Sunday Sundries: Chronic Pain

It's a real pain in the...wherever

Hi folx, welcome to Sunday Sundries where I write about whatever happens to be on my mind.

I was thinking the other night, as I tried and failed to find a position that was comfortable enough to sleep in, about how to describe the nature of chronic pain.

That night was one of many, many, many when I've been kept awake by pain that none of the available pain-reduction options work to get rid of.

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My Pains

Let me step back a moment for those that don't know this stuff about me yet.

I have multiple chronic pains, which also give me major mobility issues:

I have whatever remains of the slipped disc I got a few years ago. According to the pain consultant, it's probably fixed by now, but it seems like it's left impossible-to-see, teeny, tiny, injuries to the nerves. These give me sciatica, muscle cramps, and general pain across my lower back, which often radiates outwards. I get about 5 seconds of standing up before it hurts. If I sit upright—my torso up and my lower half underneath it—them moving again hurts a lot (depending on how long I had to hold that position). And don't even ask me about leaning forwards 😬😬😬😬😬

So basically the entire function of my core is damaged. It can't be used as a hinge, it can't stand me up or walk properly, it can't carry any weight, and every single movement increases the levels of pain until, if I don’t find a way to recover, I'm in a fog where nothing else exists except the sharpness of pain all across my lower back, down my left buttock and leg, and as it worsens, down my right one too. The rest of my upper body still retains much of its strength, it's just…mostly pointless now.

I have arthritis in both knees. The right one is manageable. The left one, which happens to be the one I smashed up in 2008, is a lot worse. There’s bone and cartilage that's just no longer there, having been ground away. So there's gaps in my knee joint, and very little acl to speak of. Unfortunately I'm only just about to turn 40, which is way too young for a new knee, and the surgeon I've seen is concerned that any other surgical intervention to try and make it last longer, might just damage it further, because of the weaknesses in the bone caused by the accident, where I had to have the shards pinned, screwed, and plated together again.

(*Side note: when the world-weary consultant at the hospital looks at your scan and goes “Oh wow, that must have hurt!!”, you know you're in trouble.)

So that always hurts too, and I'm sure you can imagine that my knee and my back trying desperately to share the job of carrying me around also causes more pain to everything else as well.

I also have, in my left ankle (where, in 2006, I broke a bone in my foot and dislocated the ankle) increasing levels and frequency of pain. At this point I'm too scared to get an x-ray, because I'm pretty sure it'll show arthritis in there too.

So…chronic pains? Yeah I have a few.

Photo by Anna Shvets

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Pain relief?

I take 2 pills 3 times daily. One that helps with the nerve pain in my back, one to help with the muscle spasms in my back.

On top of that I use ibuprofen gel on my knee/ankle as needed (and occasionally on the other knee). I use CBD when I can, but it's so expensive I can't just use it daily, it has to be there to help me sleep through the worst bits. I also like tiger balm, to go with the ibuprofen (which doesn’t always cut through the pain enough), but I ran out of that a while back, and I can’t afford to buy more.

I also have the option of cocodamol. I have the strongest version, to be taken as needed, so I use it when the breakthrough pain is too bad, and to help combat pain enough to try and sleep.

Finally, I have an electric mattress topper that provides some nice heat therapy for my back, but it's not exactly a miracle cure.

I used to have a TENS machine, and that helped my back, but it's dead and gone and I can't (say it with me) afford a new one.

So there's my circumstances.

Cosy office space ftw

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Back to the point

The other night, I hadn't done anything strenous. I'd been in the office—where I have a reclining chair, with extra lumbar support. Then when I was done, I lay on the bed.

But when I tried to lie down for sleep…there was just this constant, slightly sharp, pulsing pain, down the right side of my lower back and buttock. And it just would not stop. Didn't matter what position I tried. I did all the ones I know to go through which normally help a bit, and nothing. This is breakout pain, so I took some cocodamol, which soothed it a little, but not much as it's a general pain opiate.

Eventually I fell asleep, but as you may imagine, it wasn't very good sleep.

Good sleep is a relative term, of course. For me, between chronic pain and chronic insomnia, my version of good sleep will be very different to other people's!

And, shit, I'm not even telling you about the mental health nonsense I have going on. Other than the obvious fact that being in pain like this makes me grumpy and easily exhausted.

But during my lack of sleep I was thinking. Chronic pain, and the debilitating effects it has, are so hard to explain to someone who doesn't know it.

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It’s more than just pain

Often when we tell someone about our chronic pain, we immediately get told to just take X or use Y or do Z.

Every single day I have to try and judge what I can do, before the pain and fatigue levels force me to rest.

That's incredibly unhelpful, and patronising. Chances are someone in chronic pain has tried everything they can think of and afford to try. Unless we're asking for your thoughts, what we need is understanding that this pain can be unpredictable, making us unpredictable, and that it screws with absolutely everything, including things like time sense and appetite.

Photo by Jeffrey Czum

For example: I might really want to do something. But if I wake up in a level of pain that I know will not be feasible, and have to cancel short notice? I need to know that you understand: that it's not laziness, or lack of desire to do the thing with you. It’s that I either genuinely cannot get out to do the thing, or I know that I will wind up in so much pain it'll ruin my time, that of everyone around me, and I'll just have to leave early and be in even more pain, probably for days.

Chronic pain isn't invisible, but it can be hard to spot. You have to trust that people know their own bodies and what they can handle.

Just like a migraine is not “just a headache”, my chronic pain is not “just a back/knee ache”. It's not something I can prevent, or just push through. Every single day I have to try and judge what I can do, before the pain and fatigue levels will force me to rest. And I do it knowing that if I push it, or get it wrong, it will render me even more useless than usual for at least the next day.

Next time you have an annoying, acute pain, draining your energy and preventing you from doing…whatever. Consider that this pain you feel, is a small percentage of what folx like me have to endure consistently.

That muscle spasm that kept me awake the other night, was just an extra acute pain, on top of the other chronic pains that never go away.

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That’s all for now, thanks for your time. Please subscribe and share, and I’ll see you next time!