Wednesday, September 9, 2009

The Vicious Cycle of Physical and Emotional Pain

In the magazine "Neurology Now" there was a recent article about CRPS - Complex Regional Pain Syndrome, a condition in which nerves go crazy following an injury. You may have heard of it, esp. in relation to the ketamine coma, an extreme treatment administered in other countries. Some patients revert to this when there is no relief for nonstop extreme pain - they've tried everything from acupuncture to high doses of medications. In many cases,they decide to go through with this risky procedure as an alternative to suicide.

The main thing that caught my attention from the article was its wholistic approach to pain management. It pointed out that basically three factors are involved when someone experiences ongoing pain - the underlying causes of the pain, the pain itself, and the emotional affect it has on the patient. All three need to be treated.

I know this to be very true from my own comparatively minor daily struggle w/ discomfort. I call it that because it doesn't really hurt, it just nags at me, sort of like a sore stiff muscle or back ache. Right now as I'm writing this, I'm feeling pain in my backside, to put it delicately. I'm going to try adjusting my position which I do umpteen times a day to try to make it go away. (Editing note, after I finished this entry my discomfort was gone.)

There is a cycle that accompanies all this - the pain or discomfort creates emotional anxiety which then tenses the muscles which then leads to further pain. Of course the main thing to target is the underlying source of the pain, but that gets tricky for some of us folks. My physical therapist tells me repeatedly that I've got some of the most unusual symptoms she's ever seen. How does that make me feel? Good on the one hand, that I'm not going crazy, and terrible on the other, because it's harder to overcome. I have a hip rotation, SI joint displacement, one leg shorter than the other, and mild arthritis in my back (L1 and L2). Not an easy problem to fix.

Getting back to the article, the three things that need to be treated are the underlying source of the pain, the pain itself, and the emotional suffering. The author recommended targeting the initial injury area w/ physical therapy or some type of orthopedic related treatment, being under the care of a doctor who can help you choose appropriate medications to block pain and minimize anxiety or depression, and in some cases seeking psychological help.

If I'm understanding my body correctly, my vicious cycle goes something like this - first the discomfort/pain, then the anxiety and muscle tension accompanied by emotional distress, and finally twitching. I'm still under the care of a neurologist and am slowly weaning off of visits w/ the physical therapist while following her plan for restrictions/exercise. If needed I can go back to my orthopedic specialist and get more injections to the problem site. I take four prescribed medications, all of which are targeting the nervous and muscular systems. Fortunately, some of these also help w/ anxiety. I also take vitamins/supplements, some "prescribed" by my neurologist and others of my own choosing. I'm popping lots of pills!

When or if my SI joint stablizes (which is very unpredictable according to my physical therapist), I would like to try pain free living techniques that I've heard about. Right now those things could worsen my condition.

One last note, a secular medical article is often on target spiritually without knowing it, because it addresses the idea of wholistic health, pointing to the fact that we are God's creation. I like to remind myself that I'm here to glorify my maker, and my body is His temple, no matter how healthy. I should continually be striving for the best health possible, while at the same time accepting each difficult situation, knowing either way I'm an instrument to bring glory to His name.

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