As previously mentioned, I’m reflecting on 20 years in the chiropractic profession through my blogs and newsletters this year. The chiropractic profession, like all things, continues to evolve. Slowly. Today, I’m using this newsletter to connect the dots of topics we discuss often:
- Pain
- Health
- Longevity
As a chiropractor, naturally, I see many patients in pain: New, recurring, and chronic pain. Managing these pains changes depending on the type of pain, my experience, and, of course, your previous experience/results and preferences.
But I also work with many patients that are not in pain. Many patients visit me routinely for chiropractic care to help them keep their body well maintained: mobile joints, muscle flexibility, and exercise training, all to keep the body well and able to perform its best day in, and day out.
I talk a lot about the importance of exercise for self-care and wellness.
Collectively, I’m trying to instill a balance between pain/injury management, preventative body care, and cultivating a routine of physical and positive mental health habits. If you focus too much on one of these wellness elements, you might be missing some important aspects from the others. Find a balance between high-stress exercise, recovery activities, and self-care strategies.
Two books that I’ve read stand out as influential on my approach to pain management, health, and longevity.
- Healing Back Pain: The Mind-Body Connection, by Dr. John Sarno
- Outlive: The Science & Art of Longevity, by Dr. Peter Attia
Dr. Sarno’s book, published in 1982, was ahead of its time. He was making the case that chronic pain is rooted in stress, anxiety, and other mental health matters, rather than a physical abnormality. I think there is partial truth to his claim. I don’t think we can completely dismiss physical findings as part of one’s pain, but science has been very clear these days that we tend to focus too much on physical findings. MRIs, x-rays, and ultrasounds revealing old disc herniations, healed spinal fractures, and torn tendons, to name a few, grab our attention and dominate our pain diagnoses. After all, if your shoulder hurts, and an ultrasound reveals a torn tendon, then, of course, this finding must explain your pain! Right? Or a recent x-ray reveals evidence of an old spinal fracture. Surely this is why you have back pain today! Right? Not so fast. For every person in pain with a torn tendon, or a history of disc herniations, there are countless numbers of people with the same findings with no pain. So, there is more to it than just the physical abnormality finding.
Acute pains are easier to manage, especially when there is an obvious physical injury at the root of the pain. As many of you with new pains and injuries have experienced, various physical treatment options can, and often do, make a big difference by reducing pain and inflammation, and accelerating the healing process, shortening your injury duration. Massage techniques, cold laser therapy, joint mobilization, manipulation, etc. all work to reduce pain and point the body in the right direction toward healing. Without treatment, the body will still try to heal, albeit slower and more haphazardly, resulting in scar tissue, tissue tension, restricted joint motions, and other physical tissue deficits.
Chronic pain is more complicated to manage. Chronic pain tends to involve both ongoing physical injury as well as the complicated biological processes that elevate or diminish pain levels (eg. Systemic inflammation, sensitized neurological tissue).
Fortunately, the rapidly evolving science of pain, health, and longevity is shedding light on how to manage chronic pain and improve wellness.
If you’ve been in my office in the past six months, we’ve likely discussed Peter Attia’s book, Outlive. This book delves into the trendy and incredibly worthwhile topic of health and longevity. (Note: Longevity is not about living forever. Longevity is about living healthier, longer.)
What I find so fascinating, and compelling about these two books, and their seemingly different topics is that they both point to similar solutions for chronic pain, health, and longevity.
Pain science is uncovering the biological pathways behind the connection between stress and pain. This might explain why some people have pain, while others do not, despite having the same physical abnormality on MRIs and X-rays. This does not mean we should disregard imaging results, but it does mean that we need to find a balance between imaging results and other influencers of pain. Exercise, healthy mental health habits, and sufficient sleep all help balance our nervous system, reduce cortisol levels, helping the body recover from stress.
Meanwhile, health and longevity science also points to managing stress levels to balance sympathetic and parasympathetic nervous system modes.
Outlive shares the evidence on improving your odds (no guarantees in life!) of avoiding metabolic, neurodegenerative, cardiovascular, and other diseases, leading to healthier living now and in your older years. The common thread between these books, written over 40 years apart, points to the role of physical and mental fitness as the key to both pain reduction and longevity. There are specific aspects of our mental and physical fitness that need to be optimized for healthy living. All the exercise physiologists I read point to improving our metabolic health via consistent zone 1 and zone 2 cardiovascular exercise. Walking, cycling, swimming, and other sports/activities that get our heart rate into these zones are essential physical fitness activities. Zone 1 and 2 cardio/metabolic training improves your heart and lung capacity, reducing your odds of cardiovascular illness, and improves your body’s handling of blood sugar, insulin, and all related matters to metabolic health. This form of exercise aids in stress relief, reduction in cortisol levels, balances your nervous system, and improves circulation. Similarly, mental health improvement strategies like social connectedness, meditation, and deep breathing also help with nervous system balance and reduce various stress biometric data linked with poor health. Activities like Yoga or a long walk outdoors address both the physical and mental game at the same time!
Of course, this is all easier said than done. Life can be stressful, and time is tight. But that doesn’t change the rules. Do your best to play the prevention game by engaging in these physical and mental activities. Self-care goes a long way. And, as your chiropractor, I am here to help. Regular chiropractic care can help relax and optimize the physical body, increasing your odds of being able to participate in the activities of life.
Book your next visit to continue or restart your health optimization game!