Seeing the Bigger Picture
The muscular, skeletal, neural, vascular and lymph systems of the body all affect one another. A good treatment plan works toward optimizing all of them. When there is pain, as from nerve impingement, a common protective reaction of the body is to tighten up and stabilize the area. Unfortunately, this tightening can exacerbate the problem by putting more pressure on the damaged structures. Also, chronic spasm of the muscles leads to decreased blood infusion (ischemia) and poor lymph movement. The muscles become poorly nourished, and the tissues are not properly cleansed of cellular waste products. A large component of patient’s pain can be from this muscular dysfunction, rather than from the direct nerve impingement itself.

Tight muscles, especially when their forces are not well balanced, are intimately involved with skeletal joint dysfunction. The skeletal system, after all, is aligned and controlled by the soft tissues around it (with limits set by the bony structures themselves and by the ligaments that surround the joints). When muscular action on one side of the spine is stronger and tighter than the other, it can significantly change the alignment between the vertebrae, and inhibit the natural smooth gliding at the joint surfaces. Besides nerve irritation (remember that squeezed marshmallow), this can accelerate arthritic changes in the joints.

Nerves are responsible not only for sending pain signals back to the brain, but also for sending motor control signals out to the muscles. Therapy should address the neural components of the problem. Neuromuscular reeducation refers to therapy that aims at normalizing the interaction between muscles and their nerve signals.

Many types of non-surgical therapies are available, and each has its strengths. Chiropractic adjustments can restore normal joint function, and thus release tension and inflammation in surrounding soft tissues. Unfortunately, some people do not respond well to this high-velocity approach, and normal muscular function often does not follow. Skilled massage, physical therapy, yoga, stretching, strengthening and other manual therapies can address the muscular components. Functional and postural habits that exacerbate the condition may need to be relearned. Acupuncture works via several pathways: it can release and balance muscle tensions, moderate nerve signals, decrease inflammation and increase local blood flow to the tissues.