A very interesting, more academic view, that should provide some food for thought and some talking points for you and your own Doctor. Tissue Remodeling: perhaps your own connective tissues need some realignment.
Chronic Pain's Relationship to Microscopic Scarring of Elastic, Collagen-Based,Connective Tissues
By Dr. Russell Schierling
Are you aware that approximately one in five Americans suffers with Chronic Pain?Chronic Pain is miserable, and can quickly make every day your personal "Mount Everest". It affects every area of your life, and can be seen on your face and in your eyes. The latest medical research likens brain scans of people suffering with Chronic Pain, to those of people with dementia or Alzheimer's.
Those of you suffering with Chronic Pain have been through all the medical tests, but no one can seem to tell you why you hurt. You are, perhaps, sick of going to doctors who not only do not understand what you have to deal with 24-7-365; they act like you are nothing more than a drug-seeker. Or a free-loader who is trying to collect Social Security Disability. Or a whining hypochondriac.
They look at you with blank stares and give you words of wisdom like, "After all Mrs. Smith; you just aren't as young as you used to be." Or they tell you that it's, "Just a little arthritis". Or maybe they try the latest scheme, and tell you that your pain is being caused by Depression (even though current research shows that the opposite is closer to the truth).
Either way, you have been through all the tests, and tried all the treatments; and you are no closer to a solution than when you started. Believe it or not, your problem could be as simple as scar tissue.
MICROSCOPIC SCAR TISSUE:
Some collagen-based connective tissues like bone and most cartilages, are part of your body's load-bearing framework. Their purpose is to withstand Compressive Forces, while grossly maintaining the body's shape. On the other hand, you have the elastic, collagen-based, connective tissues, whose chief job is overcome the Tensile Forces that are constantly trying to pull the body apart. These tissues must be able to stretch; and includes ligaments, tendons, muscles, and fascia.
When healthy, these "elastic connective tissues" are all very similar. If you were to look at them under a microscope, you would notice that the individual collagen fibers all align in a very orderly and organized parallel fashion to each other ---- sort of like well-combed hair.
On the other hand, when these tissues are injured by overuse (jobs, sports, etc) or trauma (sports, car wrecks, etc), they become disorganized and tend to take on a "Weaved Basket" appearance microscopically. We now end up with injured tissues whose microscopic fibers run every which way --- in all three dimensions. The injured tissue becomes very disorganized, with individual fibers acting more like a wadded up and tangled "hairball" than well-combed hair. As you can imagine, this "micro-scarring" is a big problem.
MICROSCOPIC SCARRING CAUSES PROBLEMS:
Microscopic scar tissue is problematic because it is dramatically different than healthy tissue. Some of the ways that it differs include;
a...SCAR TISSUE IS WEAKER:
As you can imagine, the tangled "clump" of tissue that characterizes a microscopic scar is far weaker than normal connective tissue. You already know this. Sprain an ankle, and it is easier to sprain it again and again and again.
b...SCAR TISSUE IS LESS ELASTIC:
The hairball is less elastic than well-combed hair. Look at it another way. Put your hands out in front of you with the palms facing away. Now run the fingers from one hand, back and forth, between the fingers from the other hand. Notice how the fingers glide? Now run your fingers from one hand to the other, and ball up your fingers. This is what tangled and twisted connective tissues do microscopically. Subsequently, they lose their stretchiness and elasticity.
c...SCAR TISSUE DOES NOT OXYGENATE WELL:
Known as hypoxia, decreased oxygenation is terribly harmful because oxygen is critical for healing to occur. When connective tissues are injured, swelling occurs; and it is this combination of swelling and twisted / tangled tissue that restricts the blood flow and oxygen supply to the connective tissues. Lack of oxygen also creates a very acidic environment, which is detrimental to the healing process and health in general.
d...SCAR TISSUE IS DIFFERENT NEUROLOGICALLY:
It is easy to see how microscopic scarring is different mechanically. What most doctors fail to tell you is that scar tissue is different neurologically as well. The latest research tells us that the nerves in scar tissue can conduct pain up to 1,000 times more effectively than normal tissue. This creates what is knows as Type III pain (Supersensitivity).
Abnormally functioning nerves in scar tissue, lead to problems like diminished proprioception (which causes degenerative arthritis and joint deterioration). It can also lead to HYPERALGIA (extreme sensitivity to pain -- stimulus that should cause a little pain causes extraordinary amounts of pain), or ALLODYNIA (stimulus which do not normally cause any pain, now causes pain). In people dealing with underlying scar tissue, these three frequently overlap.
FASCIA:
The most abundant connective tissue in your body is fascia. Although you may have never heard the term "fascia" before, you undoubtedly have seen it and know what it is. It is the thin (almost translucent), white / yellow membrane that surrounds muscles ----- or a pot roast. When doctors diagnose a "pulled muscle", about 95% of the time, the problem is not with the muscle itself, but with the membrane-like "sheath" that wraps the muscle like cellophane.
Fascia is a tough layer of fibrous, collagen-based connective tissue that permeates the human body throughout. It is the thin connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves; binding these structures together in much the same manner that plastic wrap can be used to hold sandwiches together.
