I found Dr. Azzolino a year after developing a repetitive stress injury. I had never seriously considered chiropractic care, but Dr. Azzolino’s explanation of my condition meshed with what I taught myself about repetitive stress injury and allowed me to finally fully understand my condition. Two years later, I am significantly better.

I have had severe problems with vertigo, general dizziness and lack of balance for over a year. Luckily, I found Dr. Azzolino’s group. It’s hard to express just how much better my life is now that the whole world isn’t constantly spinning around…

Chronic Pain

PAIN and Your BRAIN

By definition, pain is an “unpleasant emotional response due to adequate nociception, and  there is no correlation between the amount of pain one experiences and the level of tissue To appreciate this statement, we must understand how pain is processed by the brain.

Embedded throughout many tissues of the body — especially the skin, joints, ligaments, tendons, and muscles — we have free nerve endings acting as pain fibers. These nerve endings, called nociceptors, respond to harmful mechanical pressure and chemicals liberated from tissue damage.  When nociceptors are activated, they transmit signals into the spinal cord and brainstem where the nervous system responds reflexogenically by activating sympathetic nerves.

The sympathetic nervous system, which mediates the “fight-or-flight” response, has the following functions:

• Increases heart rate
• Increases blood pressure by increasing constriction of blood vessels
• Increases respiratory rate
• Increases sweating
• Indirectly increases muscle tone

The pain pathways ascend from the spinal cord to the brainstem and limbic system (a primitive area of our brain dealing with emotions) and to the somatosensory cortex (the area of our brain which has a map of our body to allow us to localize sensations).

It’s important to understand that approximately 75% of our pain pathways direct information to our brainstem centers and limbic centers. Only 25% of these pathways actually connect to the somatosensory cortex. Therefore, it’s quite possible to have dysfunction in the tissues (subluxations, degenerative joint disease) and activation of the nociceptors and pain pathways (with resultant sympathetic changes in the nervous system) without the perception of pain.

Therefore, we can’t judge health by the absence of pain or symptoms. Furthermore, blocking pain perception with drugs doesn’t decrease or eliminate the deleterious effects of nociception.

Long-term activation of nociceptors causes “wind-up” in the pain-sympathetic loops and “central sensitization,” which is essentially an increased efficiency of the pathways through the growth of more nerve connections and the production of more neurotransmitters. This central sensitization results in hypersensitivity, not only at the site of injury but in many tissues of the body. It is also responsible for the overactive stress response leading to many negative widespread subsequent changes in our bodies. Ultimately, it may lead to one developing chronic pain syndromes such as sympathetically mediated pain, complex regional pain syndrome, and reflex sympathetic dystrophy.

Patients with these pain syndromes and reflex sympathetic overactivity have difficulty rehabilitating themselves. That’s because the reflex sympathetic dysfunction compromises the blood delivery to muscle, resulting in rapid fatigue, the patient subsequently fatigues quickly which causes the release of further pain-activating chemicals. As a result of such dysfunction, a patient becomes predisposed to overuse-
type syndromes.

The Chiropractic Neurologist’s unique approach is to effectively treat these syndromes by restoring biomechanical integrity of the joints. This has two very direct benefits:

1. Increasing biomechanical integrity, through specific adjustments and various therapy modalities, improves tissue healing following acute and chronic injuries. This will greatly decrease the amount of nociception and — if addressed in the early stage following an injury – will decrease the probability of wind-up and central sensitization.

2. Improving biomechanical integrity of joints increases the firing of mechanoreceptors, activating relay centers in the brain to inhibit pain pathways and sympathetic function. If applied appropriately (according to the individual’s aberrant biomechanics and unique neurological state), the chiropractic adjustment is unique in its ability to activate these pathways without placing a further demand on the sympathetic system.

3. Brain based exercises can target and activate relays in the brain to help with the natural inhibition of pain, improve blood flow and decrease hypersensitivities.

4.  Hyperbaric Oxygen Therapy has been show to be very benenficial for a variety of pain syndromes and neuropathies.

We have extensive teaching and clinical experience dealing the early diagnosis, treatment, and rehabilitation of individuals suffering with a variety of pain syndromes.