We may have cancer and feel good, or be submitted to substantial disability and suffering without doctors finding any evidence of disease. Medicine gives no acceptable answers to the last situation and arbitrarily appeals to denying the reality of suffering, making the calvary of patients even more unbearable. This blog tries to contribute with the knowledge of the neuronal network, giving a little light to this confusing section of pathology.
The physical therapist feels the area in which pain is perceived and concludes:
- Your neck is stiff.
If there is a confusing issue in the field of pain it’s the aching muscle. The so-called "muscle-skeletal pain" is a damn jumble, a conceptual disaster.
The muscle is a tissue of varying consistency to palpation and the joints also show a varying opposition to pasive movement. By feeling and moving, the physical therapists draw conclusions about the muscular condition, their responsibility in the genesis of pain.
Muscular consistency is influenced by many variables. A muscle of increased consistency can be too tight, or not. If it’s tightened, it can be due to neuronal stimuli or specific conditions of the muscle fibers.
Contracture is not synonymous with contraction. Increased consistency is not synonymous with contraction. A muscle that is painful with palpation doesn’t have to be contracted. Pain is not something that makes the painful muscle contract. It is a false cliché.
The static muscle aquires more consistency and higher viscosity, but moving it actively or pasively is enough for its consistency to decrease. It’s a strange property of the so-called non-Newtonian fluids, the thixotropy. A "hard" muscle becomes "soft" simply because it’s thixotropic. The same happens with ketchup, paints, honey ...
Muscles can be unnecessarily contracted (as lights could be unnecessarily turned on when there is no one in the room) and express their discomfort or vulnerability through pain. Relaxing them is enough for consistency and pain to yield.
There may be bad postural, psychological, programming conditions, overexertion... There may be myofascial trigger points that fatten the vicious circle of pain (always with the collaboration of a vigilant and catastrophic brain). There may also be a brain that defends an area from individual’s purposes.
After the pain and increased consistency of muscles from one area, there are many variables: muscular, neuromuscular, cerebral ... There are contractures, contractions, viscoelasticity, protections, alerts, bait points ...
The physical therapist palpates, moves, questions, values ... informs, back to palpating, moves, shows, convinces...
The universe of static and kinetic muscle is complex. It’s not my universe. I’m a neurologist. The physical therapists have a great job to do: to clarify that universe for themselves and for citizens.
- It hurts ...
- Let's see, calmly... This is very complex.
PD Elefante, a worthy reader of the blog, recommended me this post: