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Ouch! How to cope with pain?
September 13, 2010 5:59 AM   Subscribe

How do I cope emotionally with severe lower back pain? I have seen a doctor, and they said that I am doing all the right things, but it will be between 2 to 10 weeks before it stops. In the meantime, everything really, really hurts. Cuddling my partner. Standing. Walking. Grocery shopping. Driving. Going to the laundromat. Making the bed....

Ten days ago, I was kicked accidentally (and it really was an accident) by a total stranger.

Ever since, I have been in pain.

I've had xrays and seen a doctor and it's all good - it's just a muscle thing, and it should go away with rest, physio, massage, gentle exercise etc etc etc.

But in the mean time, I am in so much pain.

It's getting to the point that I am almost in tears about the pain and limited mobility every day.

And I am so angry that I didn't get the stranger's details... they have no idea how much pain/medical expenses they caused me, and I have no way of getting in touch.

Not that I would neccessarily have sought my medical expenses... but it would be nice to have them know what the impact of their actions was, so that they will be more careful in future, and not injure someone else.
posted by Hot buttered sockpuppets to Health & Fitness (32 answers total) 5 users marked this as a favorite
 
Have you been given pain medication and/or been referred to a pain clinic? 2 weeks in severe pain is a long time to go, and there's no need for you to be in pain if it can be avoided.

I believe that a pain management clinic can also help you deal with the emotional issues associated with pain. That's what they deal with every day.
posted by xingcat at 6:07 AM on September 13, 2010 [2 favorites]


Were you given pain meds? A friend of mine ruptured a disk (she was bending down to pick up the mail) and she was given heavy-duty pain meds for the first couple of weeks.

If you're in so much pain you can hardly stand up, and it makes you cry, then you need to talk to your doctor about pain management; healing takes longer when you're having pain.
posted by rtha at 6:08 AM on September 13, 2010


First, you might want to get a second opinion, just in case. Back pain can be many things, and not all doctors can't everything. Also, if you're in this much pain, are you taking anything? Did the doctor give you medication? If you don't have anything for the pain, you need to talk to the doctor again.

The only thing I can say, as someone whose had back pain daily for roughly 10 years, is that you will get used to it. The body does adjust. Do as much as you can to take your mind off it. Find any position you can that will give you some sort of relief, and do as little else as possible (you really, really don't need to make the bed right now, and maybe your partner can do the shopping, okay?). Warm baths, heat packs, If the doctor doesn't give you anything, there's advil or aleve and you should see which one works better for you (not both at the same time).

And it will get better. It will. Just believe that. Don't get discouraged, and honestly, if it hurts that much, feel free to cry. It helps relieve stress, which sounds like something that might help.
posted by Ghidorah at 6:09 AM on September 13, 2010


Doctors have as much of an obligation to manage your pain as to manage your injury. Be frank with your doctor about how much pain you're in. If your doctor doesn't take pain management seriously, its time to get a new doctor.
posted by anastasiav at 6:09 AM on September 13, 2010 [3 favorites]


Back pain can be really difficult to deal with. People don't understand how much of one's physical life gets channeled through the muscles of your back. I am still in recovery from back surgery and the list of what I am forbidden from doing is extremely frustrating. Basically, I can't do squat that might stress my back muscles.

Can we assume that your doc has prescribed some sort of pain-killer or muscle relaxer to help with the discomfort?

I hate to say this but there really is no magic bullet for recovering. It simply takes time. Are you on your own? Is it possible to get some temporary help with the physical chores (like bed-making, laundry, etc?)
posted by Thorzdad at 6:12 AM on September 13, 2010


I cracked some vertebrae a few years back and spent three months in a back brace. There were a huge number of things that became insanely difficult to do (tie my shoes, for example) and even sitting was kind of painful. I eventually stopped trying to compare my then-current condition with some idealized time when I wasn't in pain and unable to do simple things and just accepted that pain was what I felt at the moment. Weirdly, this made everything hurt less -- I think because I wasn't constantly reminding myself that I was in pain. I have no idea if this will work for you, and maybe it's not the kind of thing you can be told, but it might help.

