The ‘pain cycle’ plays a vital role. When trauma strikes,that is, physical or psychological injury, a painful response is frequently felt. This pain precipitates responses by the body to protect itself by guarding — usually noted as physical spasms. This guarding promotes subsequent dysfunction, that is, abnormal functioning, of the soft tissue and the joints.
The pain cycle is accompanied by certain internal changes which tend to compound the element of pain. The guarding process in turn produces a state of muscle tension which reduces the blood supply within the area. The condition is called ischaemia — deficient blood supply. There is an increased production of metabolites as a by-product of the muscle contractions. Metabolites are the breakdown products of the chemicals necessary for proper muscle function. Metabolism is the series of changes in a living body by which life is maintained. About 20 per cent of the energy produces mechanical movement or stabilisation, while most of the energy produces heat with the by-products of increased metabolites. Thus there tends to be an increased accumulation of these metabolites. Trauma may also include the production and concentration of internally made pain-producing substances such as peptides, amines, substance P, and prostaglandin.
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