Chronic musculoskeletal pain is the leading cause of disability worldwide yet continues to be the most misunderstood of all illnesses. Historically and still today, the assumption has been that chronic back, neck, shoulder, knee, and other areas of chronic pain are the consequence of some type of injury or disease process in the affected joints and associated tissues. However, the evidence points to a different problem altogether. A thorough analysis of the anatomy and physiology of the neuromuscular system suggests that most of the pathological findings that are associated with chronic musculoskeletal pain are not the cause of the pain but the consequence of a much more subtle but highly treatable problem. Skeletal muscles produce lactic acid, and when this natural byproduct of muscle metabolism begins to accumulate in muscle tissue, it distorts the neural feedback that allows the brain to properly regulate the resting tension of the affected muscle. As tension in the muscle increases, more lactic acid is produced, thus creating a vicious circle of tension and toxicity that ultimately causes local nerves to become irritated by the tightening muscle. In addition to causing pain, the nerve irritation causes the muscle to become even more spastic, the consequence of which is a downward spiral of pain and disability from which there is no natural escape. Though some of the therapies that are currently available for chronic musculoskeletal pain may provide symptom relief acutely, they fail to get to the root of the problem; they fail to unlock the lactic acid that is accumulating in the muscle. Hence, they fail to provide any lasting symptom relief. This review will discuss the theoretical mechanisms behind the most common treatment approaches to chronic musculoskeletal pain and discuss them in light of a simple, non-invasive way to both treat and prevent this highly common and often disabling condition.
Published in | Rehabilitation Science (Volume 7, Issue 4) |
DOI | 10.11648/j.rs.20220704.11 |
Page(s) | 43-50 |
Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
Copyright |
Copyright © The Author(s), 2023. Published by Science Publishing Group |
Low Back Pain, Chronic Musculoskeletal Pain, Sciatica, Piriformis Syndrome, Herniated Discs, Hypertonic Muscle Spasm, Stretch Reflex, KANON Myotherapy
[1] | World report on disability. https://cdn.who.int/media/docs/default-source/documents/disability/world-report-on-disability-factsheet.pdf?sfvrsn=2a22ed1e_2. |
[2] | CDC Grand Rounds: Public Health Practices to Include Persons with Disabilities. MMDR. Morbidity and Mortality Weekly Report 2013; 62 (34): 697-701. |
[3] | Lynch ME, Watson PN. The pharmacotherapy of chronic pain: A review. Pain Res Manag 2006; 11 (1): 11-38. |
[4] | Griner T. What’s really wrong with you? A revolutionary look at how muscles affect your health. Avery Publishing, 1995. |
[5] | Lima LV, Abner TSS, Sluka KA. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena. J Physiol 2017; 595 (13): 4141-4150. |
[6] | Weerapong P, Hume PA, Kolt GS. The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Med 2005; 35 (3): 235-256. |
[7] | Witvrouw E, Mahieu N, Roosen P, McNair P. The role of stretching in tendon injuries. Br J Sports Med 2007; 41 (4): 224-226. |
[8] | Kroll HR. Exercise therapy for chronic pain. Phys Med Rehabil Clin N Am. 2015; 26 (2): 263-81. |
[9] | Binder MR. Mind-Brain Dynamics in the Pathophysiology of Psychiatric Disorders. AJPN 2022; 10 (2): 48-62. |
[10] | Muscle tone physiology and abnormalities. Toxins (Basel) 2021; 13 (4): 282. |
[11] | Senzon SA. The Chiropractic Vertebral Subluxation Part 2: The Earliest Subluxation Theories From 1902 to 1907. J Chiropr Humanit 2018; 25: 22-35. |
[12] | Crelin ES. A scientific test of chiropractic’s subluxation theory: The first experimental study of the basis of the theory demonstrates that it is erroneous. American Scientist, 1973. |
[13] | Whedon JM, Mackenzie TA, Phillips RB, Lurie JD. Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66 to 99 years. Spine (Phila Pa 1976) 2015; 40 (4): 264-270. |
[14] | Finger S, Piccolino M. The shocking history of electric fishes: From ancient epochs to the birth of modern neurophysiology. Oxford University Press, 2011. |
[15] | Johnson M. Transcutaneous electrical nerve stimulation: Mechanisms, clinical application and evidence. Rev Pain 2007; 1 (1): 7-11. |
[16] | Navarro X, Vivo M, Valero-Cabre A. Neural plasticity after peripheral nerve injury and regeneration. Prog Neurobiol. (2007) 82: 163–201. |
[17] | Fleming KC, Volcheck MM. Central Sensitization Syndrome and the initial evaluation of a patient with fibromyalgia: a review. Rambam Maimonides Med J 2015; 6 (2): e0020. |
[18] | Yang S, Chang MC. Effect of Repetitive Transcranial Magnetic Stimulation on Pain Management: A Systematic Narrative Review. Front Neurol 2020; 11: 114. |
[19] | Wright AR, Richardson AB, Kickuchi CK. Effectiveness of Accelerated Recovery Performance for post-ACL reconstruction rehabilitation. Hawaii J Health Soc Welf 2019; 78 (11 Suppl 2): 41-46. |
[20] | Moseley JB Jr, Wray NP, Kuykendall D, Willis K, Landon G. Arthroscopic treatment of osteoarthritis of the knee: a prospective, randomized, placebo-controlled trial. Results of a pilot study. Am J Sports Med 1996; 24 (1): 28-34. |
[21] | Bicker MC, Gupta A, Brown CH, Cohen SP. Epidural injections for spinal pain: A systematic review and meta-analysis evaluating the “control” injections in randomized controlled trials. Anesthesiology 2013; 119: 907-931. |
[22] | Delicce AV, Makaryus AN. Physiology, Frank Starling law. StatPearls [Internet]; February 10, 2022. |
