Pain, especially chronic pain, is fraught with confusion, misunderstanding, and still limited understanding on the part of the medical field. Yes, we know that pain signals emanate from the part of the body where the trauma has occurred/is occurring. And we know that the signals are sent to the brain, which is where we get to obsess over them. Most pain medications try to suppress the pain signals in the brain, despite the pain's locale being elsewhere. Locally-focused solutions, such as patches, creams, stim devices all have shown limited efficacy, especially with chronic pain. And even more so with chronic pain that is the result of continuing local trauma and inflammation, such as we clubbies experience.
But some of the confusion around pain comes as much from how we talk about it as how it actually works in the body. For example, we speak of "dealing" with pain, "relieving" pain, and "stopping" pain, as though these were all synonymous. In actuality, these are three completely different issues. Stopping pain means, or at least should mean, the resolution of the condition causing the pain in the first place. Sadly, we tend too often to "stop" pain by deadening the parts of the brain processing the signals, usually through the use of addictive opiods, rather than trying to actually resolve the causes therein. Yet we at least colloquially use this term as a statement of desire - "please make the pain stop." Sadly, masking the pain does not halt the factors which cause the pain to persist. Arthritic joints continue their damaging decline, even if the mind is temporarily oblivious to the fact.
Relieving the pain is close to "stopping" the pain, but allows for more nuance. If one can achieve a sizable reduction in the degree and duration of the pain, making it more tolerable, this can count toward relief. The advantage of this term to describe the desired result is that is opens the door to more solutions than "stopping" pain affords one. Solutions other than opiod addiction are more desirable, less damaging themselves, and easier to access most of the time, as many such solutions do not require a prescription (though a few do, FYI). Salves, massage, compression socks, OTC pain meds, footwear and orthotic solutions - these and more can be used as your arsenal aimed at relieving the pain to manageable levels. It takes more trial and error to get the right combination that works for any given person, but in the instance of chronic pain, it is the more useful term.
The third term, "dealing" with pain, includes "relieving", but adds another aspect to the mix. Dealing means finding ways mentally and emotionally to cope not only with the physical impacts of chronic pain, but with the emotional and psychological ones, as well. Short term acute pain does not impact the mental state to the same degree or in the same manner as does chronic, unrelenting pain. We live with this, whether we want to or not, so we need mechanisms to aid in how we face all of these aspects of our pain. Mental tricks like compartmentalization, distraction, biofeedback for pain management, hypnosis all can have their place in helping us deal with the pain. Making psychological therapy a part of one's life is also highly beneficial - we can easily fall into depression, feel isolated, rejected, resentful of the ease with which others get to live compared to ourselves. Add these to having to also deal with the physical impacts, the disappointments we experience with the medical profession, family, friends, strangers who are sometimes merely ignorant, and sometimes outright cruel in their ignorance, and it becomes clear tat we have a significant load to bear. Trying to do this alone is a recipe for disaster.
Dealing also means adjusting our life styles to make the management of our pain more realistic. Finding our "half-way point" for when we go outside, on walks, to the store, to events, can benefit us by acknowledging the actual distances we can handle in a day without having to spend days or longer recovering. Learning to sit as often as possible when out and about also serves us better than trying to do the same thing your able-bodied family or friends want you to do, which may also require you to say no a little more often than yes. Developing techniques to educate others about your limitations is an essential skill - you should not allow others to dictate, by whatever means they may do so, how much pain you should have to endure to please their tender sensibilities. You need to take care of yourself, first!
In each of these ways of speaking about pain, we need to be clear of their distinctions, because we run the risk of failing to see how, say focusing on one such term, may hide from sight other ways of approaching the problem. We need to see with clarity the issue of chronic pain from every angle, so that we open up as many options for solutions as possible. The reality is, nothing is going to "cure," Correct," or "fix" our feet, and the odds currently of medical science even addressing our particular issues are frankly so low as to be non-existent. So, we either figure as much of this out for ourselves as we can, or fall into victim mode and lose out on a better quality of life.
Will it still hurt? Oh, yes. But we can mitigate the severity, and we can still find ways to enjoy our lives. But we are limited, you say, and of course, that is true. But as true is the fact that everyone is limited in their own fashion as to what they can achieve in their life. We just happen to know more clearly than most where our limit is situated. And once you develop the skills to deal effectively with pain management, you will feel more in control of your own life.
Which, if you think about it, gives us a bit of an edge!
