This last installment of The Hitch Hiker’s Guide to Pain: a trilogy in five parts (this might be the sixth post on pain; please forgive) should provide you with some tips on how to temporarily reduce pain in the lower extremities.
1. Legs on the Wall: “Anywhere, anytime…so long as you don’t mind dirty floors or having people stare at you.” This pain reliever was taught to me by a dear friend who is a gymnast and suffers from knee pain. Lie on your back in a supine position with your derriere at the edge of the wall and floor. Stay in this position for at least 15 minutes and make sure not to stay longer than 30 minutes. Bring a book or magazine. NB: It is difficult to write essays in this position.
2. Ice Plunge: “Go to the Arctic for a fraction of the usual price.” My orthopedist recommended that I do an ice plunge after I’ve been on my feet more than usual. So on those rare nights when I consume a large amount of alcohol (yes, alcohol is far and away the best pain reliever, but for obvious reasons I don’t use it for this purpose and am not advocating that anyone do so) and get home realizing that I’ve been dancing like a person without a foot condition, I plunge away (alcohol also distracts you from how freaking cold the plunge is). Get a large, deep container that goes half way up your shin. Fill 1/4 to 1/2 of the bucket with ice cubes. Add cold water, making sure to leave enough empty space for the water your foot will soon displace. Wrap neoprene around the affected foot (you can fashion an old knee brace into a foot glove by using duct tape and your imagination), ensuring that the toes are covered. Place your foot in the ice bath for 10 minutes straight. Bring stress balls or someone who is super funny and can distract you from the intense pain you will feel until your foot goes numb.
Make sure to cover your foot (feet?!) with neoprene.
3. Soap in Your Bed: “A Donation to Dove and Dial.” I have not tried this method, but one of my ortho’s patients, along with thousands of people on the internet, swear by it. Place a bar or two of your favorite soap under your sheets. Feel the magic. Bring a psychiatrist.
Pop a pill. Slap on a patch. Go see the ortho or podiatrist for an anesthetic or corticosteroid injection.
American society is centered around quick fixes for acute pain. Perhaps because some of us cannot imagine corporeal pain extending indefinitely into the future, and the rest of us can picture this scenario but are terrified of a freaky fantasy becoming a stark reality, we have inadvertently encouraged the construction of a medical system that often fails to deliver to its patients who have chronic illnesses and/or disabilities.
Take the example of pain control. After patients have narc’d out, western medicine provides them with scant resources to control their pain.
Most methods for the management of chronic pain have been transported here from other countries and cultures.
Who are the real dummies? Those who pursue complementary medicine treatments or those who reject them?
- therapeutic yoga
These “complementary therapies” are seldom covered by medical insurance companies and are thus inaccessible to most people experiencing chronic pain.
I have tried acupuncture and therapeutic yoga with minimal and moderate success, respectively. Four months of bi- or tri-weekly sessions as a human pincushion provided me with temporary pain relief; certainly not worth the cost, time, and unpleasantness (one day, the acupuncturist accidentally nicked a tendon in my hand. Fun stuff). My yoga instructor was influential in helping me realize that I could be fit, strong, and physically flexible with a dysfunctional foot. In this case, it was my own frustration at the slow pace of the practice and a persistent yearning to be tearing up and down a soccer field or spiking volleyballs that blocked me from continuing with what would have likely proved to be a helpful therapy.
FOOT FOR THOUGHT
Are these complementary therapies effective or are they quackery?
Should they be covered by insurance companies?
Can you think of other pain therapies that have been effective for you or someone you know (or have read about)?
How do you treat chronic pain without damaging the body?
Some people opt to alternate between narcotics. They face serious side effects that can interfere with functioning in multiple arenas of life. Others rely on acetaminophen for mild coverage. They realize that Tylenol is great for curing an average headache but lacks the power to dampen a dull, nagging pain or a sharp, shooting one. Others live with the pain sans medication. They end up on Prozac because chronic pain is…depressing.
I have found PRN (as needed) use of prescription-strength NSAIDs (non-steroidal anti-inflammatory drugs), namely Celebrex, to be a moderate path between narcotic use and disavowal of medication. But the Celebrex is suboptimal: in order to experience some pain relief, I must take the medicine for two days (two times per day). When I discontinue, the pain gradually intensifies to its pre-Celebrex level.
