Where Did That Pain Come From?

Over 30 years of practice, the phrase that I have heard more than any other when asking patients about their pain has been, "It just came out of nowhere." Pain is unpleasant. When it seems to come out of nowhere it can be downright scary. The truth is: It NEVER comes out of nowhere. There is always a cause. And because there is always a cause, that cause can be corrected in most cases and the pain will, to use another popular phrase, "go away as quickly as it came."

Although the pain mechanism is very sophisticated and complex, it can be described simply. There are special nerve endings all over the body that transmits signals through a nerve, which joins a bundle of nerves that enter the spinal cord and goes to the brain. Only after the brain interprets the signal as pain do we say "Ouch!" So, we have a nerve ending, a nerve, the spinal cord, and the brain involved in a painful sensation.

These nerve endings exist all over the body. That's why they have a "threshold" of pressure or inflammatory chemicals that must be crossed before the nerve ending will "fire." Otherwise, every touch would hurt. So, you have to press hard enough or the inflammation has to be great enough to cause the nerve ending to fire or you won't even know anything is going on. The nerve endings that register pain are like switches, not dimmers. They are either on or off. The intensity of pain is caused by the number of them that are firing.

Imagine that you are sitting in a room reading. Someone on the other side of the wall where the switch is located is pushing it down very slowly. You have no idea that anything is going on at all until the switch hits that point where the contact is broken and the light suddenly goes off. It happened out of nowhere as far as you are concerned. 

Something similar happens inside your body. The pressure or inflammation builds up slowly over days, weeks, months, or even years, but you have no idea of what is happening until there is enough (maybe you bend or twist or pick up a gallon of milk) to cause the nerve ending to fire. Then, you show up at the chiropractor's office and tell him: "It just came out of nowhere!"

Now you know better.