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Muscle and Joint Pain Self Care

 Muscle and Joint Pain Self Care

When man is living, he is soft and flexible.
When he is dead, he becomes hard and rigid.
When a plant is living it is soft and tender.
When it is dead,  it becomes withered and dry.
Hence, the hard and rigid keep company with the dead,
The soft and supple keep company with the alive.
                                                         Lao Tzu

            Most muscle and joint pain syndromes are caused by easily correctable faults in function. Many of these mechanical faults can be greatly improved by self care methods. The following guide will assist those with a wide variety of conditions -- headaches, neck and back pain, tendonitis, arthritis, jaw pain, carpal tunnel syndrome, sciatica, to mention a few. It should not be used as a substitute for proper evaluation and treatment by a qualified health care professional but can greatly help accelerate health improvements made with other therapies.
            Usually, the most effective way to deal with musculoskeletal pain syndromes is to consult first with a reputable chiropractor. Chiropractors are usually the best qualified to properly diagnose these conditions and prescribe a cost-effective treatment plan that has the lowest risk of complications or adverse side effects. Problems with treatment are greatest with dangerous drugs and invasive surgery. The fewest and mildest problems occur with natural methods.
            Most muscle and joint pain syndromes have the following contributory elements:
            1. Muscles can be too tight. This causes pain itself but will also stress joints and cause pain that way.
            2. Muscles can be too weak or lack sufficient endurance which will cause joint movement irritations.
            3. Joints can be too tight which can cause them to become arthritic, muscles to go into spasm, and nerves to become irritated.
            4. Joints can be too loose due to lax ligaments or weak muscles. This results in excessive wear and tear of the joint surfaces leading to arthritis. It can also cause muscles to go into spasm in response to trying to stabilize the joint. Nerve irritation can also come from joints with excessive mobility.
            5. Insufficiently nourished tissues can lead to fatigue, injury, difficulty healing, or degeneration.
            So the goal of recovering fast from these types of pain syndromes amounts to relaxing muscles that are too tight, stretching joints which are also too tight, strengthening muscles that are too weak, and stabilizing joints which are excessively mobile.
            One of the main, indispensable functions of a chiropractor is to mobilize joints that are too constricted. Often there is no other way to loosen up these joints completely. The exercises which are recommended will greatly help in this process but can’t restore all movement to all joints. Consulting with other professionals such as massage therapists, acupuncturists, and biofeedback technicians can be helpful for the best health recovery and health maintenance.
            These guidelines are not designed to take the place of these important health care professionals but rather be a valuable aid to self-care. The more we can do for ourselves the less we have to pay and depend on others for services. Self-care is very economical and very appropriate for muscle and joint problems.
Understanding the Function of Your Unique Body
            A healthy, pain-free body needs a balance of essential components:
            1. Good nutrition provides the building blocks for on-going repair, rejuvenation, and energy needs. (healthy diet plus nutritional supplementation)
            2. Relaxed nerve signaling allows muscles to rest when not needed for movement. (sufficient sleep, periodic daily rest periods, massage, relaxation practice, meditation, biofeedback training)
            3. Well conditioned muscles have the endurance to sustain good posture, efficient movement, and joint stability. (aerobic sports and exercise)
            4. Strong muscles need to withstand the maximal stresses we impose on them daily so that they do not tear or that the joints they move are not injured. (variety of strength training techniques)
            5. Flexibility of muscles, tendons, and ligaments allows full range of motion to joints. (stretching exercise, massage, and chiropractic joint mobilization)
            6. Coordination of movements protect the body from injuries as in falls, awkward positioning, or poor ergonomic lifting. (sports, Tai Chi, etc.)
            Ideally, a health professional can help you evaluate which of these components might be deficient in your unique situation so that it can be appropriately addressed. Adding to this type of clinical examination and prescription these guidelines can help you understand your problems and apply self-care methods to compliment advice and therapy gained from your health professional.
 
