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Leom Woodal D.C says:
This brief introduction to this subject covers a small fraction, and is meant not to encourage patients seeking help, to speak to chiropractors about organic pain before talking to their GP, but to elucidate a little to anyone interested to read further on chiropractic as it relates to organic pain. The poverty of dialogue among health professions on this important subject costs nothing to address, no fees to the patient, no loss of respect among professional colleagues, no cost to the health system, and much to gain for everyone. Having said that, I have had patients in some cases remarkably helped for their organic pain, which was obviously related to nerve interference from the spine. In more than one case I have had patients come to me either as a last resort, or because a medical doctor presented them to myself suspecting spinal involvement.
Chiropractors help manage the largest organ of the body!
Your skin is considered the largest organ of the body due to its specific functions, different tissue types, surface area, and weight. Your skin is an exquisite sensory membrane between your internal and your external environments. It is dependent upon the nervous system to sense and respond to pressure, stretch, temperature, pain, movement, texture, vibration, sound and light (feedback). Therefore, it is much easier to detect disruption of the nerve supply to the skin.
Any interference to the nerve supply from the spine, or elsewhere will compromise this process. The nerves conduct these different impulses of speeds between 0.1 to 100 m per second, and the smallest amount of pressure to a root nerve exiting the spine, the equivalent to a coin on your hand, is enough to change the nerve impulses by 40 to 60 percent in seconds (Sabbahi & Abdulwahab, 1999)1.
Organic pain and dysfunction can arise from spinal problems, sometimes associated with back pain. Like back pain, organic pain can result from nerves that are either inflamed, damaged or compressed at the vertebrae. A chiropractor will detect either a lack of movement at the joint, or in some cases a misalignment between two or three vertebrae, and of course have all the other means at their disposal, including a medical history to help a diagnosis. Sometimes a bulging inter-vertebral disc comes into contact with a root nerve in the spine, resulting in compression or a chemical interaction causing pain, change of sensation, loss of sensation, or weakness in the muscle. More rarely, a person may develop severe degeneration resulting in bony compression around a root nerve: this is usually in conjunction with degenerative loss of disc height and an over extended curve in the low back causing lateral stenosis (boney compression on the root nerves).
Consequences of degeneration
Nerves to both the muscles and the organs are bundled together to occupy the same space as Root nerves and they leave the spinal cord between adjacent vertebrae. It is this area chiropractors influence the most when they adjust the spine, the only difference is that organic nerves generally have another synapse directly outside the spine, whereas the back and limb muscles have one long nerve cell from the spine to the muscle. Thus soft tissue pressure, impingement or inflammation to these root nerves in the spine can effect muscles and organs equally. The only difference is that feedback to the brain is perceived differently. Muscles and joints tend to be more sensitive to our awareness than organs, and are usually a better guide if something is wrong. However, dysfunction can still arise in the organ.
If the joint has degenerated, the normal range of motion between the two segments of bone may change, either being less in one or more than one direction, or too much! Given that the entire nervous system exits between these bones, it would be a very good idea to look after them. For example, in extreme cases of lumbar spine degeneration, the enteric nervous system to the gut can be badly disrupted, and even relatively small movements in an unstable spine can irritate the bowel causing an increase in peristaltic motility, or slowing down, or in one case I knew well, belching. Chiropractors and osteopaths the world over have known about these health issues as they relate to the spine. Unfortunately, making the connection between the spine and gut is intellectually challenging sometimes, especially if your profession dictates you specialise in one area of medicine such as enterolology, or spinal manipulation.
Many people who suffer with chronic back pain get used to it, and learn to accept such mantras as “what do you expect for your age”, or they block the signal with pain killers. Similarly, we should seriously question the overuse of antacids and other medications where the primary underlying cause has not been properly diagnosed.
Regardless of sensitivity, if this dysfunction continues and the individual adapts so that the muscles begin to perform below the normal threshold of activity, or the routine use of medication becomes a habit, expectations of health and fitness may unnecessarily be diminished.
So organs like muscles, may or may not consciously feed back to the brain that something is wrong, but the dysfunction continues... This is why chiropractors often list IBS (irritable bowel syndrome) as a condition they can improve. What about all the other organs? The Stomach (antacids), Pancreas, Heart, Lungs, Liver, Gallbladder, Spleen, Kidneys, Urinary bladder, Ureter, and Reproductive organs.
And why should we not have higher expectations for your health at any age? Early detection and preventative measures for spinal degeneration should be a priority in my opinion. I believe the question should be at what point, is it acceptable for the individually to take a drop in standards of health and fitness? Furthermore, how much responsibility will the individual take for their own health?
Clinical Pearl
Hilton’s law (based upon embryological development): states that “a nerve that supplies a joint also supplies the muscles that move the joint, and the skin that covers those muscles”. The skin is the largest organ of the body, and all parts of the skin have a nerve supply in a healthy human. Further, every type of nerve to the body (Somatic, reflex & autonomic) has to pass through the vertebrae. In the 1960’s the renowned chiropractor Dr CS Gonstead, taught other chiropractors to look for several trophic changes, including, peu de’orange, texture of bruised fruit, and other signs including skin rigidity over spinal lesions. In the late 1990’s Czech doctors K Lewit and A Kobesová demonstrate how to diagnose and manually treat these rigid skin lesions and soft tissues areas affected by root nerve irritation.
Further more, lack of sensory feedback (numbness & tingling) can be tested and demonstrated with nerve conduction and pin prick tests, and lack of skin thermoregulation (functional control of temperature) due to nerve interference, can be demonstrated with infrared imagery.
The skin’s sensory nerves react to changes in surface temperature (via spinothalamic tract) by stimulating the control of sweat glands, position of hair on skin, the diameter of blood capillaries below skin, or muscle activity. Similarly, internal organs respond to the internal environment partially via the nervous system, and patially through blood chemistry. If sympathetic nerves to gut are impinged at the spine, inappropriate motility (movement) can occur giving the symptom of IBS. The challenge for both patient and doctor is to recognise the root of the problem (pun intended!).
Leom Woodal D.C.
Any health professionals wishing a serious dialogue on this or any other health issues relating to chiropractic are welcome to email me: info@chiros.co.uk
London Chiropractors: FREEPHONE 0800 77 101 64 MOBILE 0781 206 9594
Chiropractic for Back pain, Disc protrusion, Sciatica, Leg pain, Neck pain, Head ache, Shoulder pain, Scoliosis, Repetitive strain injuries, Sports injuries, TMJ, arthritis
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FOOTNOTES
1 Sabbahi M, Abdulwahab S. (1999) Cervical Root Compression Monitoring by Flexor Carpi Radialis H-Reflex in Healthy Subjects. Spine 15 January 1999 - Volume 24 - Issue 2 - pp 137-141 Cervical Spine.