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#105 Measuring Pain?

4/22/2014

1 Comment

 
            PAIN is a motivator.  PAIN is an indicator.  PAIN gives direction.  PAIN is absolutely necessary to a healthy body.  But PAIN is a very poor measure.  Interpretation of pain varies greatly from person to person.  It is subject to our own individual pain thresholds and pain tolerances.  You should always use pain as a guide.  But you should never use it as a measure.  Let me give you an example or two.

            Before I do that let me refresh your memory about TSV (Total Subluxation Value).  This  is that number that I use as a measure of spinal subluxation.  It is by no means the only measure of subluxation that chiropractors use, but it is easy to measure, accurate, and reproducible.  In scientific circles it would be called sensitive but not specific.  The TSV can vary from a low of zero to a high of 304.  It is a measurement of the health of the spine.  The smaller it is the better the spine works.  Like golf scores, bigger is badder. 

            Now let us pretend that we have two different patients, Patient Low and Patient High.  Patient Low has a lower pain threshold than Patient High.  This is not to say that Patient Low is weaker or lesser than Patient High in any way.  This is just the genetic programming of our two patients.  We all have our strengths and weakness, and when it comes to our genes we can accept no more credit for our strengths than we can take blame for our weaknesses.  They just are. 

            Both of our patients have headaches on a daily basis along with neck and upper back pain.  They have a history of recurring lower back pain and have had sciatica too.  In other words, when it comes to their pain, they are exact twins.  But when it comes to their TSV Patient Low measures 60 while Patient High is 120.  THEY HAVE THE SAME AMOUNT OF PAIN BUT CLEARLY PATIENT HIGH HAS A SICKER SPINE.  It takes more damage for him to feel it.  Even though these two patients are made up, I see this kind of thing all the time. 

            The conclusion has to be that the TSV is a measure of spinal damage, while the amount of pain is a measure of the patient’s genetic threshold for pain.  TSV is cause.   Pain is effect.    Should we treat the cause or the effect, the subluxation or the pain?  This is the basic question dogging chiropractic and medicine.  Drugs treat effects and chiropractic treats cause. 

            Let’s go back to our patients.  After observing thousands of patients over my 26 years I have concluded that in the absence of complicating factors (see article #100) that most people will feel much better and be reasonably stable once their TSV is reduced by half.  Patient Low needs to get to 30 from 60.  Patient High to 60 from 120.  Think about that, this means that Patient High will feel good at the exact same TSV (60) that Patient Low was at when he/she first came to my office!  This is pain threshold at work.

            The only logical process once at the half-way point is reached is to continue to try to reduce the TSV to as low as possible, but that is a different discussion for a different article involving Reconstructive Care. 

            If your only goal is to treat the effect and you don’t care about cause and you don’t care about side-effects, take a drug.  Drugs will numb better than an adjustment.  But if you care about cause then there can be only one conclusion, forget about the effect – the pain – and focus on the TSV (and any complicating factors), so we can truly measure the health of your spine. 

1 Comment
Bianca MacFarlane link
4/29/2021 11:20:48 am

Interesting thoughtss

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    Dr. Rick

    After writing an article per week for a year, I just kept going.  These are most of my collection.  They are written with my existing patients in mind, so some stuff may seem odd or unusual, but would make perfect sense to those who know chiropractic and who know me.  Enjoy and share!  For my personal blog visit: 

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What Our Patients Have To Say

Yolanda wrote:
     
     I used to suffer severe headaches and migraines on a daily basis, usually all day.  I managed to work in an office because I had to.  When I went home at the end of the day I would often close the shades and go to bed.  I could not plan weekend events because I simply never knew how I was going to feel tomorrow.  If there were a special event such as a birthday or wedding, I would begin to medicate myself two weeks in advance to give myself the best chance of making the event.
     Friends and fellow church-goers had been trying to get me to see Dr. Rick for some time before I finally gave in.  Looking back, I don’t know why I waited.  Within a month, I was headache free.  I couldn’t remember what it was like to not feel pain.  I could do whatever I wanted and not live in fear of the headache.  This was a miracle for me, but the story does not end here.
     An opportunity came up for us to adopt a newborn baby girl not long after I began chiropractic care.  This baby was particularly important to me and my husband because her mother is a relative.  Tragically, her mother was also a drug user and did drugs during her pregnancy.  If we could not adopt the baby she would have been put into the foster system since the biological mother was incapable of raising her.
     To keep a long story short, we did adopt her and she is doing fantastically.  There is no sign of any effect of the drugs on her as of yet, and with God’s help, there never will be.  We think that is because of the vast amounts of love and attention she gets from us, her real mommy and daddy.
     What does this have to do with chiropractic?  The reality is that without chiropractic, I would still be nearly an invalid with headaches.  I COULD NOT HAVE TAKEN CARE OF AN INFANT OR RAISED A YOUNG CHILD.  THEREFORE, SHE WOULD NOT HAVE ANY OF THE OPPORTUNITIES IN LIFE THAT MY HUSBAND AND I WILL BE ABLE TO PROVIDE FOR HER.  MY DAUGHTER’S LIFE IS POSSIBLE BECAUSE SOMEBODY MADE ME GO TO A CHIROPRACTOR. 
     You need to tell everyone you know what you know about chiropractic.  Who knows who’s life you will change too.
Andrew's mother, Barbara, wrote:

     Hello, My name is Andrew and I am a happy, healthy one year old.  But I wasn’t so happy or healthy when I first met Dr. Rick a few months ago.  I had been having problems with my ears for four months, I couldn’t sleep at night and I was miserable.  We’d been to the doctor lots of times but nothing was helping.  In fact, all the medicines the doctor had tried seemed to make me worse instead of better!  Both the regular doctor and the Ear-Nose and Throat doctor said that if the antibiotics didn’t work, then they’d just have to put tubes in.  Now my Mom and dad weren’t about to let them do surgery on me, especially since they had been reading and learned that tubes can cause more problems than they solve.  My mom and dad did a lot of praying.  Then my mom heard that sometimes babies who have a traumatic birth like mine have ear trouble.  You see when I was born they used a vacuum extractor and forceps to pull me out.  I guess all that yanking on my head, hurt my neck.  She also heard that chiropractic care can be the answer.  Now she was skeptical because she couldn’t imagine a chiropractor helping ear infections!?!  But at that point she was willing to try anything!!  Happily, a few weeks of adjustments and my ears were all cleared up.  In addition, I no longer had a stiff neck or shoulders and my whole personality was happier.  I have to tell all babies who have ear troubles, don’t let them give you tubes until you at least try chiropractic care first.  After all, it can’t hurt and if you’re like me, you could be perfectly well with no drugs and no surgery.  In my family, we thank God for Dr. Rick, because I feel better, my mom and dad are happier and sometimes, I even sleep through the night.