The Nutrition Component
            Ideal nutrition helps enormously in preventing musculoskeletal pain syndromes and recovering from injuries. Proper diet will help keep our energy reserves steady and sustained so muscles won’t fatigue. Nutrients are needed to prevent joints from deteriorating. Magnesium is necessary for muscles to relax. It is a mineral which is frequently deficient in the average diet. Vitamin C is essential for spinal discs to remain healthy at levels higher than what can be consumed with orange juice. Nutritional supplements such as chondroitin sulfate and glucosamine can help repair damaged cartilage and ligaments in some cases. Digestive enzymes, such as bromelain or pancreatin, are effective at minimizing inflammation. Curcumin, the active ingredient in the herb turmeric, is a good anti-inflammatory also. There is a ginger extract under the brand name of Zinaxin, that also reduces inflammation without using dangerous medications such as ibuprofen, ketoprofen, or naproxen. If non-steroidal anti-inflammatory medication is needed for severe inflammation 5-15% ibuprofen crème can get the medication to the specific tissues that are inflamed without causing the digestive issues commonly seen with oral intake. Blood levels are also lower decreasing the medications adverse effects on other organs and systems of the body.
            Everyone should make efforts to improve the nutrition component of their life, particularly if muscle and joint pain syndromes are a factor. One basic, simple, but excellent way to do this is to use the book, Staying Healthy with Nutrition by Elson Haas, MD. It is, by far, the most comprehensive, scientifically-sound nutrition guide that goes beyond the fad diets. Everything you would want to know is included in a very readable format. Not only are the dietary guidelines excellent, but recipes for healthy meals are included. Therapeutic nutritional supplementation guidelines for different conditions, sexes and ages are a strength of the book. This book belongs in every home. Another, more specialized book is Clinical Nutrition for Pain, Inflammation and Tissue Healing by David Seaman.
 
The Relaxation Component
            In our fast-paced modern world we too often get caught up in a hectic whirlwind of activity, day-in and day-out. In this habitual pattern of doing, moving, and working we often fail to include regular periods of rest and relaxation. Our muscles and nerves need frequent periods of calming in order to help the body come into balance, restore, and rejuvenate itself.
 Sleep
 Recuperative sleep is essential for our well-being in general, but particularly so for musculoskeletal pain syndromes. Most adults need 7-8 hours of sound sleep per night. Few people can stay healthy and function optimally with less. Children need even more. Since we spend approximately 1/3 of our lives in bed it is important that this environment be a healthy one for our bodies. For some it is a torture chamber instead.
            Here are some tips to make bedtime therapeutic. Keep the bedroom dark and quiet. Light and sound tends to activate our “awake centers” in the brain. Our nervous system can’t rest as well. Proper sleeping support is very essential and is different for every person. Some people feel more comfortable and sleep better with a firm mattress and others with a soft one. Choose what feels best for you. Needless to say, old sagging mattresses or ones with the springs surfacing need to be replaced.
            Comfortable pillow support is also essential, particularly with individuals who have neck discomfort. Here again individual comfort is the key but certain generalities usually apply. Too high of a pillow or none at all is seldom recommended except in very unusual circumstances. When sleeping on one’s back a pillow that provides gentle neck support is ideal. When sleeping on one’s side it is important not to have the neck kinked left or right with too high or low of a pillow. Also when side sleeping your high knee should not touch the mattress. Otherwise, it will cause an irritating twist to the low back. A cushioned support between the knees can help prevent this twisting. Stomach sleeping is strongly disapproved since it twists the neck severely and excessively arches the low back.

