When you go to the chiropractor with any sort of pain you might question “is something out of place”? I have to blame our own profession for that misconception. The problem is that we are lying when we use this terminology! Nothing is out of place. The way most patients imagine pain is that something is dislocated, but dislocation is an emergent situation. So let’s clear up some basics of anatomy and physiology.
Don’t get me wrong when I have pain I think something is dislocated as well. However, it is important to know that bones do not move. Meaning bones don’t move by themselves. A bone cannot be out of the place on its own. More importantly, bones can’t move incorrectly without something else being involved. Which brings leads to the next important piece of anatomy, muscle.
Skeletal muscles attach to bones. In fact, the muscles have to cross a joint and attach to two different bones. For example, your spine has a lot of joints that are close together. These joints are what make a sound when you get adjusted. Muscles are what move the bones and joints. Therefore, if a muscle is not being told what to do correctly over a long period of time the bone can change. This change is arthritis, which may or may not have pain. Overall mechanics may change because of bone changes, but this takes some time to develop. Many patients have the misconception that muscle can work on its own. However, this occurs only on very rare occasions.
Some important things to remember:
1) Bones. Bones are a hard structure but can change shape under pressure over a period of time. Many people come into my office and say that their bone or joint is out of place. It usually translates that they perceive their joint is dislocated. However, a dislocation is extremely painful and an emergent situation. So what is causing your pain? It very well can be your joint that is the issue. So, how is a solid structure that does not move on its own causing your pain? This question leads to the next lesson.
2) Muscles. There are three types of muscles, but this lesson is about skeletal muscle. Skeletal muscle attaches to two bones and crosses over at least one joint. This allows the muscle to contract and move the bones around each other at the joint. You might think that muscles contract on their own. Maybe in a diseased state, this can happen, but it is very rare and not what we usually see in our office. So this leads us to the next lesson. What controls the muscle?
3) Nerves. The nervous system includes receptors, peripheral nerves, the spinal cord, and your brain. I am partial to this system, as it perceives everything in our world. It perceives and controls pain, vision, hearing, taste, balance, movement, thought, heart rate, how warm you are, if you need to cool down or warm up, love, anger, and fear. It even controls if you are able to walk and chew gum at the same time without thinking about it. So, this system sends an action potential down the nerve to a muscle and tells it to contract.
Another important thing to know is that we constantly perceive many different things in our world. We then react through senses, motor responses, or thought. For example, if you are walking and step on a Lego, you shift your weight as quickly as possible to lift your foot away from the pain. Magically, at the same time you are wondering who left the Lego out and how to prevent it from happening again.
If you have pain your bone is not out of place, unless it actually is dislocated. This situation is much more complex and needs a proper evaluation to discover the root of the problem. For one person, it may be that they need to change their workout. For another, it may be that they need to address emotional stress. Thankfully, a chiropractor can assist in both using hands-on therapy.