Why me? People coming in to see me ask: “Why me? What’s going on in my body (to cause me to have chronic pain)?” I stress that there are almost always three areas that get involved: muscles, joints, and a chemical imbalance. It can start with the muscles, or the joints, or with a chemical imbalance. Eventually, all three areas get involved. Later, I’ll explain how, in order to rid yourself of the pain, the more of the three areas you treat, the more likely you will be successful. First, let me give you my take on how the muscles, and the joints, and the chemical imbalance are involved. THE MUSCLES: Muscles develop knots in them. Or as we in the medical profession call them, trigger points. Trigger points as I see it are areas of trapped-in pain producing substances that work like a trigger on a gun, shooting off pain to distant sites, or locally. If you tell me where your pain is, I can probably tell you where you’re trigger points are. If you tell me you have headache with pain in the eyes, you will probably have a marble sized trigger point behind the neck in the middle of the neck, off to one side of the midline corresponding to the side the pain is on. If you have headache in the temples, you can probably feel a series of bead-like knots in the side of the neck causing pain referred to the temple. If you tell me you have pain going down the leg, you will probably have a pea-sized knot in the upper buttock about two inches out from the midline on the same side as the pain. And so on. There are dozens of areas with lumps or knots, trigger points, corresponding to the most common areas of musculoskeletal pain, and hundreds of other well-known sites corresponding to more unusual cases. THE JOINTS: In a pain and stress syndrome, joints become stiff and sticky. And often the ligaments and tendons surrounding the joint become swollen and inflamed. Usually, joints become jammed by the muscles that are serving the joint being under some degree of spasm or even just increased tone over normal. In time, the joint space can become more and more narrowed, and when there are discs such as in the back, or meniscuses or cartilages such as in the knee, these can get squeezed or even damaged. The fact that the joint is stiff and sticky can cause it to act like a trigger point, shooting off pain to distant sites or locally. “Facet” joints, in the neck are usually involved in headache. You can usually feel the joint capsule by palpating the back of neck in the upper outer area. It will usually be pretty tender, and cause the person to wince, or “jump.” When a person has low back pain, the joints palpable in the low back, the “facet joints”, the small joints right under the skin, will usually be tender to deep palpation. THE CHEMICAL IMBALANCE: I believe that every case of musculoskeletal pain and stress syndrome, not only both muscles and joints involved, there is also almost always a component of a chemical imbalance. There can be two factors involved, the relationship or stress, and the relationship of diet. The stress factor Pain and stress go hand in hand. If you are stressed, you can get pain. There’s the expression “(Such and so) is a pain in the neck.” What’s important to realize is the relationship is a two-way street. Stress factors can get a pain syndrome going. But to treat pain successfully, you may have to treat the chemical imbalance you’ll see associated with stress. The dietary factor Sugar intake is often the cause of the chemical imbalance component leading to a chronic pain syndrome. This is especially true with headaches with young ladies, and with most patients with Fibromyalgia. Almost every young lady I’ve seen with headaches consumes inordinate amounts of sugar. And, if she were to substitute natural food for the sugar-filled stuff, might well rid herself of headaches as the only form of treatment. Books have been written on the subject of sugar and its relationship to pain. At the same time, there seems to be an almost universal head-in-the-sand denial of this relationship. I have a lot to say on the subject, and I’d like to enlarge on it later elsewhere on this web site.