Chronic pain, pain being an underlying symptom of something that is wrong with the body, lasting longer than 10 weeks. Doctors are still trying to figure out why so many of us experience pain and how to treat us, especially the patients in recovery from substance abuse. Always talk to your primary care before starting or stopping anything that could impact your health. If you don’t think that doctor is meeting your needs, time to go find a new doctor. Stay on top of your health by being proactive and staying in tune with your body. We are going to discuss my experiences dealing with all the factors that go into chronic pain and how I try to go about remedying it.
Back in high school I was dropped on my head in cheer leading. Subsequently I have faced pain in my back and neck for over eight years. Adding insult to injury, my past abusive relationships once I graduated high school, increased my back problems tenfold. At this moment in time they have diagnosed me with degenerative disc disease, herniated C-7 disc, and osteoarthritis. I’ve gone to over ten different doctors, chiropractors, massage therapists, neurologists, and specialists, in active use and in recovery, to help combat my pain and try to have more days pain free instead of more days in pain.
It started with pain pills and marijuana in high school, mostly Vicodin, that helped me during my bad flare ups to avoid going to the ER. I continued using them throughout the day to help me get through work and everything else I would normally put off to rest my back. Increasing the dose every so often because I was becoming tolerant to what I was accustomed to. I would dabble with what I could find out there that made me feel physically and mentally better. Spending loads of money to just maintain. Fast forward to when I was introduced to heroin, it was a blast of time I could have pain free. I became addicted to that feeling and the drug that made the pain disappear. After that first hit, it spiraled me out of control into years of hard drug abuse with heroin and crack cocaine, putting my body through the ringer and adding more problems to it.
I think it’s safe to say that I’ve experienced my fair share of doctors and there are good and not so good doctors, just like in any profession. Maybe they don’t listen to you because they are overloaded with work rushing around. Maybe they don’t believe you because you look fine on the outside. Whatever the case may be, don’t settle for a less than good doctor, one that will work with you to find a solution for you to live a life of quality. Pain works in a cycle. Starting with, the pain -> muscle tension -> reduced circulation -> muscle inflammation -> reduced movement. So tune in on what’s going on with your body and see if there are any unhealthy habits that are contributing to the chronic pain.
Pain hits more then one aspect of the body.
- Physical problems caused by injury, illness or surgery
- Tense muscles (which may be the body’s reaction to protect injured joints)
- Psychological stress such as fear, anger and frustration play a big role in the pain cycle. Reducing the stress can play a big role in easing some of the discomfort. In addition to psychological stress, psychological factors like depression or negative emotions/feelings tend to fire up the problem and instead of working on a solution.
- Fatigue caused by any aliment or from the inactivity from the down time the pain produces.
I have struggled at times because of the pain being so severe that really shake you and bring on the triggers to relapse. I’m going to share a few things that I have found helpful in managing some of the flare ups.
The PPP- (Pain Prevention Plan) A PPP is a sheet of paper, placed in an area you see often. On the paper you list all the methods of relief on it while you are thinking clearly prior to a flare up. On this sheet, list of all the immediate remedies you find relief from, Tylenol, yoga, stretches, meditation, heat, ice, etc. Whatever makes you feel relief, add it to the PPP. You can choose to add your doctors numbers for easy access. We all know when we are in a middle of a flare up, we are not thinking our best. It’s easy to get swallowed up in the “this is never going to end” or “why me” so it’s important to stay present and not to magnify the situation. Like they say in AA, one day at a time, or even a minute at a time. Go at your pace and see what works best for you and your body. The cycle of pain can spiral the negative thoughts to swarm our brain, anxiety, depression, or negative self talk that potentially keeps the pain cycle flowing. By not focusing on the pain we detach our self from it and really try to see what is happening within our own bodies. It’s a helpful tool to keep us mindful of what is happening within our bodies and to be proactive about it.
PPP I use is on a yellow post-it note on the fridge and my example is below:
At the signs of a flare up:
- Ibuprofen and a heat pack
- Stretch and breath – I list a positive affirmation here, “I can get through this flare up just like in the past.”
- Evaluate the situation for any new symptoms to document on a pain log.
- If it gets past the point of “pre -flare up”, I try and make a chiropractor appointment. ( I have a few chiropractors so all their numbers are on my list. )
Another good sheet to make up along with the PPP is a Pain Log. At the beginning of this post you will find a blank pain log that you can save to your computer, print, and keep track of what is happening with your body. This helps to see if there are any patterns in your symptoms that you can share with your primary doctor to further along your hunt for relief. Just documenting the date, what emotions you’re feeling, any psychical symptoms being felt, scale 1 – 10 of the pain, any remedies you tried, and any other notes you find to be important. Tracking symptoms are very helpful not only to us but to our doctors who can see trends in our cycles and could potentially figure out what is going on. Being able to verbalize your pain to your doctor and showing your data will only be an assistance to you while getting the help you need. Make sure when you see a doctor that you do your research and ask as many questions as you need. Be sure to stay honest and keep the line of communication open. Never should you have to feel ashamed for asking whatever questions come to mind to your doctor or specialist. Having that good patient doctor relationship will positively impact you by having an open and honest line of communication with each other. Open communication is essential for them to really know what is happening with you and your pain log can track trends, habits, and build trust with the doctor.
