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That Four Letter Word

They say that music is the universal language. Recent studies show that when listening to the same piece, different listeners show similar patterns of brain activity and respond similarly. But music is a five letter word. PAIN on the other hand is that four letter word. Pain is the universal “unpleasant sensory and emotional experience associated with actual or potential tissue damage.” Studies show that when experiencing pain different people show similar brain activity but unlike music people respond quite differently.

Pain is acute or chronic. Acute pain is distinguished as being of recent onset, transient, and usually from an identifiable cause. Chronic or persistent pain is pain that continues when it should not. Chronic pain is classified as nociceptive (due to ongoing tissue injury) or neuropathic (damage to the brain, spinal chord or peripheral nerves) with mixed or unknown causes; each resulting in functional changes of the body.

Pain affects more Americans than diabetes, heart disease and cancer combined. Pain is the leading cause people visit their health care provider and chronic pain is the most common cause of long-term disability.

Treatment considerations fall under 3 main categories: conservative, pharmacological and invasive. Each can be effective under the certain circumstances. Pharmacological medications are the most common and easily accessible form of treatment used. They can be helpful for some patients but are not universally effective and may actually worsen symptoms over time and cause many unwanted side effects.

Medication related problems are among the top five leading causes of death in America. In 2012 there were 41,502 drug overdose deaths of which 22,114 were related to pharmaceuticals, and 16,007 of those were directly related to pain relievers or prescription pain killers.

Pain can be a good thing, a warning that you should move away from something that can cause immediate harm or injury and pain is also an indication that something is awry in the body. Chemical substances are produced by the body at the site or sites of injury or damage. These messengers are relayed primarily through the nervous system which is is the body’s most direct communication pathway. Messengers and markers are also communicated through our vascular system When our body produces these substances but cannot correct the systemic imbalance they contribute too we feel pain or irritation. And when we are in pain we have a tendency to avoidance. We avoid functioning, like something as simple as raising our arm overhead or picking up a sock on the floor. Pharmacology attempts to chemically alter these sites of cellular dysfunction.

Invasive procedures can provide relief but have been shown to be most effective when used as a last resort, when other more conservative approaches have not resolved the problem or used in traumatic circumstances. Injections into the site of pain of pharmaceutical agents are one form of this treatment but can only provide temporary relief. Surgery provides a multitudinous form of treatment with numerous mixed results from failure of the procedure to creating other debilitating and limiting effects within the body. It has been suggested that invasive procedures be cautiously utilized and not until conservative methods have been tried and given the opportunity to restore bodily function over a 2 year period.

Recent research into pain and dysfunction has been able to measure matrix chemicals the body produces under certain load(s). The matrix is the intracellular and/or extracellular substance of the intervertebral disc, for example. Loads are gravitational pressure(s) on the body and the body’s response to the load. Interestingly, the number one measure is a breakdown of healthy substance (those that have anabolic or a building effect) to an unhealthy substance (those that have a catabolic or destroying effect) when not wanted, such as in persistent pain. Research measurements found this breakdown to affect the structures (intervertebral disc) integrity after only a 21 day time frame of improper or an unbalanced loading. More interesting is that research shows a restoration of of healthy substance in that structure, whether a shoulder joint or a segment of the spine when the improper or unbalanced load is corrected or removed and a more physiological load is maintained. Additionally current research proposes that future invasive procedures such as injecting healthy substances (cultured stem cell or others) into the degenerating structure restores chemical matrix integrity.

We at St. John-Clark purport our work is an attempt to do just that. Remove the unbalanced loading through soft tissue manipulation working to restore proper alignment and allow a more physiological movement pattern, alleviating pain and to facilitate healthier function one individual at a time.

On-going research note briefs will discuss types of pain and pain descriptors and what they mean to you and to us as therapists.

Please visit stjohn-clarkptc website for additional information and our you tube channel for brief discussions on what we do. We also invite you to take a look at the Center for Neurosomatic Studies website:; our Neurosomatic Studies seminar website: and our Neurosomatic Therapy Foundation website where you will see the work in progress.

Your comments, feedback or questions are welcome.


European Guidelines for the Management of Chronic Non-specific Low Back Pain; 2005
American Chronic Pain Association Resource Guide to Chronic Pain Medication and Treatment; 2014
Prescription Drug Overdose in the United States Fact Sheet; CDC 2014
Evaluation and Management of Low Back Pain, Evidence Review; APS 2014
Role of Biomechanics on Intervertebral Disc Degeneration and Regenerative Therapies; NIH 2013
Dynamic and Static Overload Induce Early Degenerative Processes in Caprine Lumbar Intervertebral Discs; ORS 2012 and PLOS|one 2013
Axial Low Back Pain: One Painful Area – Many Perceptions and Mechanisms; PLOS|one 2013
A Trigeminoreticular Pathway: Implication in Pain; PLOS|one 2011
Temperament Traits and Chronic Pain: Harm Avoidance and Pain-Related Anxiety; PLOS|one 2012
The Maintenance of Mitochondrial DNA Integrity – Critical Analysis and Update; CSH 2013
Connection of Monocytes and Reactive Oxygen Species in Pain; PLOS|one 2013
Stem Cell Therapy for Degenerative Disc Disease; AO 2012
Mechanical Loading: Potential Preventative and Therapeutic Strategy for Osteoarthritis; ORS 2014
Improvements in Hip Flexibility Do Not Transfer to Mobility in Functional Movement Patterns; JSCR 2013
Physiological Loading Can Restore the Proteoglycan Content in a Model of Early Disc Degeneration;
PLOS|one 2014

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A Common Treadmill Mistake

The next time you are at the gym take a look at the people walking on the treadmills. At first you may notice the various speeds at which people are running or walking; some may even be on an incline. Now take a closer look at where people’s hands are located as they move. What you will likely see is that close to half of the people are holding on to the rails at the side or the front of the treadmill. For most people, this position can actually be causing their body harm, and here is why.

Our bodies are designed to walk upright with a cross pattern movement (right leg goes forward as left arm goes forward). When you lean forward to hold onto the treadmill, you disrupt this pattern. Holding on while walking also misaligns your back, putting extra stress on the joints in your spine.

Along with the physical stresses applied to the body from this action, there is also a neurological disruption. Holding onto the treadmill while walking destimulates your neuro-muscular system. In other words, there is a neurological breakdown in the firing of the nerves regulating the normal walking pattern. This disruption of the nerves leads to a weakening of the muscles normally used in walking by not allowing them to work as hard. Even if you do a lot of walking off the treadmill, just a few sessions per week holding onto the treadmill can counteract the positive benefits of walking with a normal cross pattern.

Many seniors hold onto the treadmill, but being over 60 is all the more reason why you should not hold on. Seniors are more prone to the damage on posture and joints that holding on can create. Perhaps your gait is a bit stiff, but if you regularly walk without the assistance of a cane or walker, there’s no medical need for holding onto the treadmill. If you feel unstable walking without the rails, the speed setting of the treadmill is probably too fast. You will burn more calories and develop a smoother and more balanced gait pattern by walking slower and swinging your arms properly.

One purpose of exercise is to make your body more efficient. Holding onto the treadmill creates an unnatural movement for your body, since there is nothing to hold onto once you leave. Walking without the use of handrails will condition your body, burn more calories, and improve overall performance.

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