Treating Chronic Pain
WHY DO WE GET BACK PAIN?
80% of our body is musculo-skeletal and prone to strain or injury. Those of us who do physical jobs or a lot of exercise are prone to overuse injuries and accidents. While those who do a lot of desk work or driving have a higher tendency to postural muscle fatigue. Then also, there are health factors like nutritional imbalances and illness. Can you remember the last time you had the flu and your muscles where sore? At that time you were probably a bit dehydrated and low on minerals such as magnesium.
WHEN YOU’RE “BACK is out of WHACK?
Well this depends on your activity. For those with a physical job or aggressive exercisers it usually occurs in the low back. If your job involves a lot of sitting then you will typically suffer neck and shoulder pain. Trauma also has a strong affect. Did you ever stub your toe and then seem to keep on hitting your toe again over the next few weeks? This seems to occur due to the fact that the area of injury causes our body to be out of proper alignment to prevent further pain and injury. Then there is also the fact that the nervous system is somewhat impaired causing local weakness and incoordination.
HOW DOES PAIN OCCUR?
Generally, physical activities lead to overuse or trauma while sedentary activity causes decreased circulation and stiffness. Either way, the end result is pretty much the same causing our muscles to get tight and/or bones to get out of alignment. This causes restriction of blood flow by muscle spasm or boney impingement of a nerve resulting in pain. Again, other factors like lactic acid buildup, dehydration, or nutritional imbalances have an additive effect to the amount of pain. In addition, the more factors involved leads to more delay in healing.
HOW CAN I GET MY “BACK IN SHAPE?”
The first thing to remember is that pain, like a fire, is best put out with W-A-T-E-R! Yes, water, a natural anti-inflammatory, is the best therapy to start out with. Also, anything else you take by mouth is going to need water to distribute your food, supplements, and medication to the injury site! Next, I would think of a supplement with magnesium which is a natural muscle relaxant that is often found to be deficient in individuals. After, this I would look at either natural anti-inflammatory nutraceutical with boswellia and/or turmeric for mild to moderate pain. For more severe pain I recommend either a CBD or compounded medication pain cream.
WHAT ABOUT ADJUSTMENTS &/OR ACUPUNCTURE?
The primary focus of physical medicine is to enhance blood and nerve circulation to compromised areas of the body. Simply stated, properly applied physical medicine allows nutrients and medication (if necessary) to get to “the job site.” Acupuncture, in a similar way opens up blood supply and additionally causes the body to release endorphins both locally and systemically. I find soft tissue myofascial therapy is most effective to relax muscles, reduce pain, and increase circulation.
DOES A DOCTOR OF OSTEOPATHY (D.O.) APPROACH BACK PAIN DIFFERENTLY THAN A M.D. OR DOCTOR OF CHIROPRACTIC (D.C.)?
Doctors of Osteopathy (D.O.) have the same medical license as a M.D. but consider the use of musculo-skeletal therapy before the use of medication to allow the body to participate in the healing process. While Chiropractic Doctors tend to focus on musculo-skeletal problems, D.O.’s look at how musculo-skeletal problems affect one’s overall health through compromised circulation. Also, D.O.s have found that chronic musculoskeletal imbalances are best treated by focusing on the tight muscles that cause the joint to be out of alignment. This allows for a less painful and more permanent treatment healing experience for the patient.
WHAT IS REGENERATIVE THERAPY AND WHEN IS IT INDICATED?
Regenerative Therapy is a form of Prolotherapy that causes moderate to severe inflammation for 12 to 24 hours triggering the release of growth factors that initiate a healing response at the perceived site of injury. This therapy is especially useful for chronic injuries that have had their healing response blocked by steroidal and nonsteroidal anti-inflammatory medication. These injections are focused to painful joints and surrounding ligamentous trigger points such as the knee, hip, shoulder, or sacro-illiac joint.
Although, non-steroidal anti-inflammatory agents cannot be used pain medication such as Hydrocodone is suggested during the initial healing process. The usual approach is doing a trial of 4 injections every 2 to 4 weeks along with soft tissue myofascial therapy. I have found this combination of Regenerative therapy with myofascial therapy to be about 70% effective.
IS STEM CELL THERAPY REALLY THE BEST OPTION?
Just about everyone has heard of Stem Cells, but few people understand the inherent limitations. Stem Cells have become a popular option for the treatment of chronic pain in various joint and ligaments. The biggest advantage is that it can be taken from one’s own fat or bone marrow thus avoiding any risk of rejection or infection.
Unfortunately, that is where the advantage ends for there is no guarantee that the stem cells will actually survive long enough after injected to facilitate the desired healing response. Then there is the reality that the growth factors from these Stem Cells are as old as you are which might be good for a young healthy athlete, but not so beneficial if your health is waning.
For those patients that fail Regenerative Therapy I then recommend the use of Fetal Growth Factors which though is more costly is able to generate a stronger healing response.
WHAT ARE FETAL GROWTH FACTORS?
Fetal Growth Factors can be derived from various parts of fetal, umbilical or placental tissue depending on the company doing the extraction. This of course involves also religious and philosophical concerns for individuals who prefer not to use an aborted fetus as the source. Then there is the additional factor that not all Fetal Growth Factors are the same since there is no set standard and companies use different processing techniques.
WHY MiMedx FETAL GROWTH FACTORS ARE THE BETTER OPTION.
With MiMedx the Fetal Growth Factors are derived from the Amniotic and Chorionic membrane (see figure below) of the placenta from a newborn. Therefore, there are advantages from religious, philosophical, and biological perspectives since healthy newborn better guarantees healthy vital tissue growth factors. Next, MiMedx uses Chorionic membrane as part of the preparation which has a 4x higher percentage of growth factors than Amniotic tissue. So think about the fact that you now have available literally hundreds of “hi octane” young vital growth factors to initiate the full potential of healing for your body.
Also, risk factors are eliminated since the tissue is both tested for various transmittable factors and has been dehydrated killing any potential pathogens. Additionally, MiMedx has done research for various uses such as membrane surgical patches to orthopedic joint injections all consistently demonstrating enhanced healing. If this is not enough, research has also demonstrated that Fetal Growth Factors additionally engage one’s own Stem Cells to participate in wound repair and rejuvenation.
WHAT SHOULD I EXPECT WITH FETAL GROWTH FACTOR INJECTIONS?
First, no blood or body tissue needs to be processed as with Platelet Rich Plasma (PRP) or Stem Cell Therapy. Next, the injection involves a combination of a local anesthetic followed by the Fetal Growth Factors to the area of pain and inflammation.
Typically, only one injection is needed, but if no significant improvement is noted by 3 months then a 2nd injection is recommended. Depending on the results of the 1st injection this can be done with either the same dose, if significantly improved, or a higher dose if only partly effective. MiMedx clinically reports that their injectable product, AminoFix, has been found to be effective for 85 to 90% of the patients treated.
YOUR PERSONALIZED TREATMENT PLAN WITH FETAL GROWTH FACTORS
I recommend doing myofascial therapy every 1-2 weeks tailored to your body’s unique needs for the duration of the 3 month treatment cycle of Fetal Growth Factors. Here the goal is reduce stress on joint, optimize overall body alignment, and allow for optimal circulation at the area of healing. In conclusion, Fetal Growth Factors are a healthy healing option especially for those individuals who have failed to benefit from Regenerative Therapy and are looking for a Non-Surgical approach to healing.