I would also work on letting go of you anger -- I mean, assuming you could magically tell the stranger how you feel, what would that do for you? Since you can't, it's just keeping you focused on your injured condition, reinforcing the feelings of pain and damage. (Yeah, I know, easier to say than do, but, still....)

Sorry for the accident, by the way. That sounds miserable.
posted by GenjiandProust at 6:13 AM on September 13, 2010


On top of pain management (really, do this, really), you could see an occupational therapist. What an OT does is to help people work around injuries in order to live their day-to-day lives. As examples, they could give you some strategies or tools for things like showering and putting on pants and shoes (as a low back pain sufferer of many years, I know those are some of the hardest things to do on a daily basis when your low back is just not right).

You probably don't want to install anything permanent in your house, but this and other such tools (shower stool, perhaps, so you can wash your legs and feet without having to bend over, and such like) might be really helpful for the short term. Severe back pain really does make it impossible to do things normally, and the more you aggravate it by trying to do things normally, the longer it'll take to heal.

Good luck.
posted by galadriel at 6:34 AM on September 13, 2010


Take every pillow you own and arrange them so they completely support you in as comfortable as possible of a position, then just sleep until you feel better (no, I'm not kidding).

Also, you might try some kind of supported immersion... like sitting in a hot tub. I found that it was key to have enough water to feel floaty, but not so much water that there was actual floating. (And then sleep. Really, it'll help you heal, it'll take your mind off of it, and there's not much else to do.)
posted by anaelith at 6:37 AM on September 13, 2010


If it's a muscle thing, acupuncture can be immensely, almost immediately helpful. It also helps to speed the healing process.
You can get topical numbing patches from a doctor, as well as recommendations for anti-inflammatory meds. If you can figure out how to gently stretch without exacerbating the current injury, I would strongly recommend that - a physical therapist will be able to help you with that. Your back will be accommodating for the injured area by taxing other muscles and it would be immensely helpful if those were kept limber instead of tightening up. (I had a shoulder injury that affected me for months because my upper back tightened to the point of near constant spasming. This is what you need to avoid, trust me.)
A not long-term solution is muscle relaxers, which are crap for the daytime cause they will knock you the hell out, but if you are as upset about the pain as it sounds like you are, then you are probably holding yourself pretty tense and rigid, which will just add additional inflexibility to the situation. I personally save these for when I am in PAIN, but it sounds like you are there. Talk to your doc. If he is unhelpful, ask for a referral for either a good physical therapist or a pain management professional. Stoically soldering through pain is not condusive to quick healing, and a good doctor will know that.
posted by 8dot3 at 6:37 AM on September 13, 2010


Hot buttered sockpuppets: In the meantime, everything really, really hurts. Cuddling my partner. Standing. Walking. Grocery shopping. Driving. Going to the laundromat. Making the bed...

Why are you doing those things? I am not being a smartass but if you have a temporary but debilitating injury, you need to set your life up to behave accordingly. Someone drives you, someone does the laundry, someone makes the bed. None of those people is you.
posted by DarlingBri at 6:38 AM on September 13, 2010 [13 favorites]


I recommend Active Release Technique which is deep specific massage for muscles, tendons, ligaments; very effective for pain relief and for restoring function. You can search for providers "http://www.activerelease.com/providerSearch.asp">here. If you happen to be in Portland, I'd be happy to give you a free demonstration; send me a MeMail.
posted by olecranon at 6:48 AM on September 13, 2010


I wanted to second a hot tub or warm-water pool if you have access. I had terrible muscle problems with my back when I was pregnant, and went to a warm-water therapy pool 3x a week, just to FLOAT, which both lifted the baby off my back muscles where he was sitting very awkwardly (not your problem) AND lifted the weight off my muscles while providing gentle heat so they could RELAX (exactly your problem!).

They had me move my legs around in various patterns to help stretch out my lower back muscles, which did help, but even just being able to relax and float in the warmness helped a LOT.

