The relationship between chronic muscle and joint pain, inflammation and oxidative stress must be understood by any chiropractor seeking to minimize the time for healing and rehabbing injuries. A crucial fact to understand about the overwhelming majority of injuries that present to a chiropractic office is that muscle and joint pain problems are more likely than not chronic in nature.
These chronic muscle and joint pain problems may be secondary to acute or repetitive stress, but typically they develop primarily from improperly managed inflammation and oxidative stress in body tissues. A major factor in the formation of chronic inflammation in your patients' tissues is the presence of free radicals occurring in greater abundance than the body's ability to remove them. This imbalanced condition is known as oxidative stress.
Oxidative Stress
Oxidative stress is caused by the release of free radicals and the inability of the cells to adequately detoxify and prevent free-radical accumulation. Oxidative stress is associated with more than 100 diseases.
Examples of conditions in which oxidative stress appears to play a role, based on research, include heart disease, diabetes, cancer and rapid aging. The presence of oxidative stress in your patients' myofascial tissues will automatically create an inflammatory response in their muscles and joints.
This inflammatory response will then cause the release of more free radicals in the affected tissues, creating greater oxidative stress and causing an increased inflammatory response. As you can tell, this forms a vicious cycle; but worse yet, this cycle can accelerate, creating what is known as a feed-forward cycle, making symptoms progressive with eventual tissue degeneration.
Free Radicals
Proactive lifestyle changes that include a healthy diet, exercise, stress reduction and antioxidant supplementation have been shown to reduce cellular damage and support the body's ability to produce more of its own antioxidant enzymes, allowing the body to naturally fight the damaging effects of free radicals from the inside out.
To limit the effects of free- radical damage, millions of Americans take antioxidants, making them a multi-billion dollar industry. Incredibly, studies show that more than 80 percent of people know antioxidants protect them from free-radical damage. What is not known is which ones really work and what lifestyle changes will most effectively reduce free-radical damage.
A Simple Breath Test to Measure Oxidative Stress
Lab testing, while not commonly used by chiropractors, is now being considered by many who are getting involved with oxidative stress, wellness care and nutritional supplements. Patients with chronic muscle and joint pain problems will typically have a significant level of free radicals in their system, which can damage cell walls. The byproducts of free-radical cell-wall damage are aldehydes, making them a highly beneficial biomarker for oxidative stress. In that regard, aldehyde testing can become a very important measurement of a patient's state of wellness.
There are two ways to measure aldehydes: one is a blood test called the TBARS Assay, which measures one aldehyde, MDA; the second is a non-invasive breath test that can measure up to 23 aldehydes. Chiropractors can conduct this breath test in their office.
Breath contains more than 1,000 different components that can be measured through spectrometry and gas chromatography in the parts-per-billion range. This makes breath testing as specific as blood or urine testing.
The breath-testing aldehyde score is extremely relevant to chiropractors who offer a wellness program that includes recommendations on lifestyle changes and antioxidant supplements. Since every patient presents with a different level of stress, each one will respond differently to a wellness program.
The key to a successful wellness practice is knowing how to adjust protocols based on individual responses to treatment; breath aldehyde testing can measure and track a patient's individual response to a treatment program. In fact a DC could use two testing options: the first consists of one breath test for existing patients under wellness care and antioxidant supplementation; the second includes two breath tests – a baseline test before a patient starts the wellness program and a 30-day evaluation to measure the effectiveness of the program and the antioxidants at lowering the aldehyde score.
Management
Science has known for a very long time that vegetables, fruits, whole grains, beans, nuts and seeds are healthful foods. Researchers assumed that the substances which made these foods so good for us were the vitamins, minerals and fiber. Of course, they were right, but only partially. Over the past 20 years, scientists have discovered a whole new set of protective compounds packed within every whole plant food: phytochemicals.
[pb]Phytochemicals
Phytochemicals are a type of antioxidant compound that naturally occurs in the skin of plant foods. Phytochemicals are plant chemicals. They are nature's way of protecting the plant from disease, and they affect humans in a variety of ways including neutralizing free radicals and providing nutritional and anti-inflammatory benefits to support healing of chronic muscle and joint pain problems.
