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Chronic Pain SolutionsDr. Richard BurgChiropractor, Nutrition Consultant, Certified ART® Provider
Disclaimer   Acute & chronic pain may be a sign of    a serious underlying disease or    condition.   It is imperative t...
The Silent Epidemic   Estimates are that 50 million    Americans live with chronic pain    caused by disease, disorder or...
The Silent Epidemic   The most common types of pain are    arthritic, lower back, bone/joint pain,    muscle pain and fib...
Pain perception   Pain receptors in the body send    signals through nerves to the spinal    cord and then up to the brai...
The Gate Control Theory   Melzack & Wall’s theory from the 1960’s    states that in the spinal cord there is a    neurona...
The Brain Controls Pain   The brain has pathways that inhibit or    modulate pain signals   These pathways rely on    ne...
Underlying Causes   Chronic low grade inflammation    – Prostaglandin imbalance causes systemic inflammation      which c...
Underlying Causes   Lack of proper motion    – ↓ frequency of firing of mechanoreceptors    – ↓ input into the cerebellum...
Nutritional Solutions   Anti-inflammatory diet     – Low Glycemic Diet, high blood sugar leads to increased       inflamm...
Neurological Solutions   Better Brain Chemistry     – Increase your body’s reserves of Endorphins and Enkephalins with DL...
Manual Therapy Solutions   Specialized myofascial therapies    – Active Release Techniques® effectively restores      mot...
Functional improvements   Exercises     – Studies indicate that exercise may be the only reliable approach to       resol...
REFERENCES 1http://www.aapainmanage.org/literat    ure/Articles/PainAnEpidemic.pdf   2      http://www.jci.org/articles/...
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Chronic pain solutions

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Presentation regarding solutions for chronic pain including myofascial therapies.

Prepared by Dr. Richard Burg, Chiropractor, Nutrition Consultant and owner of Active Wellness Chiropractic in Oakland, CA

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Transcript of "Chronic pain solutions"

  1. 1. Chronic Pain SolutionsDr. Richard BurgChiropractor, Nutrition Consultant, Certified ART® Provider
  2. 2. Disclaimer Acute & chronic pain may be a sign of a serious underlying disease or condition. It is imperative that you see your physician or health care provider to determine the cause of your pain. This lecture is not intended to diagnose or treat any condition.
  3. 3. The Silent Epidemic Estimates are that 50 million Americans live with chronic pain caused by disease, disorder or accident 25 million people suffer from acute pain from surgery or accident 2/3 of these people have had their pain for more than five years
  4. 4. The Silent Epidemic The most common types of pain are arthritic, lower back, bone/joint pain, muscle pain and fibromyalgia. Estimates are that 20% of adult Americans experienced chronic pain in 1994 and approximately 4.9 million individuals saw their physician for chronic pain treatment in 1999.1
  5. 5. Pain perception Pain receptors in the body send signals through nerves to the spinal cord and then up to the brain where pain is “perceived”. In the brain there are areas that bring awareness to the pain and areas (limbic system) that determine our “experience” of pain.
  6. 6. The Gate Control Theory Melzack & Wall’s theory from the 1960’s states that in the spinal cord there is a neuronal “gate” that signals must pass through and the gate can be open or closed. The gate is controlled by movement and other sensory information that over-rides pain signals and is specific to the area of pain
  7. 7. The Brain Controls Pain The brain has pathways that inhibit or modulate pain signals These pathways rely on neurotransmitters such as serotonin, endorphins and enkephalins to transmits signals that block pain signals to the brain
  8. 8. Underlying Causes Chronic low grade inflammation – Prostaglandin imbalance causes systemic inflammation which chemically stimulates pain receptors2 Injured pain receptors give off substance P which causes the release of histamine which leads to inflammatory prostaglandin production and sustained activation of the pain receptors. Metabolic Syndrome is linked to inflammation – 2/3 of the Adult US population are overweight or obese – 25% of Americans have Metabolic Syndrome (insulin resistance) – Chronic subclinical inflammation is part of this syndrome
  9. 9. Underlying Causes Lack of proper motion – ↓ frequency of firing of mechanoreceptors – ↓ input into the cerebellum & cortex allows increased pain signals to be perceived. – Pain fibers grow into scar tissue and lead to increased or chronic pain Neurotransmitter deficiency or imbalance – Deficiencies in Serotonin, Endorphins, Enkephalins
  10. 10. Nutritional Solutions Anti-inflammatory diet – Low Glycemic Diet, high blood sugar leads to increased inflammation – High Omega 3 diet, fish and flax, decrease fatty meats and poultry (2.7 g of EPA/DHA 2:1 daily) Adequate protein intake – Your body needs adequate protein over 60 grams per day to synthesize neurotransmitters and repair muscles and tissues – Protein with each meal keeps your blood sugar levels normal Adequate water intake – Most all metabolism in your body takes place in water – You need to drink half your body weight in ounces of water per day – Adequate water turns off histamine which reduces inflammation and pain
  11. 11. Neurological Solutions Better Brain Chemistry – Increase your body’s reserves of Endorphins and Enkephalins with DLPA – DLPA 500 mg (50:50) 1-2 tabs 3x daily before 3 PM or – DPA 500 mg 1 tab 3x daily before 3 PM – B complex vitamin daily B6 is required for neurotransmitter synthesis (serotonin and dopamine)3 – Magnesium 200 mg to 400mg daily, helps prevent over-excitation of neurons – Vitamin D 1,000 IU daily (or as recommended from blood test)4 Chiropractic Care – Improve frequency of firing of mechanoreceptors to the brain – Improve your function so you can be more active which uses the Gate Control Theory to reduce pain signals – Improved posture reduces chronic pain
  12. 12. Manual Therapy Solutions Specialized myofascial therapies – Active Release Techniques® effectively restores motion and removes interference to normal tissue function which contributes to pain – Adhesions trap nerves that travel through muscle and fascia and can cause chronic pain and disability – Movement therapies such as this retrain the body to move and function correctly to make everyday activities and exercise easier and more enjoyable
  13. 13. Functional improvements Exercises – Studies indicate that exercise may be the only reliable approach to resolving the disability of chronic back pain – Motion is Life and increased motion reduces pain, stabilizes blood sugar, elevates mood and keeps your weight normal Postural awareness and improvement – Chronic postural distortions result in chronic pain patterns – Muscles become too tight and short and pull on the body causing the antagonist muscles to become too long and tight and lead to chronic pain – Learn how to correct your posture using specialized exercises to change a chronic pattern Cerebellar training – Cerebellar exercises improve coordination and increase frequency of firing to the brain which then inhibits excessive pain signals
  14. 14. REFERENCES 1http://www.aapainmanage.org/literat ure/Articles/PainAnEpidemic.pdf 2 http://www.jci.org/articles/view/6749 3 http://ods.od.nih.gov/factsheets/vita minb6.asp 4 Ross, J. The Mood Cure (New York: Penguin Books, 2002) pp. 106-117.
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