Daily Relaxation and Rejuvenation Periods
            Everyday we can benefit from short periods of programmed relaxation. The easiest way to incorporate relaxation practices into your life for the health benefits to your muscles and nerves is to set aside one or more time periods per day of 10-30 minutes for meditation, or progressive relaxation type exercises. A great book that has step-by-step instructions on these techniques is Full Catastrophe Living by Jon Kabat-Zinn. Everyone could benefit from the practices in this book but especially those who have trouble relaxing. There are also good audio and video tapes available at music and video stores or mail order catalogs that teach programmed relaxation training.
            For those who still find it difficult to relax with the self care relaxation practices in Full Catastrophe Living it may be wise to consult with a biofeedback specialist for a number of training sessions to reprogram your responses to stresses of daily life. This may be particularly important if you have myofascial pain syndromes related to your neck and jaw such as headaches.
 
Well Conditioned Muscles
            Muscles that have good endurance, the ability to sustain repetitive, prolonged activity, improve posture and prevent injury. Postural strain often occurs when our muscles can’t sustain efficient positioning. Injuries often occur near the end of sporting endeavors or work shifts when muscles no longer have the energetic capacity to protect sound movements. Sedentary lifestyles are fraught with frequent and enduring musculoskeletal problems because of lack of muscle endurance.
            There are several ways to ensure good muscular endurance. Proper diet and good nutritional supplementation is one important factor. Getting regular, full-body aerobic exercise is very important. There are numerous non-impact or low impact exercises that are ideal – swimming, water aerobics, Non-Impact Aerobics, cross-country skiing, stair climbing, bicycling, rowing, skating. Many sports like soccer and basketball supply the needs for aerobic exercise.
            A good book that will help you with this and strength training programs is Therapeutic Exercise: Foundations and Techniques by Carolyn Kisner and Lynn Colby.
            Abdominal and low back muscles are examples of muscle groups which if they have good endurance really have a profound impact on preventing or recovering from spinal injuries.
            There is an important place for strength training in the prevention of and recovery from muscle and joint injuries. Muscle, tendons, and ligaments that are strong naturally resist strain injuries. Making tissues strong amounts to periodically stressing those same tissues in safe, controlled progressive exercises. For the average person an ideal way of getting good strength training, inexpensively is with the use of some simple aids. Rubber tubing in various thickness’ (giving different levels of resistance) can be used in resistance exercises while moving joints through a full range of motion. This is good for arms and legs. A neck attachment can be added to exercise a weak neck during rehabilitation from an injury. Large inflatable “Swiss” exercise balls can be used to strengthen the trunk and stabilize the spine. These can also be used in coordination exercises.

 A Caution About Strength Training!
            A frequent error in rehabilitation from injury is the overemphasis on strength training while ignoring the relaxation, stretching, and massage of excessively tight muscles. If a person has a pain syndrome that involves excessively tight muscles and even trigger points, signaling those muscles to tighten even more with strength training may be counter-productive. It is often necessary to train the muscles to return to their relaxed resting state with its normal length before slowly training them to be strong again. Heed this warning well! 

Massage
            Often pain syndromes involving excessively tight muscles do not respond to treatments other than deep therapeutic massage. Torn, fibrotic, and shortened tendons and ligaments often need special types of massage in order to fully heal. A skilled massage therapist specializing in therapeutic massage and skilled at a variety of techniques such as fascial release and cross fiber friction massage can make a crucial difference in correcting muscle and joint injuries. But there are excellent techniques and inexpensive aids for self massage that also can make a significant difference in attaining the best health.  

Self Massage Aids
            For tight spinal muscles, particularly in individuals whose jobs or sporting activities result in a lot of post exercise muscle soreness and residual tightness a Shiatsu massager is a good motorized device when human hands are not available. For neck, upper shoulder, (trapezius) and calf tightness the Acu-Masseur is an effective device. For tight rotator cuff muscles such as those around the shoulder blade or the muscles of the buttocks there is nothing more effective than the use of a Therapeutic Massage Ball.  There is one type of self massage device that has a diverse number of uses and is well worth the cost when considering how much you would have to pay a massage therapist to do the same thing. The Therapeutic Massage Wand can also be used on numerous muscles either by oneself or in the hands of a friend. It makes deep tissue massage much easier on the hands of the one doing the massage.
            An easily accessible area to use one’s own fingers for self massage is on the forearm near the elbow. This area is often the location of trigger points (excessively tight muscles which won’t relax and radiate pain and/or unusual sensations to a distant location, like the hand.) which mimic the symptoms of carpal tunnel syndrome. Cross fiber friction massage of this area brings rapid healing. This type of massage only needs to be done for five minutes or so every other day or every third day until the problem is resolved. Another good place to practice self massage with one’s own fingers is the jaw muscles. It is remarkable how many headaches are due to tight jaw muscles which could be easily alleviated with simple self massage.
 