So far, more than 25,000 different phytochemicals have been discovered in fruits and vegetables. Besides being strong antioxidants that neutralize destructive free radicals, some phytochemicals have tremendous anticancer activities, helping the body rid itself of potent carcinogens. Others protect against cardiovascular disease by helping reduce the formation of cholesterol, lower blood pressure, decrease blood cholesterol levels, reduce blood clot formation, open blood vessels and decrease damage to blood vessel walls. The list of significant beneficial activities of phytochemicals includes anti-inflammatory, anti-yeast, antiviral, antibacterial, antifungal as well as immune-enhancing benefits.
According to the American Institute for Cancer Research, there are two key concepts to understand about recommending phytochemicals. First, different plant foods contain different phytochemicals, each of which seems to act in slightly different ways on parts of the cell. Thus, to get the widest array of antioxidant benefits, eating a variety of plant foods is important.
Second, phytochemicals seem to work best in combination with one another. So even though you can get some particular phytochemical that you hear about as beneficial in an isolated supplement form, current research suggests that it will not function the same way when taken in isolation as it does when consumed with a host of other phytochemicals.
Which foods are the most efficient phytochemical factories? Vegetables and fruits stand out as being particularly important, although legumes (beans), grains, nuts and seeds are also excellent sources. Choosing a wide variety of colorful, whole plant foods is your key to a phytochemical-rich diet.
The phytochemical "superstars," if you will, are dark-green vegetables such as broccoli and kale, brightly colored fruits like blueberries and strawberries plus foods such as tomatoes, garlic, citrus fruits, green tea and flaxseeds.
Many people wonder from a convenience point of view if they can just pop a pill to get their phytochemicals; for instance, taking a multi-vitamin that contains lutein. At this time, we just do not know enough about the complicated interactions of the full range of nutrients in whole foods to be confident about isolating certain ones as pills.
As a quick and convenient alternative to eating the whole food, you might consider supplementing patients once a day with a high-quality whole-food drink mix that contains a variety of fruits, vegetables and other superfoods. Typically with this type of whole-food nutritional powdered supplement, one-scoop in water will provide the antioxidant power of 15 or more servings of fruits and vegetables. Be sure to only recommend a powdered fruit-and-vegetable drink mix that is sweetened with a natural product like stevia, because most on the market use synthetic sweeteners that raise blood sugar or use various chemical or technological modifications that alter the natural state of the fruits and vegetables.
From a practical point of view, recommend a lifestyle change to patients that teaches them to increase the phytochemical content of their diet by increasing the quantity, color and variety of whole plant foods they eat each day. Aim for at least seven to 10 servings of vegetables and fruits every day. Consider suggesting they take the phytonutrient-dense fruit-and-vegetable powder every morning so they can be assured of getting their daily dose of antioxidant and phytochemical protection.
Today, almost every patient is aware of individual antioxidant supplements such as vitamin A, C and E, as well as other lesser-known phytochemicals. Even though many of your patients take antioxidants, many do not realize exactly why they are taking them. Antioxidant supplementation is helpful in neutralizing free radicals in myofascial tissues, thereby reducing the presence of systemic inflammation.
By offering a simple breath test to your patients and knowing each patient's aldehyde wellness score, and recommending more phytonutrients from whole food and a high-quality fruit-and-vegetable supplement, you can help to manage your patients' oxidative stress. By doing this, you can help your patients reduce chronic inflammation.
The crucial fact to remember when it comes to chronic muscle and joint pain is this: It develops primarily from improperly managed inflammation and oxidative stress in tissues. In chronic muscle and joint disorders, the presence of chronic inflammation and oxidative stress in the myofascial tissues are inseparable; you cannot have one without the other. Therefore, to correctly heal chronic muscle and joint problems, you should measure a patient's level of oxidative stress (aldehyde score) and offer antioxidants and wellness care that manages the metabolic factors of chronic inflammation and free-radical damage.
Fortunately, there are new, innovative, non-invasive ways to help. Breath testing, lifestyle recommendations and antioxidant supplementation can assist you in naturally managing these metabolic factors in your patients with chronic pain.
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