Chronic Pain Treatment - Where's the Upper Cervical Care?!

Posted in Nervous System Disorders Head Pain Disorders on Jul 26, 2018

Chronic Pain Australia just released the results of the National Pain Survey 2018. As I read through the report, it is the comments shared by people suffering chronic pain that touch me the most:

“Validation - actually hear me, have empathy for me, listen don’t judge • My pain is not made up … the pain is real.”

 If you are seeking a natural solution for chronic pain, fatigue or fibromyalgia and you're have NOT sought the help of an Upper Cervical Specific Chiropractor, I would STRONGLY ENCOURAGE you to read this article in its entirety.

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Personally, it amazes and disgusts me that many medical and healthcare professionals still label people suffering chronic pain as if its “all in their head.” I call bull-stuff. As a healthcare practitioner myself, I will admit openly that there’s a lot of stuff about the way that the human body works that I don’t know.

No one knows it all (!), and anyone who claims to have all the answers is full of it.  … But just because we don’t know does NOT mean that it doesn’t exist or that it isn’t real.

“Sometimes I need medication to manage my pain – that doesn’t make me a junkie … I don’t always want opioids.”

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I have yet to meet a single human being who has ever said, “What I need in my life is more medication.” Chiropractors are often labelled as being “anti-medicine” because we promote natural methods first. I aim to be the voice of reason.

If you suffer chronic pain, first, take what you gotta take! If that’s what you need to get through the day, so be it … because that is what will give you the time and opportunity to get to the bottom of whatever is creating your pain so that you can discover other ways of managing or improving your circumstances.

“Mental health issues go hand in hand. … Understand my life and what a day looks like for me.”

Find me a person experiencing chronic pain who does not experience a degree of depression, anger, fear or anxiety about their condition, and I will tell you that is the abnormal person! Often, the people I meet who experience chronic pain are among the healthiest people I know.

They are conscientious and highly proactive in making sure that their diet, exercise regime and stress levels are as clean as you can get! … Still, getting through the day can be a struggle.

“Embrace a wholistic approach.”

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Alas, here is the part of the report that disappointed me … not because of the responses that were given, but because of how the report addressed the question, “What other health professionals do you see to help you treat chronic pain?”

  • Physiotherapist - 18.73%
  • Psychologist - 7.57%
  • Pain Specialist - 16.68%
  • No One - 12.38%
  • Nurse - 0.82%
  • Dietician - 0.82%
  • A combination of health practitioners - 42.99%

… Where is “chiropractor” in the general list? Without offence meant for nurses and dieticians, if the report is okay to specify 0.82% I would certainly hope that among the 1266 respondents that more than 10 see a chiropractor … and if so, I am even more seriously disappointed that the report may have chosen intentionally not identify chiropractic as a non-medical approach to assisting people with chronic pain. Not very embracing of a wholistic approach in my opinion.

So what Actually Works to help Chronic Pain?

In the same breath - I get it - there isn’t an overwhelming volume of research describing how chiropractic can help people suffering chronic pain … and even less describing the upper cervical approach! That said, there are still volumes of case studies and reported instances where chiropractic - specifically vectored adjustments of the upper neck - have made substantial improvements for people suffering chronic pain.

On the other hand, when it comes to the standard medical approaches and research reviews, unfortunately, pharmacology doesn’t have anything substantial either! (2,3,4) Ultimately, what people experiencing chronic pain are left with are a series of potential routes that they must explore where they have no choice but to make their own logical decisions - perhaps even against the advice of their medical doctors - in order to discover a solution that will work for them.

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In this article, I would like to outline the case for Upper Cervical Chiropractic as one essential piece of the puzzle in solving the great chronic pain mystery.

What and Where Pain Is

A few introductory notes on the nature of pain. First, pain is a highly subjective experience. No two people experience pain the same. Partially it is because there is no such thing as a pain nerve receptor. There are only what are called “nociceptors,” which are specialised nerve receptors that send impulses to your brain when they detect physical or chemical damage to the cells of your body.

Ultimately, your brain integrates the information into what it may perceive as “painful” or “non-painful” event. However, your brain also integrates other input from other non-nociceptive signals that can be thrown into the mix … signals such as emotional distress, memories of distress, et cetera.

In essence, your brain is a supercomputer that processes all signals in terms of nerve interactions: 1s and 0s. However, if some of these wires get crossed - OR if something corrupts the normal signalling - the brain can make erroneous conclusions and get itself stuck into a perpetual loop of never-ending chronic pain.

Pain Centres of the Brain

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Certain centres of the brain are especially important in the modulation of body pain. Specifically, I am going to mention a few of these structures located in the brainstem. … And my apologies, if you are not inclined towards technical details, feel free to skip this part.

1. Reticular Activating System (RAS). The RAS is a cluster of nerve cells that surrounds the central canal in the brain and spinal cord. One of its primary functions is to filter and inhibit nociceptive signals going to-and-from the brain.

If its normal function is disrupted, it is possible that nociceptive signals bypass the normal filter and bombards your brain with an endless stream of “pain” signals.” It is intimately associated with other brain structures called the Peri-aqueductual Grey (PAG) and the Median “Raphe” Nucleus, which are also essential for pain modulation in the brain.

 Your brainstem at the base of your skull is the primary filter that receives nociceptive input and is intimately involved with other centres of the brain that go on to perceive pain.

2. Nucleus Tracts Solitarius (NTS). The RAS, PAG and Raphe Nucleus receive-and-transmit tons of information to a cluster of cells called the Nucleus Tracts Solitarius (NTS) which is the part of your brain that receives and coordinates the function of your vital organs.

If something has disrupted the normal function of your autonomic nervous system, it is possible that this “bad” information can “spill-over” into connected areas of your brain and produce symptoms that are not immediately associated with your primary condition.

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3.Locus Coeruleus (LC). The LC receives information from the RAS and NTS and is the “alarm system” for your brain. Its activation is associated with the stress response, which includes the sensation of anxiety, which is common for many people experiencing chronic pain.

4. Cerebellum (+ Extrapyramidal Nuclei). There are so many clusters of cells in the brainstem that I am not even going to mention them all. I will instead focus on the cerebellum, which is the master “fine motor and coordination” hub of your brain that works to maintain your upright balance and muscle tone.

The significance of the cerebellum in chronic pain will be made clear shortly. For now, let me ask you this: if you were a professional couch potato, and then you decide to go to the gym for 2 hours, how are you going to feel tomorrow?

Very, very sore most likely. That's what happens when your muscles accumulate lactic acid when they are under a new or continual stress load.

I think you get the idea by now that there are a number of independent but interrelated structures within the brain involved in pain modulation … thus a number of potential sites where interference to your brain’s normal function may produce chronic pain.


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  1. National Pain Survey 2018. Chronic Pain Australia. Accessed 26 Jul 2018.
  2. Smith ME, Haney E, McDonagh M, Pappas M, Daeges M, Wasson N, Fu R, Nelson HD. Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015 Jun 16;162(12):841-50. doi: 10.7326/M15-0114.
  3. Castro-Marrero J, Sáez-Francàs N, Santillo D, Alegre J. Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome. Br J Pharmacol. 2017 Mar;174(5):345-369. doi: 10.1111/bph.13702. Epub 2017 Feb 1.
  4. Bested AC, Marshall LM. Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians. Rev Environ Health. 2015;30(4):223-49. doi: 10.1515/reveh-2015-0026.
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