Friday, August 22, 2014

Pain Part 2 - Joints and Muscles

If you’ve read the first blog post in our pain series, you are aware that one of the ways we will be talking about pain is within the context of Traditional Chinese Medicine.  If you haven’t read the first blog post, you may want to do that now.  Doing so will make this post and the ones to follow make a lot more sense.  To understand the role of TCM in joint and muscle pain, we first need a little background on the joint tissue and muscle tissue. 
The joints of the body work to provide mobility and to hold the skeleton together while the skeletal muscles work to produce movement, maintain posture and stabilize and strengthen the joints.  These two body tissues work in concert to create mobility and manipulation.  Joints are the weakest part of the skeleton, but even so, they are able to resist many forces like crushing and tearing.  The muscles definitely play a role in this.  The stronger a person’s skeletal muscles are, the more stable that person’s joints will be.  With so many of us living sedentary lifestyles with little to no exercise, the weakest part of our skeletons can become even weaker because that lifestyle decreases the strength of the skeletal muscles.  With that in mind, it makes sense that pain often affects these vulnerable parts of our bodies.  Like most people, I don’t actively think about my joints or muscles.  They just do what I need them to do.  Like most of you, I don’t think about my joints and muscles until they hurt.
When viewed from the TCM perspective, both joint and muscle pain can fall under the category of “pulling pain”.  They may also fall under the category of “aching pain”.  Issues associated with pulling pain involve Blood stagnation which basically means that the Blood is “stuck” – it’s not moving properly.  It can also involve obstruction of the vessels and a failure of the Liver to nourish the muscle tissue.  Aching pain involves an excess of dampness.  These issues contribute to the pain, so the goal is to maintain the free movement of the Blood and to dry the dampness.  That makes perfect sense, right?
 In case it doesn’t make much sense, here are a few tidbits of info to help clarify.  Skeletal muscle has a rich blood supply.  It needs to have a rich blood supply because contracting muscle fibers use a huge amount of energy and require an almost continuous delivery of oxygen and nutrients by the arteries.  Muscle cells also create large amounts of metabolic waste products that must be removed through the veins if we want our muscles to contract efficiently.  In contrast, the joint tissues are not well vascularized.  For example, cartilage is avascular; it doesn’t have a blood supply.  This feature makes it very difficult for cartilage to obtain sufficient nourishment to repair itself.  Instead of nutrients being directly delivered to the cartilage, they have to permeate through layers of tissue.  So, if the Blood, which functions to deliver all the nutrients our bodies require, is moving sluggishly along or the vessels that deliver Blood to the tissues are obstructed, the skeletal muscles don’t receive that necessary constant supply of oxygen and nutrients and the joint tissues don’t receive what little nutrients are permeating through layers of tissue.  A lack of nutrients leads to weakness, which leads to malfunction, which leads to pain.  Sluggish movement of the Blood can also cause an accumulation of dampness.  Think about how heavy your clothes are when they are wet.  Wearing wet clothes can hinder your movement by weighing you down.  Same thing can happen in our bodies.  What do we do to dry wet clothes?  We apply heat.  Certain TCM herbs do the same.  They gently warm the body, providing a tender nudge toward Blood movement.  
Now it makes sense, right?  The basic concepts of Blood and Qi (energy) movement are directly related to the skeleton's ability to move itself and to move without pain.  If we can maintain and support Blood and Qi movement, we can ensure proper nutrition for the muscles and joints and prevent the accumulation of dampness that weighs us down.

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