[23] | Lund J, Aas V, Tingstad RH, Van Hees A, Nikolic N. Utilization of lactic acid in human myotubes and interplay with glucose and fatty acid metabolism. Scientific Reports 2018; 8 (9814). |
[24] | Binder MR. The golden book of muscle health and restoration. Lightningsource Publishers, 2012. |
APA Style
Michael Raymond Binder. (2023). Chronic Musculoskeletal Pain and Disability: A Problem of Trapped Lactic Acid. Rehabilitation Science, 7(4), 43-50. https://doi.org/10.11648/j.rs.20220704.11
ACS Style
Michael Raymond Binder. Chronic Musculoskeletal Pain and Disability: A Problem of Trapped Lactic Acid. Rehabil. Sci. 2023, 7(4), 43-50. doi: 10.11648/j.rs.20220704.11
AMA Style
Michael Raymond Binder. Chronic Musculoskeletal Pain and Disability: A Problem of Trapped Lactic Acid. Rehabil Sci. 2023;7(4):43-50. doi: 10.11648/j.rs.20220704.11
@article{10.11648/j.rs.20220704.11, author = {Michael Raymond Binder}, title = {Chronic Musculoskeletal Pain and Disability: A Problem of Trapped Lactic Acid}, journal = {Rehabilitation Science}, volume = {7}, number = {4}, pages = {43-50}, doi = {10.11648/j.rs.20220704.11}, url = {https://doi.org/10.11648/j.rs.20220704.11}, eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.rs.20220704.11}, abstract = {Chronic musculoskeletal pain is the leading cause of disability worldwide yet continues to be the most misunderstood of all illnesses. Historically and still today, the assumption has been that chronic back, neck, shoulder, knee, and other areas of chronic pain are the consequence of some type of injury or disease process in the affected joints and associated tissues. However, the evidence points to a different problem altogether. A thorough analysis of the anatomy and physiology of the neuromuscular system suggests that most of the pathological findings that are associated with chronic musculoskeletal pain are not the cause of the pain but the consequence of a much more subtle but highly treatable problem. Skeletal muscles produce lactic acid, and when this natural byproduct of muscle metabolism begins to accumulate in muscle tissue, it distorts the neural feedback that allows the brain to properly regulate the resting tension of the affected muscle. As tension in the muscle increases, more lactic acid is produced, thus creating a vicious circle of tension and toxicity that ultimately causes local nerves to become irritated by the tightening muscle. In addition to causing pain, the nerve irritation causes the muscle to become even more spastic, the consequence of which is a downward spiral of pain and disability from which there is no natural escape. Though some of the therapies that are currently available for chronic musculoskeletal pain may provide symptom relief acutely, they fail to get to the root of the problem; they fail to unlock the lactic acid that is accumulating in the muscle. Hence, they fail to provide any lasting symptom relief. This review will discuss the theoretical mechanisms behind the most common treatment approaches to chronic musculoskeletal pain and discuss them in light of a simple, non-invasive way to both treat and prevent this highly common and often disabling condition.}, year = {2023} }
TY - JOUR T1 - Chronic Musculoskeletal Pain and Disability: A Problem of Trapped Lactic Acid AU - Michael Raymond Binder Y1 - 2023/01/17 PY - 2023 N1 - https://doi.org/10.11648/j.rs.20220704.11 DO - 10.11648/j.rs.20220704.11 T2 - Rehabilitation Science JF - Rehabilitation Science JO - Rehabilitation Science SP - 43 EP - 50 PB - Science Publishing Group SN - 2637-594X UR - https://doi.org/10.11648/j.rs.20220704.11 AB - Chronic musculoskeletal pain is the leading cause of disability worldwide yet continues to be the most misunderstood of all illnesses. Historically and still today, the assumption has been that chronic back, neck, shoulder, knee, and other areas of chronic pain are the consequence of some type of injury or disease process in the affected joints and associated tissues. However, the evidence points to a different problem altogether. A thorough analysis of the anatomy and physiology of the neuromuscular system suggests that most of the pathological findings that are associated with chronic musculoskeletal pain are not the cause of the pain but the consequence of a much more subtle but highly treatable problem. Skeletal muscles produce lactic acid, and when this natural byproduct of muscle metabolism begins to accumulate in muscle tissue, it distorts the neural feedback that allows the brain to properly regulate the resting tension of the affected muscle. As tension in the muscle increases, more lactic acid is produced, thus creating a vicious circle of tension and toxicity that ultimately causes local nerves to become irritated by the tightening muscle. In addition to causing pain, the nerve irritation causes the muscle to become even more spastic, the consequence of which is a downward spiral of pain and disability from which there is no natural escape. Though some of the therapies that are currently available for chronic musculoskeletal pain may provide symptom relief acutely, they fail to get to the root of the problem; they fail to unlock the lactic acid that is accumulating in the muscle. Hence, they fail to provide any lasting symptom relief. This review will discuss the theoretical mechanisms behind the most common treatment approaches to chronic musculoskeletal pain and discuss them in light of a simple, non-invasive way to both treat and prevent this highly common and often disabling condition. VL - 7 IS - 4 ER -