November 22, 2013

relationship to pain

     Chronic pain is a difficult entity to treat.  Even if one has a purely organic cause of the pain, there are still emotions about the pain that can factor in and complicate the issue.  Pain is the relationship of your nerves, your neurology, your psyche, and your physical source of pain.  No wonder we're not good at treating it.  We simply do not understand the individual pieces of that puzzle, much less how they fit together.  I understand that stress cannot possibly not play a role in my pain.  But I am also able to predict weather fronts or a northerly breeze with a high degree of accuracy which would put a goodly portion of my pain into the organic realm and not emotional.  Whatever that relationship, it is not one I understand well.  Neither have any of the numerous doctors or physical therapists given me a sufficient explanation, much less a successful treatment.  The pain management doc went so far as to accuse me of being a drug seeker despite my not requesting any medication from them.  Being who I am, trying to understand it is important so being accused did not sit well with me.
     About the only branch with an explanation, albeit non-verifiable, is eastern medicine.  And the concept of chi is pretty ludicrous to me.  But hell, we've used medications numerous times without having a clue how they worked, or we had presumed an incorrect explanation.  Perhaps the Chinese stumbled on something millennia ago that simply works.  Their explanation doesn't have to make sense.  For me, it just has to work.  And I do get some relief from acupuncture, albeit temporary like everything else.

     Each one of these needles represents where I have, for lack of a better term, a trigger point (they continue down my right arm though you cannot see them).  These are points in the muscle that are hard, and when pressed deeply, elicit pain that extends beyond the point.  I asked the acupuncturist for the picture just for my curiosity of what the needles looked like.  When I looked at the picture, two thoughts jumped into my head, and they had nothing to do with the needles.  That part of my lower back with the four needles looks swollen.  And the upper part of my back that has 5 or 6 needles in it also looks angry.  I showed the picture to my wife, almost indignantly stating, "look at this!" feeling a need to prove that I'm not making up my pain.  It's not just stress.  Something is physically wrong with my muscles.
      "That?  Oh, your back always looks like that," she replies nonchalantly.
      "What?!?!?  Seriously???  So I'm not crazy.  I am not making this pain up."
      "Yeah, that's your back at 'normal'.  I figured you already knew that."
      In some sense, I do feel better that I'm not making this up.  It's important at this point in my life to have something make sense.  Even if only a little bit.  I shattered my right collar bone which alters the anatomy of my shoulder and my spine at that level has an extra vertebra which causes it to curve a bit to the left.  Both of these add up to a shoulder and back that have "issues", if not a proper diagnosis.  After all, my left back doesn't hurt at all.  So this simple picture helps change my relationship with the pain.  The relationship has evolved into one that is moving more towards acceptance and thinking about it less, which can only be a good thing.  I worry less about the role that stress may be playing into it and accept that it is what it is.  I accept the limitation of what my shoulder is.  Whether this acceptance alters the physicality or intensity of the pain remains to be seen (maybe, maybe not) but it is nice to know I'm not losing my mind.

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