I haven’t very often suffered from significant chronic pain in my life; a fact that I am quite grateful for as I’ve worked with many patients who have faced this condition. I always had considerable empathy for their plights, but never fully understood how incapacitating it can be. And the anxiety of such pain continuing for a prolonged time doesn’t help matters much either.
So, the other day, after sitting through two and a half days of faculty retreat meetings on miserable, inflexible steel framed chairs, I felt a crushing pinch in my neck that radiated pain starting at the neck which traveled down beneath my scapula. Ouch. Over the next few days, the pain only intensified, reaching a level of about 8 on a 10 point scale. You know what? It gets rather hard to concentrate on teaching, reading, or much of anything else when your body radiates those kinds of exquisite sensations. Sleep doesn’t come all night and one’s mood deteriorates faster than a spoiled banana.
So it took me about four days to connect with the thought that calling my doctor might be a good idea even though I was out of town. I did so and he called right back. He told me (and later confirmed) that I probably had a nerve compression at C4/5 which was causing the whole thing. He said we should jump right on it and perhaps we could get things to settle down. Well, not jump in the literal sense, but fill me up with an armamentarium of medications to reduce the inflammation/pain cycle that had set in. Without getting into the actual details, he gave me scripts for serious inflammation, pain, and muscle relaxants.
Wow. What a help. Immediately relief came to me although I could tell there was still some trouble with inflammation. After another week or ten days or so, I’m tapering off these things and so far it’s working out pretty well. It’s getting a bit less likely that we’ll have to do anything more seriously invasive which is a big relief. So why I am writing you about this experience?
Mostly to warn you. If you have to go onto a set of fairly heavy duty medications like these, monitor yourself closely and watch just about everything you do! Of course my doctor said don’t drive on this regimen and definitely don’t fly any airplanes (his attempt at humor I assumed). What he didn’t say was be careful about just about everything else you do too. During the peak dosing periods, I managed to answer several two year old e-mails (not having noted they’d been answered a very long time ago), could not for the life of me remember my cell phone number, and expressed myself with unusual incoherence. And I was only marginally aware that I was messing up–my wife helped point out to me that I was looking a tad pathetic. Fortunately, she also offered to start looking over my e-mail replies, blogs, etc. Although I did slip in a few unusual mistakes in a comment on one of John’s nice blogs (sorry about that John) and I even forgot to mention that some of my source for that comment came from a friend and colleague, Brad Richards, Ph.D., A.B.P.P.
If you come down with a serious pain problem, call your doctor right away. Sometimes you may get lucky (like it’s looking I will be). But if they put you on a bunch of potent stuff, don’t fly airplanes and be careful about pretty much everything else too.
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PsychCentral (February 2, 2010)
Your cautions are right on – I would like to add that medication is great in acute situations but how about some empathy and understanding for your spine…what it needs to function normally is to reverse the insult..like passive posture adjustment: assume the opposite posture/action from that of sitting in the chair, hang over head down and let gravity gently bring all back into alignment and allow the movement of breathing to release the muscles. I’m not a PT, just one who has suffered long and seen reliance on meds past the acute moment have dreadful results. Chronic pain is the abused stepchild of modern medicine.
@Lomi: You’re absolutely right! Other approaches are usually much more effective past the very acute stage. Thanks for sharing your thoughts!
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