When I have the privilege of seeing someone in my practice who has been experiencing discomfort for a long time, we start out discussing the “pain bucket.” This is a great analogy that I often use to describe why we have recurrent symptoms and onset of symptoms without a significant injury or traumatic impetus. This analogy is my favorite way to underscore the multifaceted aspects to pain.

The pain bucket is a way to describe all of the things in our lives that have an impact on our musculoskeletal systems. The things we include can fill up the bucket halfway and we don’t have pain, but if they fill the bucket completely and it overflows, then symptoms arise. The things that fill the bucket include stress from every aspect of life — workload, finances, interpersonal relationships and more. This is then complicated by other health aspects like nutritional intake, physical activity (or lack thereof), smoking, alcohol consumption and, of course, mechanical changes that affect joints and tissues. We have two options to stop the symptoms from overflowing the bucket — slow the flow of symptoms or increase the size of the bucket.

When we have an injury like a sprained ankle or a strain to the lower-back musculature, this fills up the bucket quickly via the mechanical changes in the area due to the injurious event to the tissue. We as humans are good at recognizing that this is the cause of the symptoms. It makes sense that we need to calm down the tissue and allow it time to heal so the symptoms will go away.

However, when symptoms surface without an injury it may be confounding and confusing. These are often the cases that grow into a chronic complaint and start to impact more and more of our daily lives. When these cases come in, we work on the tissues that are sensitized at the time with adjustments and soft-tissue treatments, but we also talk about the life events around the initiation of symptoms. We are working to desensitize the tissues involved, but we also strive to provide education about the symptoms and boost confidence that these situations tend to improve and life will return to normal.

Now, back to the bucket. We can decrease the flow of elements into the bucket and increase the bucket size with one great tool — EXERCISE! The benefits of exercise have been widely addressed, but it’s always good to have research behind them, including reducing overall mortality. A study found that resistance training was associated with a 21 percent decrease in all-cause mortality and, when combined with aerobic exercise, the reduction climbs all the way to 40 percent.

Decreased activity has been shown to contribute to disease progression in a number of conditions, including fibromyalgia and osteoarthritis. Strength training and aerobic exercise improve muscular performance, coordination and posture, which not only can help in fibromyalgia cases but can also enhance a person’s ability to perform daily activities and counteract disability (increasing the bucket size).

Exercise can also increase the resilience of our musculoskeletal system in response to micro-trauma, resulting in improved repair function and adaptation during phases of exercise. One study found that this works for people without significant diagnoses as well. In healthy adults, pain scores were reduced by resistance training; this is done with improved pressure thresholds and desensitizing the tissues causing symptoms. All of this is done to strengthen the body, allowing the bucket to increase in size. Exercise is also a great way to decrease the flow into the bucket by reducing stress and often leads to a healthier lifestyle in general, which also slows down the flow.

If you are having trouble with chronic or recurrent pain, or find aches and pains slowing down your exercise routine or daily activities, don’t hesitate to reach out to Essentia Health Chiropractic for help. We will develop a plan to get you back doing what you love quickly. We will do this by increasing the size of your pain bucket and decreasing the flow into the bucket. Try to remember, “you can’t go wrong getting strong.”

Andrew Zetocha is with Essentia Health.

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