Pain and Your Health

PAIN AND YOUR HEALTH:

Through out my entire career I have been faced with literally thousands of patients asking me about pain. We all have pain in one form or another at various times in our lives. It is part of living. But the commomly held belief by most people, some doctors included I'm sorry to say, is this: "If I have no pain, then I must be healthy." I say, not neccessarily. So what about pain? The question I ask people is, "Is pain a reliable indicator of our health?" Most people say yes; I say no. Consider the following scenario that actually happened to two friends of mine years ago:

One friend ate fish one night and later was terribly ill. He was throwing up, his color was ashen, he felt horrible and was convulsing. He had food poisoning but recovered after 6 hours of thrashing about and vomiting up most of his water content.

The other friend felt great. Had no pain. Two weeks later he keeled over on a golf course of a massive heart attack. Question: which one of my friends was sick? Answer: The golfer. He had long standing heart disease, elevated cholesterol and three blocked coronary arteries but had no pain. The food poisoning friend displayed an intact immune system that repulsed the antigen. And while he felt terrible for 6 hours he was fully recovered and got through the ordeal. Question: What is the most common sign of a heart attack? Answer: Death. Left arm and/or crushing chest pain is the second most common sign. Point being; most heart attack victims feel literally nothing througout the course of their illness. They just drop dead one day with not the slightest hint of anything wrong.

Pain is NOT A RELIABLE INDICATOR OF YOUR HEALTH. It is not and never has been. How many times have we seen friends or loved ones wake up one day with an odd lump that turns out to be cancer? Did the tooth pain someone experiences happen the previous night? No, both of these situations took years to manifest, much like the heart disease that kills over one million Americans a year. Likewise, your spinal health is often at risk to degeneration, a silent but debilitating occurance that affects all of us due to trauma, sports injuries, aging, gravity and so forth. All chiropractors urge their patients and potential patients to start thinking in terms of PREVENTION.

   Typical "Bone Scan" image at left. The patient's skeleton is highlighted by the radionucleotide. This image appears dark all over in this recreation. In a real Bone Scan image, the entire plate is more of a gray color with "hot spots" showing up as dark black.

PREVENTION is often the way out of all these silent debilitating or deadly disease processess. Prevention can be in the form of lifestyle changes, dietary changes, chiropractic or medical check ups. Consider yet another true life scenario: a friend of mine from New Jersey called several years ago and said he had a little minor pain in his upper right thoracic region, around T5. I asked him how old he was and he reminded me he was 66. I told him to go and get a blood test to include the PSA (prostate specific antigen). Normal PSA values are 0-4(nanograms per mililiter). His PSA test value came back at 1800 ng/l. I next told him to go and get a Bone Scan (see above picture). That is a specific type of imaging in which the patient must first get a radioactive nucleotide injected into their body. It is called Technitium-99m. It is not harmful and has a half-life of 6 hours. But, human bone marrow has an affinity for this stuff and drinks it up. 2 hours later, the patient must return for an imaging session with a gamma camera. The resulting picture is an outline of the patient's skeleton. Any dark spots mean there is extra T-99m uptake which indicates more marrow activity such as in active fracture healing or a blastic (growing)tumor in the bone. This man's bone scan showed "hot spots" in every bone in his body above the waist. He had exuberant metastatic prostate cancer. He went on estrogen therapy and lived until he was 71. All he originally had to show for it was some casual pain in his upper right mid back. At Boston Spine Clinics we urge all male patients to get a blood test including the PSA inventory from the age of 39 and up.

So what can we now understand about pain and our health? We know that it is an UNRELIABLE indicator of our health status. We know that often we may have a medical issue and have NO Pain. We know that if we do have pain, it is a warning to investigate ourselve further. We know that chiropractic has always espoused prevention as the key to good health. We know that even the medical world has grasped this concept now and encourage yearly examinations as a valuable screening tool to prevent later, more serious problems from arising. I go to a brilliant internist here in Boston yearly for a thorough medical physical exam including the PSA as well as an EKG, Urinalysis and other blood inventories.

Boston Spine Clinics embraces the prevention concept like all chiropractic offices. We urge all patients and potential patients to think about prevention. When is the best time to see a doctor? When you are feeling great of course. Do not wait until problems flare up. Stop them BEFORE they become worse.

On the other hand, should you put off yearly exams and just wait for pain to occur?

We think not.