The Vascular Roots of Pain — and How Thrombolytic Therapy can help.
When we discuss chronic pain, we often talk only about the musculoskeletal factors involved. What many patients don’t realize is that a high number of pain disorders have a strong vascular element, too. To understand the role of the vascular system, we first need to understand fibrin.
Fibrin is the first step in your body’s healing response. This tough protein substance forms a mesh-like cover over the injury site, upon which clots, scabs, and scars are built. It can be triggered in response to trauma, infection, organ failure, inflammation, and a number of other forms of cellular damage. In a healthy body, enzymes are released a few days after injury to begin breaking down and ‘cleaning up’ the fibrin deposits. However, there are many things that can interfere with healthy enzyme function, such as pain medication, persistent infection, or chronic inflammation. These factors can inhibit the healing response, leaving the fibrin deposits to build up around the wound. Over time, the fibrin becomes thick and hard, even leading to scarring in some cases. In the vascular system, this can cause narrowing and restricted blood flow.
So, let’s imagine you have a chronic pain disorder, such as fibromyalgia. You may experience high levels of inflammation within the body, leading to increased fibrin deposits throughout the vascular system. Traditional treatment usually involves painkillers, so if you utilize this approach without realizing it you might actually be confounding your pain and restricting your body’s natural defenses. Fibrin deposits can also cause chronic pain in the extremities. Venous insufficiency, for example, whereby blood pools in the legs instead of flowing back to the heart, can lead to swelling, weakness, discoloration, and even immobility in the legs. It’s usually caused by valve problems, but it can also be related to a build-up of fibrin.
In all such conditions, the body is experiencing a lack of proper oxygenation due to the restricted blood flow, which causes or worsens the pain. For that reason, thrombolytic therapy focuses on removing the obstruction and allowing oxygen-rich blood to reach the affected areas.
Blood thinning treatment allows blood to flow more freely through obstructed veins and arteries, breaking down fibrin deposits and micro-clots within the vascular system. This allows more oxygen to circulate to affected areas and relieve associated chronic pain, while preventing the likelihood of future build-ups and clots.
The most commonly used blood thinners are Heparin and Coumadin. The former is typically an in-patient treatment, while the latter can be self-administered at home, but both require careful monitoring due to the risk of increased or excessive bleeding. While new lower-maintenance alternatives are slowly becoming available, for now it is necessary to take blood thinners under close medical supervision. Fortunately these kinds of blood thinners are rarely necessary for most common pain syndromes.
As discussed, fibrin build-up usually results from an impairment in the enzyme response that is supposed to clear fibrin out of the system. There are now a number of supplements designed to promote this enzyme function, most notably Lumbrokinase or Bolouke. As with blood thinners, it is important to consult a physician first and take these supplements under medical supervision.
How Piedmont PMR can help
For musculoskeletal disorders with a vascular component, it helps to have a physician with expertise in both fields. At Piedmont PMR, our doctors are experienced in both disciplines and have helped patients to achieve excellent results, both with blood thinning and enzyme replacement therapies.
If you believe you are suffering from vascular-related chronic pain, call our Greenville clinic now on 864-235-1834 to find out how we can help.