Stretching
            Proper flexibility exercises are the most underutilized and important type of self care measure for preventing and correcting muscle and joint pain syndromes. Professional and amateur athletes, laborers, sedentary individuals all get insufficient stretching for the best health and performance. If you do not stretch before and after every vigorous physical endeavor sooner or later you will be injured because of your lack of self care. It doesn’t take a lot of time to provide some flexibility to tight tissues either in a preventive or rehabilitative capacity. Only regions which are inflexible need attention. And the rewards can be enormous. As we age the need for these flexibility exercises to become a routine part of our life increases since our tissues become more inflexible with time. Every household should have and use the book, Auto Stretching by Evjenth and Hamburg. With excellent photos and detailed descriptions it shows how to stretch every muscle in the body.An abbreviated, inexpensive version of these core exercises can be found in The "Better Than Yoga" Stretching Guide by Thomas M. Collins, DC available at the Health Care Center.
            Often our thoracic spine (middle back where our ribs attach) is too stiff and has been posturally trained to flex forward much easier than backward. This poses problems for not only this region of the spine but for the neck and low back also. An incredibly simple, self-care exercise that helps this imbalance in movement is arching back over a six inch styrofoam cylinder (some people use a basketball or soccerball). Stretching on this for a few minutes periodically can greatly reduce neck, mid-back and low back discomfort. Using it regularly will also help at reducing the need to be adjusted by your chiropractor. 
Dynamic stretching programs now being developed for specific sports are finding their way into pre-competition regimens with good results. More comments and information will be supplied on this website about this subject as the scientific and therapeutic community further develops these techniques.

Recommended Self Care Aids
            Books
Auto Stretching by Olaf Evjenth and Jern Hamburg From Chatanooga Educational Services (800-592-7329) {approx. $35}
Full Catastrophe Living by Jon Kabat-Zinn
Therapeutic Exercise by Carolyn Kisner and Lynn Colby
Functional Soft Tissue Diagnosis and Treatment Methods by Warren Hammer, DC
Rehabilitation of the Spine by Craig Liebenson
Clinical Nutrition for Pain, Inflammation and Tissue Healing by David Seaman, DC
 The last three books are more expensive clinical manuals and available from (800-359-2289)
            Self Massage Aids
Theracane
Backnobber II
Index Knobber
Therapeutic Massage Ball 
Therapeutic Massage Wand
Acu-masseur
Shiatsu Massager   
            Postural Supports
Pillows between the knee cushions for sleeping
Lumbar Supports for sitting     
              Exercise Devices
18”x 6” cylindrical thoracic stretching roll
Thera-tubing
Swiss Balls
What Most Likely Will NOT Make Substantial Improvements
In Muscle and Joint Pain Syndromes
Homeopathy
Aromatherapy
Medication, particularly pain relievers or muscle relaxants. Short term anti-inflammatory use has a place in cases of run-away inflammation, but over 16,000 Americans die from the oral use of this class of drugs every year.
Most ointments, salves, lotions, rubs, balms are not effective. Although, for severe inflammation 5-15% ibuprofen crème can get good anti-inflammatory action to the specific tissues that are inflamed without causing the digestive issues commonly seen with oral intake.
Hoping the pain will go away if you wait long enough.
 

 



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