Tuesday, March 20, 2018

Learning a lot about my body, and about pain


As many readers will know, I suffered a work-related back injury in 2004.  After two surgeries, I was left with a fused spine and permanent damage to my sciatic nerve.  I've been in constant pain, 24/7/365, since the date of injury, with just one glorious, all-too-brief break in 2005, when I was given an epidural injection of steroids to see if it would reduce inflammation in my spine.  (It didn't.)  A spinal anesthetic was part of the treatment, which numbed everything below my waist, including the damaged nerve.  That was the last time I remember being pain-free.  It's been my constant companion since then.

I've tried many things to control the pain, and live my life despite it.  They've ranged from cocktails of various prescription narcotics, through physiotherapy, to actually seriously considering cutting the damaged nerve and (if necessary) amputating the affected limb.  (That didn't go anywhere.)  The medical advice I was given was, in so many words, to "suck it up" and accept it.  Unfortunately, that led to other complications, including a severe drug interaction between some of the medications I was prescribed, leading to massive weight gain and major metabolic problems.  It hasn't been fun.

Eventually, I got fed up with doing what the doctors were telling me.  It was killing me slowly.  I had to find a better way.  For the past nine months I've basically thrown my doctors' recommendations out of the window and followed my own path.  It's led to increased pain, but also increased mastery of my own body, and for the first time in a long time I'm feeling relatively human again.

The core of my new approach has been strength training at Mark Rippetoe's gymnasium, following the Starting Strength program.  It hasn't been easy, and my progress has been much slower than "normal" beginners, but from the perspective of one who's been half-crippled for a long time, it's been nothing short of remarkable.  I owe Mark and his coaches, particularly Carmen, a huge debt of gratitude for taking me on, with all my challenges and difficulties, and helping me to overcome them.





Despite my early progress, I began to find, a couple of months ago, that I was hitting a wall.  My damaged sciatic nerve and its associated problems were causing me more and more pain as I pushed them further and further.  I couldn't see a way past this, until I asked for the help of a chiropractor who also attends Mark's gym.  He understands the mechanics of our exercises from personal experience, and can therefore use his training and education to analyze, diagnose and help solve the issues that have been holding me back.

What's emerged is that pain such as mine - centered around damaged nerves and skeletal structure - has far more wide-reaching effects than I'd ever considered.  The sciatic nerve, when irritated and inflamed, affects muscles all around it, up and down the leg.  (See, for example, piriformis syndrome, one of my difficulties.)  Those muscles, in turn, when irritated, exert an unhealthy influence on other muscles to which they're attached.  I'd never considered that my diaphragm might be overstressed by a thigh muscle, but that's apparently one of the problems I've been having;  and because the diaphragm was overstressed, it was pulling ribs out of alignment, which was affecting my spine above the fusion site, which was . . . you get the idea.

I've got a long way to go yet, but I'm already seeing light at the end of the tunnel.  If the strained, overstressed muscles affected by my nerve damage can be relaxed, they'll stop pulling other muscles and skeletal components out of alignment, and I'll hopefully be able to break through the "plateau" I seem to have hit in strengthening my body, and move on to the next level.  This isn't reducing my nerve pain - in fact, it's greatly increasing it during treatment! - but it's helping me to understand just how various elements in my body interact (or fail to do so) under the impact of nerve pain.  I'll still have to rely on painkillers, but better posture, greater ease of movement, and a more smoothly functioning body should help me stay mobile and healthy for much longer than would otherwise have been the case.

If I hadn't embarked on this journey, I think I'd have been in a wheelchair before long, and perhaps bedbound a year or two after that . . . and it's very hard to come back once one accepts those restrictions.  I'd much rather live with greater pain, and push myself, and remain as healthy as possible.  I'd therefore like to encourage any of my readers who are also in constant pain, to consider pushing their limits as far as they're able to go.  It may be difficult physically, but it may also help you bear your burdens and regain some of your humanity.  IMHO, that's worth the cost.  I also think it's a heck of a lot healthier to do that than to simply increase one's medication level, and let the medical system consign you to early oblivion!  That's the easy way out, but you end up a physical and mental vegetable.  I can't - I won't - accept that.

