Most people stand very little chance of escaping the chronic pain cycle until they fully understand ‘latency’. Because truly healing chronic pain requires ongoing, sincere effort long after symptoms have resolved.
Many health conditions spend a significant part of their ‘life cycle’ in an invisible state of latency. Asthma is an excellent example of this. The asthmatic has asthma 365 days a year but only suffers attacks at certain times. Most pain conditions behave exactly like this to some degree. This can create a great deal of confusion. Many patients express shock and distress when symptoms that have resolved return.
The human body is a deep and mysterious phenomenon. It’s a bit like the ocean. We see what goes on at the surface, but most of what it does is unseen ‘stuff’ going on under the surface. Like the ocean’s depths, we actually still know very little about the body’s inner workings.
The 30 trillion cells reading this text all work together like instruments in an orchestra via quantum computing, which is way beyond our current understanding. Every three days, 1000 billion of these cells die off and are completely replaced.
Cells only make up about ⅔ of your body mass; the rest is fluids the cells are bathed in. Then there is the small matter of an estimated 39 trillion other life forms that live in the body at any given time. Meaning there are more bacteria, viruses and fungi in us than there are human cells
In the time it takes to eat your breakfast or send an email, literally, hundreds of trillions of cell processes occur. Yet how much of this do we actually experience? Not much. The body sends 11 million bits of information per second to the brain, and the conscious mind can only compute 50 of those bits per second. The rest is mostly reconciled to the great mystery of life.
Yet obviously, there are still many useful clues as to what is happening on the inside of our bodies. When we are very healthy or very sick, these are especially obvious, even to the untrained eye.
Symptoms tell us a lot, and so can investigations like blood tests and scans. Yet clearly, the awkward truth is that 99.9% of what the patient’s body does is still unseen and unmeasurable. It’s easier to investigate outer space than the inner workings of the body.
So much goes on without being seen, felt, heard or measured by us or our doctors.
If someone is on course for a heart attack two years from now, they might already have some symptoms – but it’s also possible they have no symptoms. Their first symptom might be the heart attack itself, after decades of heart disease. This is an example of latency.
There is often an incubation period between contracting a virus and the onset of the symptoms. In fact, some infections like the Herpes virus can sit in the body for decades undetected. This is another example of latency.
We observe breast screening routinely because we know that breast tissue can easily harbour cancerous cells that are not noticed by a patient. Unseen, unfelt cancerous cells in breast tissue are an example of latency.
People with IBS can go for long periods with no symptoms until they encounter some stress or eat the wrong thing. The IBS was sat in a state of latency until it was triggered.
These small examples demonstrate how latency works. And that we are mostly aware that latency is common to many, if not all, chronic health complaints. Yet many pain sufferers still completely overlook the fact that latency applies to pain too. But they shouldn’t because it applies to chronic musculoskeletal issues in a big way.
Radiologists routinely find spinal disc protrusions, arthritis, cartilage tears, enlarged bursa and tendon tears in patients that have no symptoms whatsoever. Many of these people go their whole lives with no symptoms. Others have very intermittent symptoms, like an asthmatic. This is absolutely normal and clearly demonstrates latency in the musculoskeletal system.
Outside of physical wear and tear, latency also applies to simple mechanical pain. The headache sufferer, neck pain sufferer, back pain sufferer, RSI sufferer, and Achilles pain sufferer all tend to have symptoms that come and go. Many go long periods with no pain at all, only to find it comes back at certain times or periods of their life.
Yet obviously, there are still many useful clues as to what is happening on the inside of our bodies. When we are very healthy or very sick, these are especially obvious, even to the untrained eye.
Symptoms tell us a lot, and so can investigations like blood tests and scans. Yet clearly, the awkward truth is that 99.9% of what the patient’s body does is still unseen and unmeasurable. It’s easier to investigate outer space than the inner workings of the body.
So much goes on without being seen, felt, heard or measured by us or our doctors.
If someone is on course for a heart attack two years from now, they might already have some symptoms – but it’s also possible they have no symptoms. Their first symptom might be the heart attack itself, after decades of heart disease. This is an example of latency.
There is often an incubation period between contracting a virus and the onset of the symptoms. In fact, some infections like the Herpes virus can sit in the body for decades undetected. This is another example of latency.
We observe breast screening routinely because we know that breast tissue can easily harbour cancerous cells that are not noticed by a patient. Unseen, unfelt cancerous cells in breast tissue are an example of latency.
People with IBS can go for long periods with no symptoms until they encounter some stress or eat the wrong thing. The IBS was sat in a state of latency until it was triggered.
These small examples demonstrate how latency works. And that we are mostly aware that latency is common to many, if not all, chronic health complaints. Yet many pain sufferers still completely overlook the fact that latency applies to pain too. But they shouldn’t because it applies to chronic musculoskeletal issues in a big way.
