our bodies simply cannot cash and while this is disheartening to some; it is a clue that we may be able to manage our pain levels by limiting our "body spend".

Your Health Matters,
Dr. Jody Anderson

Next Blog Post I will discuss Pain Management strategies