My Personal Pain Diary

TheKettleBellPhysioBlog, Pain, The Kettlebell Physio, Uncategorized0 Comments

While driving to work yesterday I had a plan to compile a ‘personal pain diary’ for the week. It lasted 24 hours.

Monday Oct 24:

1. Woke with the usual low back ache and stiffness – quickly resolved once moving.
2. Sharp pain in the left side of my neck turning my head rapidly in the car. It disappeared as quickly as it had appeared.
3. An unusual mid-thoracic ache I didn’t recognise for most of the 50mins driving to work. On occasion it referred around to the front of my chest on the right.
4. The ache in the top of my right proximal hamstring (proximal hamstring tedinopathy several weeks ago) returned for the last 5 mins of the drive then disappeared once I got out of the car.
5. Bending forward toward the ground created intense low back ache – that happened every time I did it throughout the day – not DOMS.
6. Following a 45min class at 6pm, 5 reps into completing a training schedule of 50 snatches, I had a sharp pain on the inside of my right upper arm; it was sufficiently uncomfortable for me to immediately consider stopping but I pushed on and by 20 reps it was gone. An hour later when I got home I started getting disabling pain on the outside of the same arm which made normal activities extremely uncomfortable – wiping the floor with a cloth was bordering on unbearable. It didn’t interrupt my sleep but I was aware it was still there in some positions.
7. Sharp stabbing pain in the top of my left foot before a shower – disappear as quickly as it had started
8. Bottle-feeding my daughter at 2am mid-back pain located somewhere between (1) and (3) and a different sensation to the usual
9. 5.15am – could feel the onset of DOMS in my left thigh ascending stairs

My plan was to continue this for a full week but it quickly occurred to me that I would be spending an awful lot of time focusing on my pain and not the other things in my life that make pain a lot less relevant (see image). I wrote a personal account of pain earlier in the year (https://www.facebook.com/PRIDEPhysiotherapyandNutrition/posts/1693531684245456:0) but yesterday was the first time I’ve asked myself the question – “do I have persistent pain?”

I’ve had back pain on an off since I started driving a car 25 years ago. I’m pretty sure that I’ve spent between ½ and ¾ of this year in acute pain… and I think I’ve almost stopped noticing the background persistent pain.

Dr Bronnie Lennox-Thompson shared a blog post yesterday (https://healthskills.wordpress.com/2016/10/24/when-do-we-need-to-say-weve-done-enough/), highlighting the difference between clinicians offering to *reduce* pain, rather than offering to help people *learn how to live with pain*.

I live with pain. Sometimes it’s been acute and disabling, frequently it’s annoying, but mostly it’s ok. I know it’s not a “bad” thing that I have to get rid of. I’m not suffering, I understand that it’s ‘normal’ and nothing is wrong or broken – quite the opposite in fact. I’m 41 now and feel like in the best physical shape of my life in spite of it. I work full-time 6 days a week in my own business and I have two children under 4. I did recently give Jiu Jitsu a crack but after feeling pretty battered following 3 from sessions, make what I feel was a smart choice to not continue, and that’s ok too. If I’d taken up Mui Thai it would have probably been a similar outcome – choosing a contact sport is also accepting the risk of discomfort and injury.

Life and living continues regardless of how we feel. Many of us are familiar with the message of focusing on happiness and being positive rather than misery and negativity; we will find what we’re looking and what we choose to focus on tends to become more prominent.

Dr Karen Litzy (DPT) interviewed Dr Bronnie (PhD) for a second time in episode #234 of the Healthy Wealthy & Smart podcast (https://itunes.apple.com/au/podcast/healthy-wealthy-smart/id532717264?mt=2&i=376757639) and in it she discussed how someone living with persistent pain can lose their identify when they stop doing the things by which they define themselves. I hurt my knee in the third session of Jui Jitsu and I wasn’t able to train and I quickly started to feel crap. A runner defines themselves as a “runner”; I define myself by what I do – I’m ‘The Kettlebell Physio’. I train with kettlebells and I bloody love them – I quickly became pretty miserable not being able to use them properly. We need to identify what’s most importance in someone’s life, focus on those things and set goals in relation to them instead of the pain.

“Life doesn’t stop – but the things we want to experience, the things we want to do change over time. We don’t get to hit the replay button and live life all over again. We get one shot at it. This could feel quite awful if we’re contemplating a life where looking for pain relief is our primary goal.”

“Living with pain. To me this means establishing my willingness to experience something I don’t enjoy – and believe me, I’m not a fan of pain! If all I have to look forward to is pain, pain, pain I’m not keen on doing it. BUT I am keen on living and bringing pain along with me (because frankly, my pain is coming along for the ride anyway). Living with pain to me means making room to experience pain fluctuations while doing things that bring value and meaning to my life. It means I ache – but I have a beautiful garden. I have sore legs – but I’ve been dancing. I have an aching back and neck and arms – but my house is clean. Here’s the thing: even if I didn’t work in my garden, dance or clean my house I’d STILL be sore! And I’d be bored, feel like I hadn’t achieved anything, and would have had to ask other people to help because many of those things still need doing.” – Dr Bronnie

For people living with pain, reducing pain is an important goal but so is living life fully and richly.

As Erik Meira discussed, (http://thesciencept.com/challenging-who-you-are/?) this is far easier said than done. “Now, tell me: How are you going to get rid of their pain or perceived injury when it is part of their identity? You won’t. Because a person will fight with all their might to preserve their identity. Their problem is not just their pain or injury; it is also their narrative. Until you change their narrative, you ain’t changing shit.”

Clinicians don’t focus on getting rid of diabetes; the focus is on management. What if we treated persistent pain the same way and learnt to live life in spite of it; controlling it rather than letting it control us?

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