For the chronic pain suffers, there are treatment options to help you co-exist, cope, and potentially heal your body. This list I have composed is only the start to the treatments. I’ve also tried some of the treatments and below, you can read about my expierence
- CBT – Cognitive Behavioral Therapy – A short-term, goal based therapy treatment that takes a hands on approach to how we go about solving our problems with pattern/habit changes. The goal is changing the patterns of thinking or behaviors that make life more difficult. This helps us change the way we think, therefore changing the way we feel. This approach has seen successes with anxiety and depression as well. They have a series of techniques to apply to every day life to improve one’s life and gain self awareness. In counseling, I was taught some of these techniques and I have seen a benefits from them. I unfortunately had to stop due to financial issues but do some of the work on my own. There are plenty of websites, books, and therapists that can help provide you with this service to see if it can be a good for for you. At the bottom of this post there will be a link provided for those who want more information.
- Physical Therapy- In PT, they teach patients how to prevent or manage their condition with exercises and stretches to achieve long term goals of being released from the grasp of pain. PT’s examine each individual and develop a plan, using treatment techniques to promote the ability to move, lower the pain, bring back function, and prevent future injuries. They help you maintain or even restore your health, fitness, and body. Currently, I’m in Physical Therapy working on my neck muscles and the muscles surrounding it. I’m learning how to stretch and strengthen the necessary muscle groups. It took me three tries to find the physical therapist I liked. It’s okay to be picky about who you have treating you and that good relationship is important to have. There are all different areas of Physical Therapy.
- Pediatric Physical Therapy – Focuses around children development while they grow and strengthen their bodies.
- Geriatric Physical Therapy – On the other side of the spectrum, this is for the older patients. PT will help them stay mobile and strengthen any weakened muscles.
- Orthopedic Physical Therapy- Having injuries can cause long-term damage to muscle strength, even after the injury heals. Atrophy from immobility after surgery or even prolonged reduction of use of a muscle because of an old injury will often go see an Orthopedic PT to help in that area to regain and maintain muscle strength.
- Cardiovascular and Pulmonary Types of Physical Therapy– Specializing in the heart and lungs, they treat heart disease or those at risk and to improve overall health.
- Vestibular Rehabilitation- Focusing on vertigo, dizziness, and over all imbalance, they work with a hands on approach to help you get back to your equilibrium and improve the quality of life to the patient.
- Neurological Physical Therapy- The focus being the brain, nervous system diseases or aliments, this area of PT will help figure out what injury is happening to the CNS (Central Nervous System). They help people become active again after disease or injury to the nervous system.
- Medical Massage – Massaging works to release the tension in the muscles that are tense and causing you pain. Some benefits of massage are that it increases serotonin, which is a natural pain reliever, even if it’s a minor relief. Massage also aids in increasing the range of motion and lowering the anxiety level. Not to knock massaging but for me personally, it hasn’t worked. I feel I would need a massage every other day for a year to make my muscles chill out and not cause spasms. It became way to expensive for me to keep up with it as my insurance does not cover it.
- Acupuncture– Acupuncture may be effective against pain and inflammation because it aims to hit the trigger points, the area causing the pain. Additionally, acupuncture may decrease pain-causing inflammation by stimulating the pituitary gland to release cortisol, a hormone that is known to reduce inflammation.
- Trigger Point Injections – or TPI – is a temporary procedure done in the doctor office. Doctors use TPI to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax on their own. Every four months I receive a series of “injections” into my over stimulated neck muscles to release the trigger points or knots. The doctor only injections lidocaine into the areas where the injections go so the TPI can be barely felt. However, the next day I typically feel sore like I just worked out at the gym. It takes about two weeks for the effects to start kicking in. I liked this method the most because it allows your body to heal itself with minimal lidocaine.
- Chiropractor- Chiropractic is a form of therapy focused on the structure of the body, especially the spine. They manipulate the body’s alignment to relieve pain and improve function and to help the body heal itself. I see my chiropractor often for my neck re-alignment, but it’s what give me the most rapid relief. However, the relief seems to be short lived to about one to two weeks. I’m hoping that with physical therapy I’ll be able to limit my chiropractor appointments.
- Medications – Medications are there to make you feel better. Just make sure your not just covering up the symptom and continue working in other aspects of where the pain is so it doesn’t have to be so constant. Be careful with any and all medications because of their side effects and their addictive aspects. Keep an open line of communication with your doctor if you start feeling an adverse way. Below listed are the addiction help line and a pain management website for you to obtain more information on the topics.
I hope you find this post helpful and I hope you can find some relief from pain! With all the treatments and doctors being so different you will find yourself in a trial and error process. It’s hard to not get frustrated and just want to take out the white flag and surrender. Take it slow and do whatever is best for you. Below are some websites for help or more information.
–Until next time,
SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
http://www.practicalpainmanagement.com – is another extremely helpful tool for those experiencing chronic pain, with or without a substance abuse problem.
https://www.psychologytoday.com/us/basics/cognitive-behavioral-therapy – CBT website for more information