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Natural Awakenings Sarasota / Manatee / Charlotte

Chronic Joint Pain: Finding Relief

by Dr. Eric Winder, DC 

 It might be a knee, an elbow, an ankle or a shoulder. But it still hurts after healing from an injury. Why does pain continue in a joint months—or even years—after being injured? Sometimes the reasons are obvious, but this is not always the case. A clear understanding of pain sources makes it easier to successfully treat that pain and find relief. Let’s consider a few:  

Tissue Damage 

The most obvious possible cause of chronic joint pain is permanent tissue damage. This can include changes like osteoarthritis, bone spurs, spinal disc degeneration, torn ligaments, or an altered alignment in posture such as scoliosis. All these changes could be present in a chronically painful joint, but they are not necessarily the source of pain.  

In fact, research shows only a low correlation between how much spinal arthritis someone has and how much pain they experience. Many patients at our clinic achieve tremendous pain relief despite having scar tissue and arthritis in or near previously painful joints. And yet, after the relief, the scar tissue and arthritis are still present.  

This means those factors are not the main cause of pain. In our clinic, we see that other factors are more important in causing pain. So while arthritis and scar tissue can cause stiffness or discomfort, they are not always responsible for intense pain levels.  

Inflammation 

Another likely suspect, inflammation, is normal in a new healing injury. However, sometimes a joint is still inflamed long after recovery. This can result in swelling, tenderness or pain in the affected joint on a consistent basis. Anti-inflammatory medications might offer temporary relief, but in some cases, symptoms return without the medication.  or lasting relief, it is important to locate and treat the root cause of inflammation.  

Instability 

Chronic joint pain can also be caused by instability of the joint.  If a joint moves in directions or ways it is not supposed to (even a small amount), this can cause anything from mild to severe pain. Think of it is a similar to the wheel on a car or a bicycle—the joint should rotate smoothly without even a small amount of shake or wobble. If a slight wobble occurs, this can ruin bearings and even cause damage to other parts.   

Fascia Restriction 

Finally, the connective tissue (called fascia) can experience restrictions that cause joints to be painful. Fascia is a network of fibrous sheets and web-like structures that runs throughout the body to cover muscles, bones, joints and other tissues.  

Fascia contains the nerve endings that give us position sense, which makes coordinated motion possible. All muscular balance, joint alignment and joint stability require accurate position sense. When fascia becomes restricted or distorted, all those functions can be altered by faulty position sense, which causes faulty joint mechanics as a result.   

Finding the Root Cause 

These four major causes of chronic joint pain can be intertwined. Structural damage, such as torn ligaments, might cause instability, then lead to inflammation and new fascia restriction. On the other hand, pain from inflammation could trigger muscle tension, which leads to instability, new fascia restriction and possibly arthritis.   

Any of these factors can lead to developing the others. The temporary treatment of painful symptoms is often required, but permanent relief requires finding the root cause wherever possible. Let’s look at each of these factors again from a treatment point of view.  

Fascia  

Treating joint pain is a large part of my practice. Due to the ability of fascia restriction to disrupt muscle and joint function, I find that treating problems in fascia offers the most powerful results in relieving joint pain for most people.  

Restoring position sense often returns joint stability and reduces inflammation. I have seen hundreds of cases where a joint that often “gave out” became more stable with the release of fascia restriction. It is also typical for successful fascia treatment to reduce or eliminate swelling and tenderness in joints that have been inflamed for months or even years.  

Structural Damage  

This can lead to chronic pain, and the structural changes are usually not reversible. However, it is important to understand that research has found low correlation between the severity of join degeneration and the severity of pain. Often, pain is due to fascia restrictions and the subsequent instability or inflammation they cause.  

If the structural damage is severe, a person might need to wear a support or brace. In some cases, they might even need surgery. However, in my practice, patients often find pain relief with fascia treatment. Their joints continue to look the same on an x-ray or MRI, but their pain is relieved. They often become more flexible and resilient in the problem area. Also, patients whose arthritis has been worsening each year (as seen on x-ray or MRI) often see the progression halt after a thorough course of fascia therapy.  

Instability:  

Sometimes joint instability is due to permanent ligament damage and, therefore, can only be treated with muscle strengthening, orthopedic supports and braces, or surgery in severe cases. However, 95% of the joint instability that I see in my own practice is the result of distorted position sense from abnormal fascia restriction. When these restrictions are released, muscular balance is restored, and the joint becomes more stable.  

Inflammation:  

For reasons poorly understood, inflammation can often get stuck in its own feedback loop, perpetually maintaining itself instead of disappearing after an injury heals. If this is the case, a steroid injection is sometimes given to break the feedback loop and resolve the inflammation. However, steroid injections usually do not offer permanent relief, since deeper underlying factors often cause the inflammation.  

Oral anti-inflammatory medications, such as ibuprofen, can be helpful in relieving pain, but they do not resolve chronic pain, and sometimes they cause troubling side-effects too. Fascia therapy, on the other hand, can often remove the underlying stressors that activate chronic inflammation. In fact, I see long-term pain relief from treating fascia restrictions more often than with steroids or anti-inflammatories. 

Because multiple factors contribute to chronic pain after a joint has been injured, each case is different. The most effective relief comes from addressing root causes. While at times surgery, orthopedic supports and steroid injections are required, the less invasive option of fascia therapy is, in my experience, the most effective treatment.  

In fact, releasing fascia restriction frequently helps to achieve relief in cases where surgery or orthopedic supports are also required. Of course, physical therapy to strengthen affected areas is usually helpful too, in conjunction with facia treatments. In the end, each patient needs careful assessment to determine the right kind of treatment which will address the root causes of their chronic injury-related joint pain.  

Dr. Eric Winder has been practicing chiropractic for 25 years, with a focus on fascial treatment and soft tissue therapies for the past 22 years. Dr. Winder’s practice focuses on relieving pain and restoring alignment and motion through gentle soft tissue therapies. For more information, call 941-957-8390 or visit GentleBay.com. 

March 2024 Digital Edition

 


 


 

 


 

 

 

 

 

 

 

 

 

 

 

 
 
 
 

 

 

 

 

 

 

 

 

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