One of the Causes of Backsliding

I recently saw a patient with frozen shoulder who reminded me of a subject I had been meaning to cover here and that has to do with what is sometimes behind a patient’s backsliding. This particular patient was already suspecting this phenomenon was behind this. In her case, we had been making steady progress on her shoulder pain and range of motion but then she had a modest flair-up that happened about the same time she was fighting-off a cold. She asked if the two could be related and I told her they absolutely can be because the body has a limit to the resources it has available to it to fight any problem so if a new problem – such as a cold – comes along, the body often needs to triage its resources, pulling from one ongoing fight (like shoulder pain) to deal with the new one (the cold).

This phenomenon of limited resources was something I had learned sometime into my third year of practice.  I had seen a few patients with things like headaches or allergies who had experienced some set-backs when they caught a cold but I thought it was the case of the cold adding to their existing problem. I then had a patient with pain in his big toe (similar to but not technically gout) that had taken several treatments to improve his condition and further treatments were wearing the problem down steadily. He then caught a cold and BAM! – his toe pain increased. I thought this was strange since the cold had nothing to do with the toe problem and then I realized this was not a matter of a new problem adding to an old one but rather the body pulling resources from one battle-line to establish another.

This sort of thing does not only happen with colds or the flu, far from it. It happens anytime a new problem or even something adding to an existing problem forces the body to withdraw resources from one fight to help another fight. This backsliding can be disappointing to patients but the good news is that when the body gets the upper hand on the problem it had to make more of a priority of, it will then shift those resources back to the problem you had been treating and the flair-up will subside. Of course, taking the time to address the more acute issue will reduce the time it takes the body to get it under control and so also speed-up the time it take to get the flair-up to ease.

In my area of Southern California, we have lots of brush fires. I tell my patients that like those fires, if a new fire springs up the body needs to move some firefighters from one fire-line to establish another one. When that happens, the original fire often advances because there are less firefighters to contain it. People understand this and will tend to be willing to give it time to get the problem we had been working on moving in the right direction again.  

The moral here is flair-ups are not only caused when something adds to an existing problem. This also underscores the value of always remembering that acupuncture works by getting more out of the body’s resources but that those resources have their limits.

Matthew Bauer