In any sport that involves executing proper form such as a tennis serve, baseball pitch and boxing right cross, it is essential to follow through with the movement.  You must commit 100% to the movement the instant you initiate it.   When you do this, things go well—the movement is executed with power and precision, and you’re likely to have success.

If you are hesitant, the movement collapses or comes out wrong; it is basically doomed from the start.  This is why any pro athlete will tell you that concentration and focus are equally important to athletic ability.   The mind literally determines success and failure.  So when you throw that punch, put everything into it!

Use this sports mindset for the things you set out to do in life, especially if they involve improving yourself, and you will succeed.  Commit 100%.  Follow through.

Some examples:

• Changing your appearance – certainly achievable. There are even “makeover” TV shows that prove it.
• Changing your persona, attitude and outlook – certainly achievable. Not easy, but if you commit to it and follow through, you are likely to succeed.  Lots of motivational/ high performance gurus out there to help.
• Losing fat weight is certainly achievable. Again, not easy, but achievable.  If you’re overweight, it’s like going through life with a backpack full of rocks.  It puts a burden on you and limits what you can do.  Remove that backpack you’ve been carrying around for decades, and the change will be dramatic and amazing.
• Improving your health—quitting smoking, cutting down on alcohol and drugs, exercising more: definitely achievable.    Commit and follow through.

If your health is not where you want it to be, don’t be passive about it – be active.  Health is priceless, and the number of years you have left in this life is a finite number and decreasing each day.

Without good health, all those other plans you have in your head, short and long-term, are jeopardized.  Sure, you could do without certain things due to some physical limitation; that’s fine as long as you’re happy.   But what if you didn’t have to?  That’s something you need to find out.

This brings us to the issue I deal with – musculoskeletal health.

Musculoskeletal is exactly what it sounds like – your muscles, skeleton, and all its components:  joints, tendons, ligaments, cartilage, fascia.   This system carries your body and all its other critical systems.  It enables humans to be mobile and perform incredible, physical feats.

Basically, your ability to do things in life is largely dependent on the health of your musculoskeletal system.

The longer you’ve been alive, the more demand you’ve put on your musculoskeletal system and naturally, the more likely you’ve experienced breakdowns.  It’s just like any machine; the more usage hours the more likelihood of parts failing.

And if you participated in contact sports; a heavy labor occupation; have a history of physical trauma—accidents, falls then chances are, your musculoskeletal health is not 100%.

Conversely, if you had a sedentary job all your life and didn’t exercise, your musculoskeletal system is likely weak in strength and responsiveness, and you also have issues – back pain, neck and shoulder pain, etc.

Musculoskeletal pain is the #1 cause of disability, world-wide.  It causes billions of dollars in lost productivity and medical costs each year.  Drilling deeper, pain has other negative effects such as depression and emotional stress; pain killer addiction, and stress to the people close to the sufferer, which causes more problems and adds to the cost.  Low back pain is at the top.  Knee pain and hip pain are also high on that list.

Getting back to the original topic, is it possible to eliminate chronic, musculoskeletal pain just as you would unwanted weight?

Obviously, there is no definitive answer because of the many variables involved.  No two cases are exactly alike, because people are different.  Doctors can’t make a blanket statement that “chronic pain can be eliminated;” that would be irresponsible.  The answer depends on the case.

THE NATURE OF MUSCULOSKELETAL PAIN

So, can your situation be improved?  Let’s first discuss the nature of musculoskeletal pain so you can see what’s involved, and what needs to happen.

Acute pain from a recent injury has a very good chance of being eliminated with proper treatment/ therapy and time, as the body has amazing healing ability.  However, the more extensive the injury (such as a really bad car accident resulting in a fractured pelvis, ribs and femur) the more opportunity for chronic pain to develop.

Chronic pain is a different beast.  The body has gone through the normal stages of healing and repair, but something went wrong and pain persists.  Cases that have reached a year of daily pain likely have crossed over to the central nervous system which is a bad thing.  Generally speaking, the pain has “taken residence” in the brain and spinal cord.  In other words, it’s not only being generated by the injured tissue; there is now self-running “memory” of the pain signals.  It’s a very complex topic in neurology, and there is still a lot that is still unknown.

Chronic pain most often involves joints, and it’s no surprise.  Joints are the stress point in a muscle-lever (long bone) system.   This is where movement occurs, under a load (force).  The weight bearing joints are the most vulnerable (hips, knee, feet, and lower spine) but non-weight bearing joints (hand, elbow, shoulder) can develop chronic pain from overuse/ old injuries.

Cartilage gradually wears out, and since cartilage isn’t easy to make the damage becomes progressive.  The immune system begins to notice the damage and initiates inflammation.  This leads to swelling and a bunch of inflammatory biochemicals that generate pain.  In fact, most over-the-counter pain medications (aspirin, non-steroidal anti-inflammatory meds like Motrin and Ibuprofen) work by blocking the formation of these biochemicals.

If the pain becomes unbearable, surgery can help with artificial joints.  But the drawback is that artificial hips and knees have to be replaced every ten or so years as they get loose—not a fun experience.

In some cases the patient cannot pinpoint it because it is diffuse, and appears to be generated in a broad area of muscle such as the back muscles.