This is also helping me to write more, and hopefully better as well.  I'm almost finished a military science fiction trilogy that I began on the spur of the moment last December, and I'm looking forward to bringing it out soon.  If my increased productivity continues, I'll be able to produce more work, and earn a better living for myself and Miss D. (who brings her own part as well, of course).  I hate the "soggy brain syndrome" that excessive pain produces in me.  If I can become healthier in body, then perhaps, in spite of the ongoing pain, I can have a healthier and more creative mind as well, as Juvenal put it.

Food for thought.  I hope it helps some of you who may suffer from similar issues.  In particular, if you're struggling with health issues that the medical profession doesn't seem able to solve, consider the Starting Strength program.  There are gyms offering training in many states, and online coaching is available if there's no gym in your area.  Miss D. and I can testify from our own experience that the program really is worth all the time, effort and money it will cost you.

Peter

15 comments:

Arrgh said...

This guy has useful videos...

https://www.youtube.com/channel/UCe0TLA0EsQbE-MjuHXevj2A

CGR710 said...

So, about the trilogy - when should we expect it?

Peter said...

@Arrgh: I'd be very careful about those videos. They aren't designed to build overall core strength, but emphasize "the burn". That's not what Starting Strength is all about.

@C.G.R.: I'm working on it. Look for the first late next month, if all goes well, followed by the other two at approximately 30-day intervals. I'll have more to say about that soon.

Arrgh said...

His videos on working around joint issues, and having proper form are more what I meant.

Go to youtube and search for athlean x knee/shoulder/whatever bothers you.

If you're doing only the big compound exercises you can search for them to get form pointers as well.

Jim said...

A couple of years ago I had sciatic pain that was caused by arthritis in my lower back. The pain was debilitating at first, then gradually started tailing off. After about 6 or 7 months it simply went away and hasn't(yet) reappeared, thank God. You have my respect dealing with this year after year in a proactive way when it would be easier to just give up.

Anonymous said...

Good for you for seeking treatment and deciding to make yourself stronger instead of just bitching, which is what most people do. Very inspiring.

Anonymous said...

Peter,
Recently problems with my own forced me to reevaluate treatment plans and modalities. Not to sound like some folks, who think it's a cure-all, have you considered medical marijuana? I believe in some of my reading, I've seen something about it helping to block pain (transmitter or receptors, IDK), and reduce swelling and irritation. Also, you may want to consider massage therapy. In has been proven to not only be beneficial to the muscles, but also nerve impingement. I know some might consider both of these as "hippy-dippy, new age crap", but I can personally testify to massage therapy, as well as acupuncture. I haven't tried "burning the herb" since my twenties, as I'm tested regularly. Given the evolving state of things throughout the country, that to, may soon change!
Above and beyond all that, I must say, as a daily reader, thank you! You may never know how many of us you inspire as you take on your personal disability and pain. I know personally, all to well, how hard this can be. A thank is small reward for what you have given us, but maybe one day I'll get to buy you a drink!

Judy said...

You have my sympathy. I only know about the rib-pulled-out-of-place pain. Once a rib is pulled out it doesn't want to go back in, nor stay where it belongs. Too many muscles involved going different directions. The last go-round took forever. I used a TENS unit to keep the muscles from spazzin' out and dislocating the rib again until the rib and muscles got used to being where they belonged.

hammer said...

I know how bad sciatic pain is but fortunately a two level fusion took out the main pain. I still have residual pain from nerve root damage but I am able to get away from opiods.
I have a friend who has a lot of issues from agent orange exposure. He fractured his upper leg a year or so age resulting in a rod and pins. One of the pins broke causing much pain and medical advice saws it would cause more problems to try and replace it. He has gone to using a canabis oil message treatment and has gotten completely off the opiods. Supposedly no psycoactive elements. It might be worth a try if it isn't problem in your state. Here in Alaska pot is legal.

