Pain Relief in Muscles
January 14, 2021
Dr. Serola

Sometimes we get aches and pain in muscles, and we are not sure what is the best thing we can do to find relief. Should we take medication, stretch, exercise, apply heat or ice, massage, vibration, etc. Basically, we can classify these types of pain relief to one central cause and effect based on reduced circulation.

First, we have to understand muscle tone, which is the state of tension in a muscle while at rest. Balanced muscular tone allows greater strength, energy, flexibility, reactivity, and overall health. Conversely, unbalanced tone can reduce all of the above. The question is what do we mean by “balanced?”

Let’s take the elbow as an example. During flexion, the biceps brachii, etc. (agonists) pull the elbow into flexion while the triceps, etc. (antagonists) release the joint so that it may flex. As the tension increases in the agonists, it decreases in the antagonists, but both remain enough in tone so that tension in the joint itself remains relatively constant. All joints have this agonist/antagonist relationship.

Muscles don’t regulate themselves, i.e., there is another element that requires balanced tension; the ligaments within the joint itself. Just like the agonist/antagonist relationship of the muscles, there is a similar relationship between the muscles that move a joint and the ligaments within the joint. For a better explanation, please see: Muscle-Ligament Role in Joint Tension.

When the joint is injured, the relationships are thrown out of balance as the ligaments within the joint are sprained. Reflexes come into play which tighten the muscles that move the joint away from injury (becoming hypertonic) and inhibit those that move the joint toward injury (becoming hypotonic). To maintain balanced tension in an injured joint, the muscles become unbalanced. This exemplifies the adage that ligaments rule and muscles adapt.

Both sets of muscles may suffer from decreased circulation because they no longer can pump efficiently. Decreased circulation lessens the amount of oxygen that reaches the tissues and reduces the removal of cellular waste products, both of which can lead to pain.

The key is to increase circulation; we can do that by numerous means. Here is a generalization of some popular methods, including benefits and drawbacks:

    • Stretching and exercise: very effective for increasing tone, increasing circulation, and relieving pain – but may stress the joint and increase reflexive hyper/hypotonia, which can result in more muscular imbalance and pain later, in a damaging reflex cycle.
    • Massage: passive, relatively safe, with release of endorphins, removal of cellular waste – but too deep of pressure on blood vessels, nerves, joints, or inflamed tissue by an untrained professional may be harmful.
    • Heat: heat increases circulation in muscle – but may increase edema in joint, which may increase reflexive hyper/hypotonia, causing more pain later, in a damaging reflex cycle.
    • Ice: initially reduces swelling and decreases reflexive hyper/hypotonia in joints– but, if used longer than 20 minutes on a joint at a time, can cause vasodilation and increase joint swelling – and, when used only on muscle, may cause increased tightness and pain.
    • Vibration: increases circulation in muscle – but may irritate joint, leading to increased reflexive hyper/hypotonia. 
    • Over the Counter Medication: Inexpensive & easy to administer – but may mask pain rather than relieve the underlying condition.
    • Chiropractic Adjustment: relieves pressure on ligaments, improves muscle balance and helps joint integrity – but may stress joint if done by non-chiropractor with insufficient training and experience.
    • Support Brace: may stabilize joint & balance muscle tone by acting as a secondary, external ligament (e.g., on sacroiliac joint), & allows safer exercise – but if used on muscles (e.g., on belly), may cause weakness and atrophy.

Pain relief does not always mean healing. Methods to relieve pain and increase your quality of life are available, but not always understood, even by many professionals. With knowledge, you can evaluate your treatment options and make the best choice for yourself. Hopefully, this article gives you a sense of what you can do when you suffer muscular pain. With any injury, the most important thing you can do is think!

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