Consider pain as a component of Vertebral Subluxation Complex (VSC). As it is just one component of many, pain does not have to be present for the VSC to exist. Much like heart disease, cancer, osteoporosis, diabetes, and all other chronic diseases exist long before symptoms appear. In most circumstances, these diseases do not manifest symptoms until the end. Significant disc herniations, degenerative changes, and unhealthy muscle tissue can be present without back pain. No one would suggest that asymptomatic cancer or atherosclerosis are not “real” conditions or problems, and we believe the same hold true for spinal issues.
Biomechanically stressed or strained tissue releases inflammatory chemicals that stimulate pain fibers in the spine. Initially, these changes can occur without obvious signs of inflammation, pain, or degeneration – much like other chronic diseases. Pain fibers (also called “nociceptors”) have very high thresholds for activation and often require an injurious stimulus, such as a fall. Sometimes you don’t realize an area hurts until you start pressing on it!
As chiropractors, we look for other clinical findings that signify issues are going on. This includes loss of normal vertebral motion, hyperactivity of muscles, temperature changes, joint capsule swelling, and neurological changes. Much like having your car’s oil changed or going to the dentist, having your spine checked on a regular basis is very important for your spinal and overall health. The best time to have your spine checked is after birth – the second best time is now!
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Reference: Faye L & Seaman DR. The vertebral subluxation complex. In Gatterman M. Foundations of Chiropractic Subluxation. Second Ed. Elsevier-Mosby. 2005. Chapter 9. 195-221.
