I broke my back in October 2012 and lived with chronic pain for over four years. Unfortunately this is a reality for many people who undergo surgery or suffer from spinal conditions.
If you are a chronic pain patient, you have pain 24 hours a day, seven days a week, every minute of your life. The most common outcome of living with pain is depression. Pain can be debilitating and you spend a lot of time in denial and asking “why me”. The internet can be a good source of information to find out whether your condition is normal, but don’t become too hooked on reading medical blogs because it can also make you paranoid.
Living with pain is not difficult once you accept it and don’t make it the focus of your life. Nerve pain can last a long time, years or decades. Nerves repair at a rate of 1mm per week. The first 6 months are the most difficult, following which people typically go in either one of three directions:
- Depression and addiction to pain medication
- Passive Acceptance – accepting the pain but not doing anything about it
- Active Acceptance – accepting the pain but still seeking help and solutions
Ideally you want to aim to be at stage 3. Active Acceptance, however it can be a gradual case of passing through all stages. If you want to accept pain and move on with your life, the best mechanism for coping is a combination of exercise, meditation, ergonomics and pain relief.
The cause of nerve pain will vary for every person, however exercise will always help. Having dealt with nerve pain for two years, during periods I am very active the nerve pain is significantly less severe, irrespective of the type of exercise I am doing, than when I am not active. Even when every single movement causes extreme pain, exercise makes a huge difference in long-term pain management and general well-being. I sought advice from both a physiotherapist and a personal trainer to devise my own exercise plan, which involves cardio, stretching and some light weights with the key goal to strengthen my core muscles (the centre of all movement). It took approximately 2 months of regular exercise to realise the benefits, which were enormous. My preferred exercise regime now is a combination of medium-difficulty Pilates classes combined with some light cardio (40 minutes combined on the treadmill, rowing machine and stair machine per workout).
- Get advice from physiotherapists and personal trainers
- Exercise at least 3 times per week for 45-60 minutes
- Include some cardio-exercise in your work out for general well-being and releasing of endorphins
- Include activities that strengthen core muscles (yoga, pilates or weights)
- Any weight training should be done with a personal trainer for at least the initial 8 weeks
Regular meditation will help your mental well-being and provide the mental tools you need to withstand constant pain. Meditation does not need to be in the Buddhist style, the purpose is to focus your thoughts on preparing your body for recovery: mentally imagine your body including all the bones and nerves running through it, imagine the broken bones knitting together, envision the damaged nerves repairing, and block out the pain. You can meditate anywhere, even in bed before falling asleep. The focus is mental control not location or ritual.
- Mentally control your body
- Work through mentally achieving what your body must do to repair
- Meditate at least 1 time per day for 5 minutes
Whoever thought that the boring ergonomic claptrap was actually meaningful? But knowing how to get out of bed, stand up, sit and pick-up objects properly is actually important. It can break or make you. Do some reading online or speak with an occupational therapist to understand small things you can do in your home and work life to reduce further injury.
- Learn how to get out of bed properly (roll onto side and use your arms to lift up)
- When standing up, use your buttocks and stomach muscles to rise
- Sit on height-adjusted chairs so your feet are flat on the floor and your back is always supported
- Squat (not bend) to pick up objects
It is easy for other people to say avoid pain relief. However anyone who has suffered from chronic nerve pain knows it is debilitating and pain relief is a necessity. Chronic nerve pain can prevent people from sleeping, or make it impossible to walk, move or put any pressure on the legs. There are a few different options for medication that you can use exclusively or in combination, the key is to ensure you maintain the dosage. You should never take enough medication to completely stop the pain, you need to maintain some awareness of what is happening with your body and likewise you must allow some room to increase the dosage overtime as your body does get used to long-term use. Lastly, the side-effects of pain relief are considerable, so you want to minimise those as much as you can. Most doctors use the following scale, if your pain untreated is an 8 then try to reduce by 50% with medication. For chronic long-term pain, a combination of tricyclic antidepressants and opiate pain relief is sustainable.
Amitriptyline is the main type of tricyclic antidepressant used to treat nerve pain. It works by interfering with the way nerve impulses are sent to the brain. You will generally not see results until after 4-6 weeks of use, so many people give up on them quickly. It can be a good solution for long-term nerve pain because the side effects are minimum and decrease over time: constipation, nausea, irritability, and anxiousness. These also work well in combination with opiate painkillers and anti-epileptic medication.
Anti-Epileptic medications work by interfering with nerve impulses causing pain. You normally start with a low dosage that will increase over time. It can take a number of weeks before you can start feeling the effects. The two most common types prescribed for pain relief are Pregabalin (Lyrica) and Gabapentin (Neurontin). I’ve trialled both separately over a course of several months and found the pain relief to be fairly minimal and not worth the side effects include constipation, diarrhoea, dry mouth, headaches, increased appetite, weight gain (or loss, sometimes), and drowsiness.
Opiate Pain Relief
These are stronger than traditional pain killers and include Morphine and Codeine, or Tramadol which is a man-made opiate and most often prescribed. The pain relief is normally very quick, and you don’t need to wait weeks of trial like the above medications. It is not normally prescribed unless the pain is absolutely chronic and other medications do not work because there is a risk of mental impairment and drug dependence. Always take paracetamol in conjunction with any opiate medication because it increases the effects. The strongest and most common side effect is constipation and psychological and/or physical dependence. Withdrawal symptoms can be bad, so when it’s time to stop try The Thomas recipe for Opiate Detox.
The above recommendations will help to deal with pain on a day-to-day basis. However if your pain is long-term you will want to look ahead at other solutions such as alternative remedies, acupuncture, chiropractic treatment (not suitable for people who have had surgery), anesthetic injections, and surgery. Read other websites and forums for nerve pain and back-related problems, and speak with your doctor.