Will said...

Back in the 80's, my sister developed a really bad case of sciatica. Doctors and drugs didn't help at all. Chiropractor made it worse. She looked like a hunchback, she was so bent over. Someone suggested acupuncture. She was pretty desperate by then, so what the heck, there was a practitioner right across the street from her home. She started getting better almost immediately. IIRC, it took about a dozen visits to get her back to normal, with occasional tuneups to maintain it.

BTW, as far as chiropractors, what I found was that it is as much an art as science, and someone may have to try several doctors to find one that works for them. After trying a couple, I ended up at a clinic that had three, and got three different results, even though they were all doing exactly the same thing. One was great, one was ok, and one left me in worse shape than I arrived in. In my case, it seemed the difference was in the amount of force being applied. I got the best results with the biggest, strongest guy, and the gentle guy didn't work at all. Which seems strange, as I'm not big, at 115-120 lbs.

Will Brown said...

With all of the usual cautions required for YouTube videos, being a fellow proponent of Starting Strength, I have found these two physical therapists' video's to be helpful in my own (largely self-directed) exercise and pain management efforts. They have videos specific to sciatica, along with their more general approach to physical health management. I hope you find this resource helpful as well:

https://www.youtube.com/channel/UCmTe0LsfEbpkDpgrxKAWbRA

Peter said...

@Anonymous at 12:34 PM: Medical marijuana is a no-no. I own and use firearms. On the Form 4473 you fill out to buy them, you're asked this question:

Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance?
Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.


If I use medical marijuana, I'd be committing a felony offense under federal law, and would disqualify myself from owning firearms. Ain't gonna happen.

Paul, Dammit! said...

Peter- I spent the last week with one of my brothers, who has degenerative disk disease, a fusion, and a half-dozen failed surgical interventions in between. His injury, like yours, was work-related.

One particularly insidious aspect that you haven't touched upon but which might be worth exploring is how workers' compensation or other insurance-underwritten medical care programs force suboptimal medical treatment on recipients. Has this happened to you? Doctors throwing pain medication instead of medical treatments, things like that?

Given that you have to take a maintenance dose of pain medication, how do you ensure that you don't mask the warning signs that you might be pushing yourself too far in exercise? I had to physically stop my brother from lifting a 200-lb beam just the other day, because he was having a 'good' afternoon.

Anonymous said...

Peter,

Have you looked into practicing tai chi? From what I've read the relaxed and circular movements of tai chi encourage gentle opening of the joints and muscle stretching. This type of exercise can strengthen your lower back and reduce nerve root compression, relieving the pain associated with sciatica.

Leadhead

(I am not a doctor or in any way associated with the medical profession. Just a regular reader who enjoys your blog and giving my 2 cents worth.)

Ruth said...

It gets even more complicated for women.

I just (in January) had an extremely enlarged cystic ovary removed. I'd an incredible lack of overt symptoms, to the doctor's bafflement. But discovered a change in my body less than 2 weeks after surgery that I'd not expected.

Since early 2010 I've had "diabetic nerve pain" in my left thigh. Had repeated bloodwork done to try to diagnose me as diabetic (spoiler, I'm not diabetic). Mostly numbness, but occasional stabbing pains as well, in the outside of the thigh, right above the knee. It would spread and contract randomly. 3 different doctors basically shrugged and said well, if you're not diabetic it might be the result of surgery you had in that location as a teenager, we can do more surgery to "correct" the offending tendon if need be! I told them it didn't bother me that much....

It turns out that "thigh pain or numbness" is actually a not uncommon symptom of an enlarged ovary.

Guess what became drastically reduced less than 2 weeks after my surgery?

Its kinda amazing how its all connected, and how little doctors can sometimes see it all.