While most people have one specific area of pain when they initially visit a Chiropractor, sometimes there are several problems or even a generalised aching throughout the back and other joints. This could be a posture-related phenomenon, but there are also a few conditions such as Fibromyalgia which can cause widespread pain.
There is a well-documented phenomenon in the human body, where a problem in one area can rapidly spread to other areas through a system of compensation. Let’s say, for example, that a person has gout in their big toe. This is extremely painful – it is caused by crystals forming in the joint, and it makes the area very red, hot and agonizingly uncomfortable. Our person certainly isn’t going to want to walk on it, so they start to change how they are walking to avoid setting it to the ground. They may start rolling over onto the outside of their foot, so they can continue using the outside of the foot but they don’t increase the pain in their big toe. This puts a huge strain on the ankle, which in turn puts a twisting force through the knee. By twisting the knee, the person will also start twisting through their hip. Your body tries to minimise the effect of a limp like this, and will over-use various muscles in your lower back in an effort to keep the rest of your body facing the right direction and at more or less the right angle. This causes tension into the muscle and may even result in a dysfunction of the joints in your lower back, leading to back pain. A very simple example of how a problem in one area (sore toe) can spread in a matter of days or weeks to a whole series of other areas.
So sometimes an apparently general pain pattern actually will be the result of a single root cause. It is vital that your Chiropractor is able to recognise this phenomenon, as if we only treat the secondary complaints without addressing the root cause, then the pain is just going to keep returning.
In other situations, a generalised ache can be the result of a single muscle being tight. There are muscles in your back which cover a larger area, such as your Trapezius and Latissimus Dorsi. These are big and very powerful muscles, so once they start to tighten in one area, it doesn’t take long for that tension to spread to other parts of the body.
It is possible as well that the fascia has become involved. Fascia is a thin connective tissue which can cover large areas in a single sheet. In areas where there has been an injury, this usually separate layer can become adhered to other layers such as the muscle. This can give a widespread, painful burning sensation which can be addressed by locating these points of adhesion and freeing them through soft tissue techniques.
While these are probably the most common types of general complaints we see as Chiropractors, there are also some systemic complaints that affect several joints or even the whole body.
Rheumatoid Arthritis is one such example. This is an inflammatory condition where your own immune system starts attacking your joints. There is often a strong genetic component to it, so if your mother and grandmother both suffered from this disorder, it is possible that you may develop it as well. Treatment is going to be aimed more at managing the symptoms than actually attempting to cure the disease itself. Your GP and arthritis specialist will be able to provide you with medication to help reduce the inflammation, and may also try to suppress your immune system a little to stop it attacking you. Chiropractic can also be of use in trying to reduce the muscular tension and pain in the joints, but the frequency and quantity of treatment will need to be carefully managed in order to avoid increasing the inflammatory reaction.
There are also illnesses which have no known cause, but are a recognised collection of symptoms which have been grouped under a collective title. Two such syndromes that I will discuss here are Polymyalgia Rheumatica (PMR) and Fibromyalgia.
Polymyalgia Rheumatica is associated with widespread pain, primarily across both the shoulders and hip girdle. It is noticeably worse first thing in the morning, where the stiffness and pain can last for well over 30 minutes before it starts to free off (differing from conditions such as osteoarthritis, where the morning stiffness generally lasts less than 30 minutes). When suffering from this condition, you may also feel completely flat, lifeless and miserable. If your Chiropractor suspects that you are suffering with this condition, they will suggest you attend your GP practice, so that you can have blood tests done as there may be confirming indications in the results to support PMR as a diagnosis. Once it has been confirmed, your GP will then be able to give you corticosteroids, which generally cure the condition.
Fibromyalgia is another condition in which the sufferer experiences widespread pain. Technically, fibromyalgia is what is known as a “diagnosis of exclusion”, meaning that you can only be accurately diagnosed with the condition after all other possibilities have been completely ruled out. There is a hypersensitivity to touch, which can make even wearing clothes painful, and it is often associated with other problems such as sleep disturbances and depression. The process which leads to these symptoms is a complete mystery, and treatment is somewhat hit and miss. Gentle Chiropractic treatment may help, but it is important to gauge the frequency of treatment carefully as too much and too often can cause irritation of the symptoms. However, I have had several patients in the past few years who have had fibromyalgia and have found that treatment gives them at least a few days of ease.
In summary, general aches and pains may be a compensation pattern from one original injury, a problem in one muscle which is large and covers a wide area, adhesions in the fascia causing a widespread burning pain or a condition such as fibromyalgia or polymyalgia rheumatica. There are, of course, about a hundred other reasons that pain could be widespread, but I think these are enough to be going on with…don’t you? Remember, if you suspect you have a problem and want to know if Chiropractic can help, please feel free to contact us.