Where Does Joint Pain Come From?
Soft Tissue Influences on Pain via
Nerves, Periosteum & Joints
It is well known, described and recorded in the medical literature that there is no direct correlation between joint degeneration and joint pain.
Many people present with clearly visible degeneration (observable via X-rays and MRI) surfaces and tissues within their joints, but have NO pain. Other people have NO visible degeneration but LOTS of pain.
In the photo, it appears the joint surfaces have reached the joint of bone-on-bone. Yet many such cases of this do NOT necessarily present with pain & dysfunction.
The surfaces that are rubbing against each other do NOT contain nociceptors or pain sensitive nerves.
This phenomena has been known by the medical research community for many decades, and written about in their journals. Yet many physicians jump to conclusions that visible degeneration correlates with pain and other dysfunction.
IT DOES NOT!
I had a Client once with visible severe hip degeneration and joint pain. Yet his pain was in the opposite hip ! Structural analysis revealed the postural deviations were indeed more likely originating in the hip with NO pain but with visible degeneration (on X-ray). We released (or more precisely relaxed) the C.E.M.&.N.T. — (Chronic, Excess Muscle & Nerve Tension & Stress) in the degenerated hip, and the pain in the opposite hip stopped!
The joint structure is interesting in that there are FEW or NO pain sensitive nerves (called nociceptors) within the joint capsules or on the joint surfaces. If you think about it, if there were pain sensitive nerves on the joint surfaces, every time you took a step or picked something up with your arm, you’d have pain. That would not be a very good design feature of being human!
The nerves within the joints are called proprioceptive nerves. They measure the position and movement of the joints, telling the CNS (central nervous system) where the joints are in space and what they’re doing. But they are NOT pain sensitive!
We DO, however, have plenty of nociceptors in the soft tissues surrounding the joints.
Therefore, when a person is experiencing joint pain, what they are really feeling is not the degeneration of the joint itself, but the pressures upon the other tissues surrounding the joints being measured by the nociceptors.
Simultaneously, IF there is chronic joint degeneration (rather than injured tissues from an accident), it is the soft tissues that have produced the joint degeneration.
Spinal disc degeneration provides a Perfect Example.
The discs of the lumbar spine are highly susceptible to degenerative conditions. We consider this to be the result of over-shortening of the psoas muscles.
You can see in the illustration to the right the fibers of psoas muscle (red, blue and green) crossing over the lumbar vertebrae. When those musculo-fascial fibers chronically contract and shorten, they will increase the pressure on the vertebral discs.
That also decreases the space available for the spinal disc material, forcing it out to the sides, front or back, depending on what vector forces are applied to the tissues.
Understanding, observing and working with vector forces is a critical component of BIO-Structural Analysis & Postural Assessment.
It is also the musculo-fascial soft tissues that contain nociceptive nerves, the “pain sensors.” Treating soft tissues is in mot cases a more direct path to treating “joint pain,” rather than attempting to manipulate or repair joint surfaces.
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“I read David Scott Lynn’s book which I highly recommend for every massage therapist [as well as yoga teachers & therapists]. I was amazed at how intricately he delves into and emphasizes, over and over from various angles, how our work mostly works to affect the nervous system in a variety of ways.
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Thanks for Reading,
David Scott Lynn (DSL*)
DSL: Your Hi-Touch Up-Link to the Inner-Net.
* Inner-Net: Your Psycho-Neuro-Musculo-Fascial Network.