Chronic pain: the unwelcome life’s companion

Until it starts to abate, I don’t think even the suffers realize how much long-term chronic pain can diminish their lives. It does more than limit activities that exacerbate the pain, it affects and informs virtually every aspect of life, from mood and sense of well-being to sleep to willingness to go and do and simply experience life. It limits not only motion, but endurance as well, both physical and mental. Chronic pain, even with palliative treatment, can be exhausting.
And that’s where I have been over the last weeks: an unwilling and increasingly debilitated subject of acute and chronic lower back pain, a legacy of too many unwitting injuries coupled arthritis in the lower spine. I had reached a point that nothing I did…from buying a new mattress to loading up on OTC codeine meds…gave me any appreciable relief. I would awaken dreading the activities of the coming day, knowing that the only question regarding my pain would be “how bad?” and “how soon?” There was no pain-free day or even time of day…it was all a matter of degree.

On a good day, fortified with pain medication, I could make it through the supermarket without bending over and leaning on the trolley to take some pressure off my lower spine. Most days, however, were not good days. Walking through the mall became an exercise in bench-spotting: if my back got so bad my legs were starting to give out, where were the benches? Pain even dictated where to park the car: if we couldn’t find a space close to the business we wished to patronize, Hubby would drop me at the entrance to begin the shopping (or find a bench) while he found parking.

Pain circumscribed and dictated my world. I could not participate in any activity that required walking more than five minutes; I could not participate in anything that required prolonged (more than five minutes) standing. Queues at supermarkets, banks, even waiting lines at restaurants, were daunting as standing in one place was even more painful than walking. The pain awakened me at night when I tried to roll over in bed. I began sleeping with a pain tablet and drink on the nightstand next to the bed.

My doctor knew of my back pain but I had not discussed its steady increase in intensity with her. My husband was sick and my focus, medically, was more on helping him. But the day came that I could not prepare dinner…not even peel and chop an onion…without sitting down to “rest” my back. I could not put it off any longer.

Doc started with x-rays, anti-inflammatory drugs, muscle relaxers, and more potent pain killers—and a prescription for physiotherapy. Six weeks later, I was not improved…in fact, despite treatment, it was slightly worse. The x-rays revealed some lumbar facet joint arthritis, likely the source of my pain, but the treatment she prescribed had had no effect. She renewed my prescriptions to try to keep the situation from deteriorating further, and referred me to a neurosurgeon for a more detailed workup and treatment.

Have you ever had an MRI? If you have even the slightest tendency towards claustrophobia, I recommend against it! It took only twenty minutes—and my eyes were closed the whole time—but it was one of the more unnerving experiences of my entire life. And God forbid you should have an itch or a cramp or some other compulsion to move because you have to lay as still as the dead while inside what feels like a coffin, the upper portion of the machine literally inches from your nose! Then it shakes, vibrates and quivers while making the most horrific noises, everything from a deep rhythmic thrumming to an eerie space shipish sound. I endured, of course, as many before me have done, but the experience would not be on my list of things I’d enjoy doing again!

The result of the MRI was pretty much as expected: degenerative stuff due to aging and repeated injuries (accidents with horses, motorcycles, cars, stairs), slightly bulging disks, but nothing worthy of surgical intervention, a mixed blessing because it spared me another trip under the knife but limited the treatment options. He gave me some new prescriptions, this one for a high-level pain killer and a nerve-stabilizing pain reliever, prescribed a back brace and scheduled me for a procedure to have steroids injected into my back.

I left his office with mixed emotions: on the one hand, I was looking forward to the pain becoming just an unpleasant memory; on the other hand, anything involving needles and tender parts of my anatomy (my back was even tender to the touch) did not inspire great waves of enthusiastic anticipation!

The new drugs were an improvement over the old but still not able to adequately mask the pain. I hurt less, definitely, but my ability to go and do was not appreciably improved. The relieved the intensity of the pain but didn’t make it go away so, despite my trepidations, I was almost looking forward to the procedure.

It was amazing. Within hours my stamina had tripled: where before I had to sit down about every ten minutes while out on an excursion, two hours after the procedure I was walking around an antiques show and only had to sit down three times in an hour. The very next day I was able to take a shower and wash my hair without taking a break to sit down and rest my back and within days I was doing the grocery shopping without having to lean on the handle of the trolley for support. Before the week was out, I noticed my outlook was improving, that I felt more energized, less immobile, more willing to go out and about, looking forward to excursions rather than fearing them.

The back brace is a miserably uncomfortable thing, but it works synergistically with the continuing pain meds and the injections. I am returning to physical therapy and soon I shall see a biokeneticist to create an exercise plan to strengthen my back without risking the fragile progress we have made against the pain.

I’m feeling so much better, in fact, I’m beginning to feel like writing again…