Some of the factors (variables) that play a role in chronic pain are:

• Age, sex and general health of the individual
• History of repetitive stress to joints, or major injuries
• Structures involved
• Genetics
• Mental health

So,

• Younger people tend to heal better and more completely.
• Females tend to experience more pain than males, for unknown reasons. For instance, in fibromyalgia, a condition involving widespread pain throughout parts of the body, females tend to be more affected about 60% of all cases.
• Underlying health conditions such as diabetes, blood and auto-immune disorders can result in sub-optimal healing.
• Your diet directly impacts your health on many levels. What you put in your body influences your digestion, mood, blood pressure, heart rate, strength, endurance, immune system and more.
• Those in heavy labor (construction workers, movers, etc.) and who have a history of major injury are more likely to develop chronic joint pain.
• Tendons and ligament strains have a better chance of healing than cartilage.
• Genetics can be a factor in susceptibility to degenerative changes in joints. Your genes make all kinds of proteins; many of which play a role in structural integrity.
• The research shows that patients who are more optimistic tend to have lower pain levels and higher function, compared to those who mentally embrace the pain, called “pain catastrophizing“ and allow it to dictate their attitude and mood. It’s validation of the brain-body connection; i.e. your thoughts can affect your body.

CAN YOU GET OUT OF CHRONIC PAIN?

Ok, now that you have a better understanding of what chronic pain is and the risk factors involved, you should have a better idea of your chances of improving your pain.

Whether you have all the risk factors, or just a few, I believe you can still improve your situation.  But first we must define “improvement.”

While pain reduction is important, what’s perhaps more important is functional improvement.  They tend to go hand in hand; i.e. the more pain you have, the less you are able to do (less function), and vice versa.  The problem with this, though, is that chasing the pain with medication, chiropractic, acupuncture and other passive therapies without working around it and focusing on regaining your functional capacity (your ability to do certain tasks/movements) could be the wrong strategy.  It traps your mind into thinking that your pain determines your ability; like a gate keeper, and as long as that pain gate keeper is there, you convince yourself that you cannot move properly.  The consequences can be psychosomatic where your thoughts literally change your physiology and inhibit proper healing; and they can be limiting; causing you to avoid movement and stay bed-ridden, leading to muscle atrophy.  Remember the brain-body connection—thoughts have a powerful effect on your body.  Thoughts can imprison you, or they can liberate you.

Back to defining improvement.  In the previous post, I introduced you to the Pain and Disability Questionnaires.  This is a tool doctors use to “quasi-quantify” pain; i.e. assign a number to it.  But they are so simple to use and available for free download (the links are at the end of this post), anyone can use them.

You select the pain questionnaire that applies to your condition—low back, neck, shoulder, upper extremity, lower extremity.  Fill it out according to the directions and determine your “percent disability” or “percent functionality.”  If you’re at 40% disability for low back pain, strive for 20% in about two months; then 10% after a couple more months.  This provides something tangible to work with.

These questionnaires came about when doctors decided that improvement in common, every day movements/tasks such as walking up the stairs or raising something above your head is much more important and meaningful than improvement in pain, which is harder to measure since it is so subjective.

So, the 30 Day Challenge will focus on improving your Pain and Disability score; not so much on your pain level.  As your score improves, your pain should improve anyways, but it won’t be the focus in this challenge.

Now that you know that we will be focusing on functional capacity, you can probably guess what the strategy will be to improve your pain/ disability score.  The focus will naturally be on nutrition. 

The fastest way a person can significantly and dramatically change his/her health metrics is through diet.  The reason is simple – what you eat becomes you—the proteins, oils/fats, and fluids in your food become part of each cell in your body.  Like many things in life such as clothes, shoes, houses, cars and bridges, if high quality materials are used in construction, it lasts longer.  Use cheap materials, and the item will break down much earlier with use.  So. eat high-quality, nutrient-dense foods, and your body will be stronger and will therefore last longer without breaking down.

Food, particularly plants, have numerous phytochemical nutrients that help your body work better—vitamins, minerals, co-factors, anti-oxidants.  Eat those, and you get all these beneficial nutrients that your body needs to run its thousands of biological processes.

But as you will soon find out, it’s not just about what you eat.  What if you ate the healthiest meals, but your body couldn’t absorb the nutrients very well due to a digestive problem?

Well, those nutrients will be excreted in your waste, and your body will be deficient in them.  You can eat well but still be nutritionally starved.

So part of the strategy will focus on optimizing your body’s nutrient absorption potential.  Think of it as flushing out your plumbing and fixing any worn out parts.

How and when you eat is also important.  Should you eat three meals a day?  Is it OK to skip breakfast?  What’s the latest hour of the day that is OK to eat?  We’ll talk about this, too.

Although it’s a 30 Day Challenge, you don’t have to start all the activities in 30 days.  Try them out and implement them at your own pace.  But the most important thing is to commit.  Follow through.  How badly do you want to get out of pain?  To be able to easily do a 5-mile hike again, or go up two flights of stairs without losing your breath?  Dramatic change demands dramatic commitment—perhaps a level that is new to you.

If you truly want to reduce your pain by at least 50%, you must give it your best effort, as if your life depended on it.  Laser focus, ignore the nay-sayer thoughts that are bound to pop up (again, your mind can imprison you and it can also liberate you; you have the choice), and execute the plan faithfully and consistently.  Do this, and you will reap the many rewards in life that better health brings.

The 30 Day Pain Relief Challenge will be based on video tutorials.  Tomorrow, I will send you the first one, so keep an eye out for it in your In box.

Sincerely,

Dr. P