Fascia is the tissue where the musculoskeletal system, circulatory system, and nervous system, all converge. Fascia consists of several layers, and extends uninterrupted from the top of the head to the tip of the toes, and is arguably, the single most pain-sensitive tissue in the human body. Nor does it show up on any current diagnostic imaging.
This creates Chronic Pain's "Perfect Storm". Think for a moment how serious this situation is. The single most painful tissue in the body (fascia) does not show up on even the most advanced diagnostic tests. Many of you who suffer with Chronic Pain know full well what this means. It means that doctors stare at you with a blank look, while offering to give you another prescription, or send you to another specialist ----- even though you have already been through all of that --- several times over! These " Fascial Adhesions " can cause a wide variety of symptoms and various Pain Syndromes.
As amazing as it sounds, a nearly identical tissue model is being used to explain tendinitis.
TENDINITIS -vs- TENDINOSIS:
Tendons are the tough, white, "cords" that connect muscles to bones. Overuse injuries of the body's various muscle tendons is a leading reason for doctor visits. Although these injuries are often referred to generically as "tendinitis", tendinitis is actually an incorrect term in the vast majority of cases.
Over the past decade, medical research has shown conclusively that the major cause of "tendinitis" is not inflammation. In other words, the scientific evidence is saying that the culprit in most tendon problems is not inflammation of the tendon (aka "itis"), but is instead an "osis" of the tendon. The suffix "osis" indicates that there is a derangement of, or even a deterioration of the individual collagen fibers that make up the tendon.
The truth is, even though doctors (including me) still use the term "tendinitis" with patients, their AMA-mandated ICD-9 Diagnosis Codes usually indicate that the problem is "tendinosis" or "tendinopathy".
Am I splitting hairs, semantically speaking? Am I making a big deal out of nothing? I will let one of the world's top tendon researchers and orthopedic surgeons answer that question:
"Tendinosis, sometimes called tendinitis, or tendinopathy, is damage to a tendon at a cellular level (the suffix "osis" implies a pathology of chronic degeneration without inflammation). It is thought to be caused by micro-tears in the connective tissue in and around the tendon, leading to an increased number of tendon repair cells. This may lead to reduced tensile strength, thus increasing the chance of repetitive injury or even tendon rupture. Tendinosis is often misdiagnosed as tendinitis due to the limited understanding of tendinopathies by the medical community."
Tendon researcher, Dr. GA Murrell from an article called, "Understanding Tendinopathies" in the December 2002 issue of The British Journal of Sports Medicine.
As you should be noticing, the models describing injury to the various collagen-based, elastic, connective tissues are virtually identical. This is critical for physicians to understand, because the microscopic scarring that is the cause of multiple Pain Syndromes can all be addressed in similar fashion. The medical community has understood this for a very long time.
Unfortunately they have ignored it and largely focused on treating symptoms by prescribing an array of pain killers, anti-inflammation drugs, muscle-relaxers, and corticosteroid injections. Because these drugs do not address the underlying problem (tissue restriction) that is associated with microscopic scar tissue, they never really work --- especially over the long haul.
They also cause the affected joints to go through an increasingly accelerated degeneration process. Loss of normal range of motion (joint restriction) is the known cause of degeneration ----- and degeneration causes loss of range of motion. Repeat. It is a vicious cycle.
Notice how pain is not really part of the cycle (at least at first). It is a by-product of the cycle as it spins around and around and around. Instead of focusing almost solely on symptomatic relief, the real question should be, "How can this cycle be broken"? Can you say I.I.R.E.C-B.C.T. Tissue Remodeling?
I.I.R.E.C-B.C.T.:
I.I.R.E.C-B.C.T. is not the latest electronic gizmo. It stands for Intrument Induced Remodeling of the Elastic Collagen-Based Connective Tissues (otherwise known in my clinic as "Tissue Remodeling"). Although it has only been around for a couple of decades in its present form, the Chinese have been using something similar for several thousand years.
Our Tissue Remodeling Treatment enables the treating physician to effectively detect and treat, fascial adhesions and microscopic scarring of the elastic, collagen-based tissues.
Dr. Schierling has been in practice in Mountain View, Missouri for two decades, and for half of that time he has been using Tissue Remodeling to treat a wide variety of problems (Patient Testimonials). These include chronic neck and back pain, shoulder (rotator cuff), elbow, wrist, hip (and buttock), knee, and ankle problems; Piriformis Syndrome, chronic headaches, tendinitis / tendinosis, muscle problems, bursitis, Osgood Schlatter's Syndrome, Carpal Tunnel Syndrome, shin splints, DeQuervain's Syndrome, ITB Syndrome, and too many others to list.
For more information and real patient testimonials, go to http://www.DestroyChronicPain.com
Article Source: http://EzineArticles.com/
Tissue Remodelling: Hopefully this information will assist you in some small way and perhaps become part of your own chronic pain management. We offer this as a starting point of ideas that you might want to share with your own medical professional.Each guest writer presents their own views and they may not be ours. Just some ideas to think about and share.
