VIII. Nutrition and the Underlying Physiology of Chronic Pain

34. How do these nutraceuticals help individuals overcome the musculoskeletal pain of osteoarthritis, fibromyalgia or plain old chronic back pain?

First we need to understand what causes muscle and joint pain to become chronic in the first phase. Throughout our body in the muscle, tendons, and ligaments, we have special nerve receptors call nociceptors. These special receptors monitor these tissues and send signals to our spinal cord; if strong enough these messages are then sent on to our brain. These nociceptors signal any problems or damage in our tissues. However, it is only when these messages reach the cortex of your brain do you experience pain.

If you experience recurring chronic back or neck pain, you would have numerous trigger points in and around the muscles of your spine. When you have trigger points in muscles, tendons, and ligaments in a region, these tissues become abnormal and certain inflammatory like chemicals are released by these peripheral tissues. These noxious chemicals released by these tissues cause them to become more sensitive or "inflamed." Therefore, these trigger points are constantly sending signals to your spinal cord, but most of the time these messages do not reach your brain. Therefore, you do not experience constant active pain.

However, when you do something, lift to much, sit or sleep wrong, or come under a great deal of stress these latent or quiet trigger points become worse and actively send signals that reach the sensory cortex of your brain. When this happens you would then perceive pain. You can see now why it's so important to take the time to search out and remove all the quiet or latent trigger points in a problem area, before some physical, chemical, or emotional stress cause them to become active and create pain again.

The best way to remove these active and latent trigger points is to normalize muscles, tendons, and ligaments in problem areas. Do this by physically working on the myofascial trigger points with a Self-care Fenix Rehab System, and by helping to normalize the tissues with effective nutraceuticals. In other words, work on correcting the underlying problems instead of just covering them up with drugs.

35. Does this process relate to the problem of pain all over in fibromyalgia syndrome?

Recent research reveals that many times the pain begins in a region or two, and then by this process it will spread throughout their body. Some studies have stated that as much 45% to 60% of fibromyalgia cases started with a whiplash injury. The more sensitized peripheral tissues become the more signals the nociceptors send into the spinal cord. The more signals sent into the spinal cord, the more noxious chemicals such as Substance P are released in the spinal cord. The greater the release of noxious chemicals in the spinal cord the more sensitized your spinal cord becomes. The greater your spinal cord becomes sensitized the greater your perception of pain becomes, this is called Central Sensitization.

This Central Sensitization of the nervous system may be the underlying cause of the global pain of Fibromyalgia Syndrome. The causes of this Central Sensitization are usually a combination of genetics, physical injury, decreased energy production, exposure to stress, toxins and poor detoxification function, more on this later. These multiple causes of Central Sensitization of the nervous system are what make Fibromyalgia Syndrome so difficult for doctors to understand and treat.

There are many inflammatory chemicals that are released in painful muscles, tendons, and ligaments and released in the spinal cord in chronic pain states. A few of the primary ones are: Substance P, and the pro-inflammatory prostaglandins PgE2, and LTB4. There are nutraceuticals that can lower these noxious chemicals in chronic pain states, and help normalize pain-causing musculoskeletal tissues.

This is a very simplistic explanation of the most recent research defining what actually happens when a person develops chronic musculoskeletal pain disorders or fibromyalgia syndrome. In research it is referred to as Peripheral and Central Sensitization of the nervous system. Recently our understanding of this process has been well developed by the work of DF. Woolf and M.W. Salter, their studies can be found on a PubMed search.

Next: Nutritional Supplements Relief