Radiologists routinely find spinal disc protrusions, arthritis, cartilage tears, enlarged bursa and tendon tears in patients that have no symptoms whatsoever. Many of these people go their whole lives with no symptoms. Others have very intermittent symptoms, like an asthmatic. This is absolutely normal and clearly demonstrates latency in the musculoskeletal system.
Outside of physical wear and tear, latency also applies to simple mechanical pain. The headache sufferer, neck pain sufferer, back pain sufferer, RSI sufferer, and Achilles pain sufferer all tend to have symptoms that come and go. Many go long periods with no pain at all, only to find it comes back at certain times or periods of their life.
Many patients think of themselves as ‘fixed’ once they find a treatment that resolves their symptoms or when they naturally arrive at a pain-free chapter- in a way that people with conditions like asthma never would.
We know full well it’s not safe for cancer patients to self-discharge after treatment just because they feel better – we let the scans determine when treatment has been successful. Asthmatics don’t throw away their inhalers after an attack. But chronic pain sufferers routinely self-discharge based on how they feel. Believing that being symptom-free for a short time indicates they are ‘fixed’.
And in fairness to them, there are times when that strategy works just fine. When we were children and had a virus, Mum kept us home until we felt better, then sent us back to school. When we cut our fingers, they do heal, and it’s pretty obvious when that process is complete. Food poisoning is generally short-lived, and when we feel better, it’s genuinely over, thankfully.
Even more relevant, simple musculoskeletal injuries are often fully healed once the pain stops – which is the crux of the issue. We tend to keep pain in the same file as injuries. Unfortunately, though, chronic pain is far more complex.
The natural history of chronic pain is the same as asthma, IBS, endometriosis, psoriasis or cardiovascular disease. It is a chronic condition that tends towards periods of latency and subsequent relapses until its causes are healed.
Chronic and recurrent pains are signs that the 30 trillion cells are going through some struggle – usually patterns of biomechanical strain, poor lifestyle choices, emotional stress, and sometimes unresolved physical or psychological trauma.
The body is a bit like ‘you’
If you were unhappy at work, chances are you wouldn’t complain constantly – much of the time you would probably be too busy to complain. You might only complain at specific times, like on really bad days. The body does the same. It only ‘complains’ via symptoms when things are really bad. The rest of the time, it just quietly does its best and makes do.
In rare instances, chronic pain can become constant. But mostly, the body suppresses pain. Sometimes for years. Sometimes for parts of the year. Sometimes for part of the month. Sometimes for parts of the week. Sometimes for parts of the day. But the underlying problems persist during pain-free times. This tendency is probably due to our ancient survival hardware.
Our distant hunter-gathering grandparents led a hard-knock life. If they’d felt every bit of inflammation in their bodies, they would have felt sore all the time. In order to hunt and gather consistently, it’s necessary to suppress a certain amount of pain. Or live with the discouragement of constant pain.
Food and water are far more important than aches and pains in the big outdoors. So from an ancestral perspective, it makes perfect sense that latency would be baked into the chronic pain cake. Latency saved us from spending our lives hobbling instead of hunting. Through the vast network of cell processes, we learned to suppress pain in favour of supporting survival.
There is a big reason why understanding latency is so vital to truly recovering from chronic pain. The real work of resolving chronic pain happens after the symptoms go away. Just like it does with dentistry.
We don’t stop flossing and brushing just because our cavity was filled in by the dentist. We understand that teeth take lifelong care and stewardship in order to stay healthy. Why would body parts that have struggled with chronic pain be any different?
Consistent strengthening, stress management, self-care and biomechanical checkups are the ‘dental floss’ that keeps pain at bay in the long term.
The problems underpinning pain might not go away the moment symptoms stop. And they seldom spontaneously vanish in between episodes. So they do usually require longer-term attention. But once we figure out our causes, gentle but persistent effort is enough to resolve them in most cases. Symptoms or no symptoms.
Pain is a symptom. Symptoms are the feedback that the body generates when it faces problems with its delicate internal balance (homeostasis). Without symptoms like pain, thirst, nausea and fevers, it would be very difficult for us to maintain a healthy body in the same way that it would be hard to drive a car safely with no dashboard display.
John is one of those rare gentlemen who has continued to play competitive soccer well into his late 50s. He is in really good shape, which you need to be to play football at that age—good shape except for his left leg. His left leg is not in good condition at all. In fact, once you get to know his left leg a bit better, it becomes apparent that it’s miraculous that he’s able to run at all, Let alone the type of running required to play competitive soccer against younger men.
Shockwaves, Pain Treatment & Hormetic Stress
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