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Chronic Pain: The Future of Rehabilitation

By Dr. Michael Veselak, D.C.

Chronic Pain: The Future of Rehabilitation

For those that suffer with chronic pain the initial trigger could have been from a trauma, poor posture, repetitive stress, metabolic issues such as diabetes or autoimmune issues. Initially, for the most part we do not experience a lot of pain and then over a period of time the pain will increase sometimes intermittently, where the pain comes and goes.

Eventually, however, the pain becomes more severe and we are searching for answers beyond just pain management to improve our symptoms.

Conventional interventions often times falls short of restoring function and decreasing the pain. In part because the impact of this chronic issue has affected the way our brain interprets sensation. They call it nociceptive pain, which is the sensory nervous system’s response to potentially harmful stimuli. Over a period of time this chronic nociceptive stimuli presents itself as pain, stiffness, numbness, tingling or weakness.

The end result of this bombardment of altered stimulation to the relay stations of the brain is a reduction of movement and function. It can also affect the muscle recovery when we attempt to rehab the patient.

The brain is a global network and when one part becomes affected it can present issues in other areas. For example, a job of the neo cortex is to inhibit the brain stem or our autonomic centers. If the cortex can’t perform its job properly there will be not only chronic nociceptive stimuli but an increase in our sympathetic nervous systems response.

The sympathetics is the “fight or flight” part of our nervous system. Over a prolonged period this can impact not only the brain but the gut as cortisol can be inflammatory to the brain as well as lead to a permeable gut lining or a leaky gut type situation.

We can see how an event that has gradually increased over time can not only impact the sensory system, but our motor output and finally our sympathetic output.

To put it is more simple terms, it will cause pain, numbness or tingling, affecting our muscles, which limits our ability to function and rehab. The end result is the vicious cycle impacting our autonomic nervous system, which controls blood pressure, heart rate, and our emergency response. Chronic stress leads to more gut and brain inflammation and the cycle continues.

In part this is why methods you have tried never worked long term or perhaps even aggravated the condition.

We focus not on improving the motor function or muscles but rather the sensory input that is ultimately responsible for this vicious cycle. We want to decrease the nociceptive output.

There are many techniques we employ to achieve our desired output. Stimulation of the fascia and mechanoreceptors that feed the neurosensory system will help improve the motor output. There are movement patterns that help the brain to begin to improve the body’s mapping in the somatosensory and somatamotor cortex. Our goal is to achieve smooth coordinated movement by restoring proper motion to the joints.

The other component that is almost always neglected in chronic pain is the underlying metabolic issue. Is it diabetes? Anemia? Autoimmune issues? Toxicity?

Through lab testing and our training as a Functional Medicine Practitioner we can isolate the cause and generally improve this with proper nutritional and lifestyle guidance.

In summary, each individual chronic pain patient is slightly different. Treatment must be designed to improve metabolic, neurologic, and structure.

Chronic Conditions such as:

  • Peripheral Neuropathy

  • Spinal Stenosis

  • Failed Back Surgery

  • Complex Regional Pain Syndrome

  • CTE

  • TBI

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Why Functional Medicine

Hello, my name is Dr. Michael Veselak, and today we’re going to talk about functional medicine and why it is important to utilize functional medicine

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Copyright 2018 Dr. Michael Veselak

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