Vijai P. Sharma, Ph.D
In my last article on pain, a reference to my chronic pain caught the attention of some people. A friend mischievously asked me if he was my "chronic pain." Others wanted to know what exactly I did to handle my pain. Although I don't like to draw attention to myself, in this article I will indulge in a bit of self-disclosure in the hope that it may help others with chronic pain problems.
A few months ago, I started noticing sharp pain while doing backward-, forward-, and side-bends, a routine exercises that I had done for years. Then I began to feel pain while walking, standing, or doing other activities that involved the back, hips, and legs. I scaled down my bends and stretches to a much milder intensity. I was determined to not quit altogether, but to just scale down my exercises and activities to the level that I could bear at that moment.
Around this time I went to India. The flight each way takes about 20 hours, with a brief break in about mid-way. Since airlines want to carry the maximum number of passengers in the space available, airplane seats are tight and provide very little leg room. The flight didn't help my problem. Either sitting in that "straitjacket" for that many hours or in maneuvering my legs while sitting, I made the pain worse. Upon my return home, in order to relieve the pain, I used ice bags for a couple days and followed it with heat treatment with little relief.
Then I got a complete physical examination. My doctor and I investigated several possibilities but we could find no ascertainable cause. Then I consulted an orthopedic physician who, after looking at the X-rays and several other tests, assured me that it was not a sciatica pain. He also ruled out any other type of nerve damage. In other words, my pain appeared to be a muscle pain instead of a nerve pain. This made me feel better and gave me the confidence I needed. I booked several appointments with a physical therapist I trusted. We went over the entire routine of exercises I had done over the years. He advised me which ones I should do more of and the ones that I should hold off for a while. He also taught me several new exercises that, according to physical therapy, were best suited to my particular problem.
Knowing that there was no definitive medical cause did not unnerve me. On the contrary, I believe that when I heard the news, 25 % of the pain just fell away. I knew that it was now in my hands and not in the hands of the doctors. I am big on medical diagnosis and advice but I also want to know everything that I can do for myself. I thought if the pain is only in my muscles and my head, then I would do just fine. Hey, mind-body medicine is my area of expertise!
Pain is the most common reason people seek help from doctors. Unfortunately, the treatment of pain is still very fragmented and inadequate because we have not integrated medical care with psychological, social, and spiritual aspects. Do not fight with your pain. Work with it. To effectively manage pain, you must emotionally and spiritually accept your pain. By accepting pain, I mean you should not spend too much time questioning the pain, blaming yourself or others or in fighting with your pain physically, mentally or emotionally. Simply accept that you have pain and that you, with divine help, are going to do the best you can to take care of yourself.
You must be a believer in the mind-body connection of chronic pain. All chronic pain is mental and emotional pain. There is nothing that is simply physical chronic pain. If a doctor is treating your chronic pain strictly within the physical framework, you need another doctor. You must also view your pain as 100% your problem and not someone else's. It's not the problem of your partner, children, relatives or friends. If they want to offer help and support, accept it gracefully. But do not expect anybody to "understand" your pain or to help you. This may appear as harsh advice but it can save you from a lot of pain. Anger with one's self and others is a major factor in chronic pain. Eliminate anger.
You must become very active in the treatment of your pain. Find out the specific exercises, and stretches that are good for you and do them regularly. Do not become inactive. Whatever level of exercise and activity is possible that day and that hour, do your part. For many weeks, it took me two to three hours of stretching, breathing, exercising and relaxation in the early morning hours before I could move about freely. Never overdo anything. Slowly and patiently work your way up from the point at which you find yourself each day.
Deep relaxation helped me more than anything else. Pain makes one anxious. Muscles and breathing respond to anxiety resulting in further muscular rigidity and pain. One weekend, I did deep relaxation and stretches for most of the weekend, for a total of 12 to 14 hours. That, I believe, greatly helped to loosen up the muscles that I felt were frozen or knotted and tangled up. Relaxation for me is the best "muscle relaxant pill." Learn to do physical and mental relaxation from tapes or from a professional. Relaxation will also help with the three "horsemen" of pain: depression, anger, and anxiety.
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