But some of the confusion around pain comes as much from how we talk about it as how it actually works in the body. For example, we speak of "dealing" with pain, "relieving" pain, and "stopping" pain, as though these were all synonymous. In actuality, these are three completely different issues. Stopping pain means, or at least should mean, the resolution of the condition causing the pain in the first place. Sadly, we tend too often to "stop" pain by deadening the parts of the brain processing the signals, usually through the use of addictive opiods, rather than trying to actually resolve the causes therein. Yet we at least colloquially use this term as a statement of desire - "please make the pain stop." Sadly, masking the pain does not halt the factors which cause the pain to persist. Arthritic joints continue their damaging decline, even if the mind is temporarily oblivious to the fact.
Relieving the pain is close to "stopping" the pain, but allows for more nuance. If one can achieve a sizable reduction in the degree and duration of the pain, making it more tolerable, this can count toward relief. The advantage of this term to describe the desired result is that is opens the door to more solutions than "stopping" pain affords one. Solutions other than opiod addiction are more desirable, less damaging themselves, and easier to access most of the time, as many such solutions do not require a prescription (though a few do, FYI). Salves, massage, compression socks, OTC pain meds, footwear and orthotic solutions - these and more can be used as your arsenal aimed at relieving the pain to manageable levels. It takes more trial and error to get the right combination that works for any given person, but in the instance of chronic pain, it is the more useful term.
The third term, "dealing" with pain, includes "relieving", but adds another aspect to the mix. Dealing means finding ways mentally and emotionally to cope not only with the physical impacts of chronic pain, but with the emotional and psychological ones, as well. Short term acute pain does not impact the mental state to the same degree or in the same manner as does chronic, unrelenting pain. We live with this, whether we want to or not, so we need mechanisms to aid in how we face all of these aspects of our pain. Mental tricks like compartmentalization, distraction, biofeedback for pain management, hypnosis all can have their place in helping us deal with the pain. Making psychological therapy a part of one's life is also highly beneficial - we can easily fall into depression, feel isolated, rejected, resentful of the ease with which others get to live compared to ourselves. Add these to having to also deal with the physical impacts, the disappointments we experience with the medical profession, family, friends, strangers who are sometimes merely ignorant, and sometimes outright cruel in their ignorance, and it becomes clear tat we have a significant load to bear. Trying to do this alone is a recipe for disaster.
Dealing also means adjusting our life styles to make the management of our pain more realistic. Finding our "half-way point" for when we go outside, on walks, to the store, to events, can benefit us by acknowledging the actual distances we can handle in a day without having to spend days or longer recovering. Learning to sit as often as possible when out and about also serves us better than trying to do the same thing your able-bodied family or friends want you to do, which may also require you to say no a little more often than yes. Developing techniques to educate others about your limitations is an essential skill - you should not allow others to dictate, by whatever means they may do so, how much pain you should have to endure to please their tender sensibilities. You need to take care of yourself, first!
In each of these ways of speaking about pain, we need to be clear of their distinctions, because we run the risk of failing to see how, say focusing on one such term, may hide from sight other ways of approaching the problem. We need to see with clarity the issue of chronic pain from every angle, so that we open up as many options for solutions as possible. The reality is, nothing is going to "cure," Correct," or "fix" our feet, and the odds currently of medical science even addressing our particular issues are frankly so low as to be non-existent. So, we either figure as much of this out for ourselves as we can, or fall into victim mode and lose out on a better quality of life.
Will it still hurt? Oh, yes. But we can mitigate the severity, and we can still find ways to enjoy our lives. But we are limited, you say, and of course, that is true. But as true is the fact that everyone is limited in their own fashion as to what they can achieve in their life. We just happen to know more clearly than most where our limit is situated. And once you develop the skills to deal effectively with pain management, you will feel more in control of your own life.
Which, if you think about it, gives us a bit of an edge!
Great post! As a older person with bi-lateral CF this is so true. I did decades of damage by taking pain meds and pushing through the agonizing pain. Stopped that in mid 2000. Thankfully I eventually learned the truth about chronic pain. It's a fine balance that takes a lifetime to ''get'. Hopefully more posts like yours will help stop the madness. My wheelchair is my friend and purveyor of a new kind of freedom. Namaste'
ReplyDeleteThanks for the response. I sometimes find myself looking at the younger clubbies and what they are going through as they are just starting the process of learning to deal with the reality of their difability. I have to remind myself I went through the same thing, but with one significant difference: I didn't have blogs like this one, or groups like the one on Facebook, where I could see I wasn't alone, and where I could find some knowledge and resources that the medical community doesn't think are worth bothering with. So as hard as it can be to learn how to live with a difability, it is actually quite a bit easier today.
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