Pain Management – a lifestyle

All the pages here are taken from a planned book on pain management, but which never transpired as the content wasn’t deemed ‘upbeat’ or ‘rosy’ enough by the publishers. Nonetheless, the pages can be seen as part of such a guide called ‘Taking Hold of Pain Management: A Practitioner’s View’. The pages are gradually being ported over to a  single blog, and perhaps extended, so please bear with me when links are incorrect.

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Pain Management is a fact of life for some of us.  It is needed when a disabling condition causes continual or frequent pain.  What’s key, though, is it does not mean that those using Pain Management techniques are pain-free: all it means is that we manage the degree of pain such that we can live as useful a life as possible.

Discussions and experience about Pain Management will be very personal. Everything here is what I have learnt, adapted and understood so should not be seen as a negative comment, criticism or reflection upon the professionalism and skills of the care I have received at the hands of the excellent surgeons and specialists at Salisbury District Hospital. Indeed, I would recommend the Plastics, Rehab and Spinal units at SDH to anyone.

So, to be personal, my pain is focused from my right shoulder along the arm to my fingers. It is related to a nerve problem, primarily the ulnar nerve, and is possibly due now to some form of entrapment in the shoulder and, certainly due to the legacy of scar tissue from various operations.

The whole things started as an accident at work in late 2008. I slipped and fell, unable to control myself, and knocked myself out on a concrete patio (I’ll never know how the customers inside didn’t see me through their patio doors). I crunched my shoulder and right side, leaving me in severe – and I mean really severe – pain.

Diagnosis was initially problematic.  I had several surgical procedures to relieve nerve entrapment at the wrist (Guyon’s Canal) and elbow (Cubital Tunnel Syndrome), which relieved some of the pain, but not all.  I was then diagnosed with (accused of having?) a non-nociceptive pain disorder, which means the specialists think there’s nothing physically there but it’s a brian-nerve dysfunction. However, I did not respond to any of the treatments for that sort of non-specific pain.

I have to be honest in that this was a very frustrating time, during which it felt as if I was being accused of making up the problem! Something that other sufferers of Chronic Pain also experience.

However, I was subsequently identified as having Thoracic Outlet Syndrome (TOS), amongst other things.  This means the nerve outlet  from your body to your arm is closed up, clenching around the nerves.  It gives pain, substantial control problems and clumsiness (lack of control: dystonia) – in my case I have no fine motor control and the arm often just jerks around on its own (dangerous in the kitchen: a pity, as I used to like cooking).

Another operation helped relieved a fair amount of pain. This means I am now able to do a few things with my right arm and even able to travel a short distance but, in both cases, I have to rest afterwards.  However, despite the good news, every keypress on a keyboard is painful; driving is painful; lifting objects, moving my arm and having it knocked is painful; movement to the arm, especially raising it creates more pain so that walking, running, or having my body jolted from being in a car or on a train is dreadful. The pain and lack of control stops me doing a great deal.

In other words, pain is constant. I won’t call it a companion as I don’t want its company, but it’s there.

The only way to relieve the pain is through analgesia, anaesthetic, other drugs, rest, pacing, distraction, relaxation and other techniques in a very strict Pain Management regimen.   You can look at the Pain Management approach as Life Management.

(I also have a growth on my vocal folds that makes continual speech a problem and pitching a note an exercise in luck.  This is really frustrating as I used to teach singing and voice and underwent substantial amounts of training! )

Ultimately, though, life has to move on, hence my focus on writing.  This part of the blog is intended to have snippets added to about Pain Management and, sometimes, disability in general so, perhaps, others can see what it means and, maybe, others can learn about it.

However, I have begun to collate my experiences into an insiders view of Pain Management, seen in this introduction.

Take care of yourself.

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An excellent short Youtube clip “Struggling to be me” comes from an ethnographical study of Chronic Pain sufferers. It highlights a lot of problems and the way such sufferers can feel. It can be found on Youtube at Struggling to be me.

Books on Pain and Pain Management

I’ve read and researched loads of these from the hospital and other areas but cannot remember their titles. I’ll provide more information as I can, but in the meantime try the External Links below.

For those who prefer listening to information, there is a Living with Chronic Pain CD. This provides a general overview of pain but is mostly focussed on relaxation and dealing with negative emotions (depression, etc). A good starter, perhaps.

External Links…

…were getting a bit too many so have all been moved to another page. There are several new initiatives in the 2020’s, some of which may provide some hope.