- You’re probably rolling your eyes…why don’t I take Celebrex every day?
Well, when you’ve gone to CVS to pick up your anti-inflammatories during a large flare-up and been told bluntly by the pharmacist, “miss, if you follow the instructions on this prescription, you will be putting yourself at great risk for a stroke or heart attack,” you come to love and hate the medicine at the same time: I’m grateful to have a fallback medication for flare-ups or to take preventively if I know I’ll be on my foot a lot (e.g., before and after a chorus concert). But I often feel I should live with the pain — no matter how debilitating — rather than increasing my risk for two cardiovascular catastrophes.
NSAID patches are a waste of money. Pennsaid, an aqueous NSAID solution, can provide some temporary relief but does not cut out that relentless ache.
Should I turn to herbs (including medical-card herbs)? Religious mysticism? Metallurgy?
Oxy — a small liberal arts college in SoCal. TyCo — an electronic company. Vike — a fishing tackle company. Perks — benefits; Steve Urkels — funny comedians who snort and ask, “did I do thaaaaat?” or proclaim their love for “Lauuuuura.”
Judging by the black/blue/purple hue of my melon-sized ankle and hot dog toes (no, this is not a picnic), the PA at the ER prescribed me some Vicodin. The next day, my orthopedist asked me which narcotics I would like to take with me to college. It was like selecting between beloved stuffed animals — both things that provide immense comfort but which you must conceal if you are to make new friends.
I didn’t know the difference between any of these meds, so I opted for the mildest one that would be sufficient for my pain level. I can’t remember which one that was because I was on narcotics. From looking back at medical notes, I’ve deduced that I was on a mixture of Percocet (oxycodone and Tylenol) and Tylenol 3 (Tylenol with codeine). I used one of them throughout the day and the other, which was sedating, at nighttime.
My ortho had joked that I could pay for my books and a sliver of tuition by selling some of the drugs (“each pill will go for $100 in Harvard Square!”). Yes, he’s a funny guy.
He’s also on target. I was propositioned for pain meds at least twice in the dining hall. The memory that breaks through the narcotic haze is when a 300-pound football player approached me and said, “man, that looks like an awful injury. You must be taking something for your pain…” (moves closer, whispering)… “how much per pill?”
It’s interesting how one person’s poison — the drugs that were making it difficult for me to concentrate on schoolwork or making new friends, and which were forcing me to take fiber supplements and consume mass quantities of whole grains and leafy greens — is another person’s candy.
FOOT FOR THOUGHT
Should we be disconcerted that medical professionals turn first to narcotics in the treatment of acute pain, or do they know what’s up? How have you managed your acute pain? Why do drugs that have so many negative side effects become popular?
Enough about shoes. We’ll return to footwear when spring hits and I pick your brains for sandal suggestions.
The topic for the next few weeks is physical pain. Don’t worry — I will refrain from making each post an organ recital or a list of the pain/anti-inflammatory medications I’ve taken in the past week.
Physical pain is a ubiquitous, multi-faceted phenomenon. Mothers who have not gone the cesearan route, fathers or other significant others who are socially obligated to listen to these women scream, injured athletes, survivors of car wrecks, and even the average Joe who stubs his toe have experienced pain, defined by the OED as
“Physical or bodily suffering; a continuous, strongly unpleasant or agonizing sensation in the body (usually in a particular part), such as arises from illness, injury, harmful physical contact, etc.”
Pain can manifest in every corner of the body at any time. Yet most of us find it a herculean task to verbalize just what we feel when we’re in pain.
- When have you felt pain?
- How would you describe the sensation(s)?
- Is it possible to agree upon an effective common pain scale?
I’ve been asked hundreds — if not thousands — of times to rate my pain on a scale of 1 to 10. How do I distinguish between a 6 and a 7? If my pain is a 10, does that mean it could not possibly get any worse? If I tell the doctor that my current pain level is a 4 or 5, will (s)he not take the pain seriously?
Please comment if you have particular sub-topics you’d like covered.