When Guarding Becomes the Illness

When one molar aches, you chew on the other side. You never decide to do this — by the first bite, you are already doing it. Once the ache settles, you go back to chewing on both sides before you notice.

This process is over in a few days. In some bodies, though, those few days become years. Using it less, moving it less, and shifting that much of the load elsewhere is all the same — it is the final step that differs.

At the Time, It Is the Right Response

If an injury has not yet finished knitting and it takes on as much force as before, it is damaged again. So the body reduces movement toward that spot, tightens the area around it to keep it from wobbling, and shifts the load elsewhere. The very sensation of pain is itself a signal telling it to do this.

Up to this point, the body has done its part. It is not a bad habit picked up along the way — it is a response that was necessary at the time.

But this response comes with an ending built into it from the start. Releasing it once there is no longer a reason to guard is part of the response too.

A Place That Works in Its Stead Appears

When one side is used less, another place takes on that much more. For a few days, it shows no sign. By a few months, the place that took it on grows strained.

This is why the spot a long-suffering patient points to as painful is different from where it started. It is not the place that was guarded, but the place that took over the work of guarding. I covered this separately in Why Treating the Painful Spot Does Not Cure It.

This does not explain all chronic pain, of course. There are several layers side by side in the body, and what arises from guarding is only one of them. No single layer plays the leading role.

Moving Less Reduces the Signals Coming From That Spot

Once pain has been experienced, the way the body moves changes. Researchers who studied movement in people with long-standing back pain view this as the body adjusting itself to reduce the chance of hurting again. They add that this adjustment comes with a cost of its own — movement that has become less dynamic increases the load falling on the same spot, and thins out the signals coming up from that area.

When movement that used to be spread across several routes narrows to one, force concentrates on the same spot. And the proprioceptive signals coming from that area also decrease. The less information comes up about where a part is and how it is positioned, the duller control over it becomes. A dulled spot also tends to be used more cautiously. In the meantime, that pattern becomes ingrained in the body.

If the altered pattern of movement continues for a long time, the tissue itself adjusts to match it. In a study comparing the lower backs of people with and without chronic low back pain, those with low back pain showed about 20 percent less sliding between layers of fascia. Even that study, however, could not settle which came first — whether the tissue is that way and so it hurts, or whether it hurt and, after moving differently as a result, the tissue ended up that way.

A Spared Spot Gets Pushed Back in Line

A place used less also gets less blood. Muscle contracting and releasing plays a part in pushing blood into that area. When that action decreases, the inflow slows down first. A place with dulled sensation also falls back in the order the body attends to. The body sends blood and resources first to wherever a signal is coming from.

That is why a spot that has hurt for years sometimes is not warm to the touch. Some are cooler than the surrounding area and duller in sensation when you touch them. An injury turning red and warm is a sign that the body has started repair, but in a spot like this, that start does not readily come through. I discussed this state in detail in When the Painful Spot Is Cold and Dull Instead.

Using it less in order to guard it comes to this in the end. While that spot is being spared, its own capacity to heal itself declines right along with it.

Somewhere Else First

What arises from guarding moves in step with how the body is used. Two things, however, proceed regardless of use.

When one arm or leg visibly thickens within a few days, and it is firm to the touch and painful when pressed. A spot that has been used less for a long time cools slowly over months. A few days is not that pace. Prolonged immobility is listed as one of the conditions for blood clotting and blocking a deep vein.

When a numb area keeps widening, or weakness keeps getting worse. Numbness that arises from guarding does not spread this way. Progressively worsening loss of strength or sensation is classified as a sign requiring urgent evaluation for nerve compression.

There is somewhere to check first.

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Once the tooth heals, chewing on that side returns. Guarding, by nature, comes with that return built in.

In a body that has been in pain for a long time, that part sometimes never comes. The need to guard has passed, but only the manner of guarding remains.

That is why I sometimes do not start from the spot a patient points to as painful. When that is the case, I always explain why.

There is nothing to fault in what the body did to guard itself. But even something with nothing to fault can remain if it is not released in time.

Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)