Pain Pills: The Physical/Chemical Mismatch


What about pain pills? The physical/chemical mismatch in chronic pain.

Dr. Christopher Aysom
Apex Soft Tissue & Spine

The use of pain medication is a huge topic. Within musculoskeletal healthcare it’s common to be asked by patients if they should use pain-relieving medication when dealing with chronic pain. While every situation is unique, we can often think of it like this: If you have a physical problem then you most likely need a physical solution, rather than a chemical one.

Pain pills and injections are all part of a chemical approach. When you ingest medication for pain management, it breaks down in your stomach, goes through your intestines, into your bloodstream, and finally gets to your back pain, neck pain, shoulder pain, etc.  Sometimes, a chemical solution can reduce symptoms, but it is not providing a resolution. 

After a short period of relief, the chemical gets broken down and wears off.  Over-the-counter and prescribed medications are time-limited. Whether it’s every four to eight hours or six to twelve hours, managing your pain with a chemical that lasts less than a day has limited value. If you take pain medicine, you haven’t improved your health. You haven’t improved your musculoskeletal capacity. 

A chemical solution won’t resolve a physical problem.

Most pain in the musculoskeletal system (muscles, tendons, nerves, ligaments and discs) is a symptom being produced because there is a physical problem. Something is being overloaded and it responds with pain. Musculoskeletal overload is multifactorial, but commonly caused by poor posture, slouching, lifting, carrying loads, or multiple repetitions of the same movement. After a while, muscles can become overused, which creates tension, pain and inflammation. 

The human body works best when its put under an appropriate amount of strain and then allowed to recover. If you exercise semi-regularly, your body needs adequate time to repair itself. If you do too much or push too hard and don’t take the time to recover, that will create problems that require treatment.

For example, if you overuse a muscle and it stays contracted, that can cause fibrosis in the muscle, so the muscle is not healthy anymore. No matter how much you rest at this point, it’s not going to recover – you have a physical problem! Hands-on treatment is needed to break down the fibrosis and restore the normal range of motion and strength. 

There is no medication that effectively treats soft tissue fibrosis, disc degeneration or nerve entrapment.

Trying to remedy what is ultimately a physical problem with a “chemical solution” doesn’t work because it’s not a solution. It might seem more convenient and less expensive to grab some pain pills to dull down the signals from the pain system. Although it can make you feel better for a short time, it doesn’t solve the problem. 

If your smoke detector goes off, you don’t pull the batteries out. You put out the fire. Pain is your body’s alarm telling you that something is wrong. If you take pain pills and turn the pain off without solving the problem, you will do more of the thing that’s harming you, circumventing the whole purpose of having pain.

Most folks already know this.

The vast majority have the intuitive awareness that long-term use of pain medication is not the preferred solution to chronic pain. Reaching for pain pills is often not a choice of convenience, but more often due to the frustration of having already invested substantial time and money pursuing physical solutions which had limited effect.

In most cases, the crucial piece that remains missing is the diagnosis. It’s near impossible to effectively manage a problem that is not fully understood. With an accurate and tissue specific diagnosis, we are able to deliver effective treatment that reduces the physical problem and thereby decreases the chronic pain.

It’s a tragedy when someone suffers through chronic pain caused by an undiagnosed and unresolved physical problem. It’s an even bigger tragedy when all that is left at the end of that road is a chemical solution, which never solves the physical problem and ultimately just leads to more pain. Physical problems need physical solutions.

Dr. Christopher Aysom, Principal Clinician
BChiroSc, MChiro (Chiropractor)

Apex Soft Tissue & Spine
Pymble, NSW, Australia

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