Cracking the Code of Chronic Pain

How chiropractors have adapted to the changing cause of disease
January 26, 2015 Updated: January 26, 2015

NEW YORK—The chiropractic profession was built on the idea that health comes from within and that if the body has the proper physical, chemical, and mental environments, it has no choice but to express health.

Chronic pain is seen as a symptom, caused by interference to the body’s environment.

The chiropractic profession has historically been mostly concerned with removing structural interference to the nervous system at the level of the spine. It considers the nervous system to be the master system that coordinates and controls all other systems, and the spine is the most likely area where there can be physical interference with nerve system function.

Throughout the 20th century, chiropractors focused on restoring the proper position and function of spinal bones (vertebrae) with a technique called an adjustment. In recent decades, however, chemical interference has become an increasingly large cause of health issues, including chronic pain, and chiropractors have had to adapt and adopt new approaches to giving care.

Because chiropractic medicine is a natural health care profession, chiropractors are able to respond to new research more quickly than the modern medical community. Because of the nature of testing, developing, and approving medication, often today’s cutting-edge research will only produce medicines 10–20 years from now.

Metabolic Approach to Pain Relief

In the 21st century, chiropractors have incorporated into their treatments inexpensive diagnostic testing and a functional approach to reading blood chemistry. Many chiropractors also now assess digestive and hormone function, and brain chemistry making it possible to identify and address interference to the nervous system more comprehensively.

The metabolic approach to chronic pain relief addresses what research tells us are the three major avenues that must be taken to treat pain. These avenues are the structural, biochemical, and electrical components of the human body. When these three areas are addressed in the proper sequence, it’s like operating a combination padlock—the right direction and code unhinges the causes of chronic pain.



Structure refers to bones and soft tissues such as muscles, ligaments, tendons, and spinal discs.

Although they seem hard and maybe even dead, bones are actually dynamic living systems that respond to changes in the environment. They can be reshaped and rebuilt by stressors placed upon them.

For example, excessive sitting as we see in our modern workplaces can lead to unbalanced posture as our bones, joints, ligaments, and tendons adapt. Over a long period of time, this adaptation can result in arthritis, disc disease, and joint inflammation.

Muscle groups are also programmed to react to different situations in a person’s life.

Take sitting as an example again: if you work 40–60 hours per week at a desk with your knees bent at 90 degrees, the result will be a shortened hamstring muscles. The shortening of your hamstrings will over time rotate our pelvis, which removes the natural curve of your lower back (hypolordosis).

This lack of curvature puts unnatural pressure on our joints and discs and will also alter the control of your knee joints, which contributes to arthritis and knee pain.

Shortened and weakened muscles due to excessive sitting will also leave you susceptible to shoulder, ankle, wrist, and spinal pain syndromes.


Biochemical refers to blood chemistry. Key to treating chronic pain on the biochemical level is understanding how blood chemistry impacts energy production, oxygen delivery, systemic inflammation, immune responses, and even gastrointestinal factors.

For example, one common but little understood chronic pain syndrome with biochemical causes is systemic inflammation.

Inflammation happens when the immune system is chronically activated. This chronic activation is commonly caused by digestive disorders, often related to food sensitivities, because the majority of our immune system is in our gut. This is why many people feel much better when they stop eating things like gluten, dairy, or soy.

Biochemical causes can be tricky to diagnose. Many times I’ve seen patients in severe pain, yet X-rays and MRIs show nothing. Conversely, other patients are pain-free, yet they have X-rays and MRIs that show severe arthritis.

Blood tests can reveal biochemical markers for inflammation and give doctors a lot of clues. However, oftentimes patients have their blood tested, and the results show nothing is wrong because the doctors don’t understand the markers that explain the relationship between chronic pain and blood chemistry.


Electrical refers to the state of the nervous system—how nerve impulses travel through the brain, brain stem, spinal cord, and peripheral nerves in your limbs and body.

The brain dictates our experience of pain: the emotional components, the location, and the type. Thus, chronic pain can result in several psychological factors that alter mood, happiness, depression, anxiety, attention, and focus.

The brain stem dictates the autonomic responses associated with pain as they relate to blood pressure, heart rate, breathing, muscle contractions, and other automatic functions, including digestion.

The spinal cord is very important in determining the sequence in which muscles contract when performing different activities. This can be dramatically altered by chronic pain and needs to be reprogrammed through treatment.

The peripheral nerves are impacted by blood sugar, oxygen delivery, pH balance, and inflammatory responses, both local and systemic. These small nerves can be damaged in a number of ways.

Finding the Sequence

Chronic pain that involves more than one area of the body may not be fully explained by test findings. This is especially important to remember for patients who are contemplating a “structural treatment” like surgery, because if there is a biochemical component to the problem, surgery won’t fix it. So before undergoing an operation, it’s a good idea get examined for biochemical or electrical abnormalities.