On The Origin of Atraumatic Neuromusculoskeletal Pain
SOURCE: Chiropractic J of Australia 2016 (Jan); 44 (1): 1–8
Joe Evans, PhD
CEO, Sense Technology Inc.
1052 Corporate Lane,
Export, PA
The purpose of this study was to examine the possible origins of non-specific or atraumatic back pain by applying the Gate Theory of pain and current physiologic concepts. I present a theory that accounts for the initiation and potential consequences of neuromusculoskeletal pain incorporating failure of the mechanism of muscle relaxation and resulting in pain and compromise of the lymphatic system. The theory provides an alternative to current theories and hypotheses of the cause and consequences of neuromusculoskeletal pain.
Keywords: Pain; Muscular System; Muscle Relaxation
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INTRODUCTION
The incidence of low back and other neuromusculoskeletal pain continues to increase, with low back pain being the leading cause of disability in the world. [1, 2] In addition to the loss of quality of life for those experiencing musculoskeletal pain, the cost to both patients and society is significant and increasing:
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The annual cost of chronic pain in the United States, including healthcare expenses (direct medical costs), lost income, and lost productivity, is estimated to be $635 billion. This is significantly higher than the estimated annual costs in 2010, dollars of heart disease ($309 billion), cancer ($243 billion), and diabetes ($188 billion).
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Total estimated medical costs associated with back and neck pain, two of the commonest presentations of patients with chronic pain, increased by 65% between 1997 and 2005, to about $86 billion a year. Overall, pharmaceutical expenditures related to back and neck pain increased by 188% between 1997 and 2005, but costs associated with prescription narcotics rose by an astounding 423%.
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In the US, the estimated annual direct medical cost of low back pain is $30 billion. In addition, the impact of back pain is $100-200 billion in decreased wages and lost productivity while in Australia, the direct cost of is estimated to be AU dollars 1.02 billion in 2001. And the indirect costs of AU dollars 8.15 billion giving a total cost of AU dollars 9.17 billion. [3]
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Patients with chronic pain have more hospital admissions, longer hospital stays, and unnecessary trips to the emergency department. [4]
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