Also, Fetal McGee completely freaked out that I introduced him to buoyancy, so that was pretty funny every time! "Mom -- mom -- mom -- what happened to gravity??? ACK!!!"

Also lying still with a heating pad, lots of supportive pillows, and pain killers and muscle relaxants!
posted by Eyebrows McGee at 6:59 AM on September 13, 2010 [1 favorite]


This question of mine from a couple of days ago is essentially about muscle strain in the lower back; there are a variety of answers that might be helpful for you, although it sounds like your situation might be a little worse.

You asked how to deal emotionally, though, not how to make the pain better (although making the pain better is important, if possible).

It's completely normal to be angry at mystery stranger who kicked you. Even if it was accidental. Of course, being angry isn't going to soothe your muscles, but don't beat yourself up for having a human emotional response. Thank you for knowing that it's just an emotional response, and not a reflection of the fact that the other person is somehow stupid or evil. Stuff happens, but you know that. It sounds like you have a generous heart.

Just endure, do as little as you can once you've exhausted all pain relief avenues, and wait for your two weeks to be over. Good luck. I'm sorry this happened to you.
posted by amtho at 7:35 AM on September 13, 2010


"just a muscle thing" can be incredibly painful and long-lasting - I'm saying this from the perspective of someone with a chronic trapezius problem that occasionally puts a stop to life as I know it. You have my sympathy!

When my problem acts up there are three things that help: flexeril, taken regularly every 8 hours for three to five days; 800mg ibuprofen, again taken every 8 hours (not "as needed" but regularly), and an ice pack, rather than heat (which has been suggested by previous posters). Heat, on the other hand, feels nice temporarily but seems to aggravate the condition if not followed by ice - IANAD and YMMV, but I thought I'd put the suggestion out there. I use a large ice pack that looks like this.
posted by chez shoes at 7:36 AM on September 13, 2010


Availability and desirability of the following will no doubt be personally questionable according to your circumstances, but I found the greatest relief from the mental burden of pain during my several past spells of severe back problems came from low doses of either valium or marijuana.

Just having the option of something that every few days would give me a couple of hours respite and allow physical relaxation as an option made a huge difference to my outlook.
posted by protorp at 7:38 AM on September 13, 2010


On top of pain management (really, do this, really), you could see an occupational therapist. What an OT does is to help people work around injuries in order to live their day-to-day lives. As examples, they could give you some strategies or tools for things like showering and putting on pants and shoes (as a low back pain sufferer of many years, I know those are some of the hardest things to do on a daily basis when your low back is just not right).

You probably don't want to install anything permanent in your house, but this and other such tools (shower stool, perhaps, so you can wash your legs and feet without having to bend over, and such like) might be really helpful for the short term. Severe back pain really does make it impossible to do things normally, and the more you aggravate it by trying to do things normally, the longer it'll take to heal.


I think this will be especially helpful in the emotional department-- after accidents and surgery, the frustration I experienced when trying to do the most elementary tasks added to the toll the pain was taking on my body. Or mind/body. If there are any hacks to make stuff easier it might make a difference.

WRT the anger: after being struck by a hit-and-run driver three years ago, I landed in the hospital for three days ($10000 bill) and was stuck with a broken elbow, a knee slashed through to the kneecap, and three chipped teeth. The guy didn't even slow down. I'm still angry, but in the end, even if I'd had a chance to yell at the guy and he'd taken a hit on his insurance and had his license pulled, the only person who was going to truly feel and recognize and suffer with my pain was me. It helped me stop thinking about him instead of me.
posted by foxy_hedgehog at 7:50 AM on September 13, 2010


First off, I wanted to say I am sorry to hear you are in this kind of pain!
I feel you in your frustrations in having your life hindered by pain. I have chronic pain in my lower back and I cannot for the life of me remember the last time I didn't have pain.
In terms of how to make this situation better, you should follow up with doctors and look into physical therapy (it doesn't do much for me but physical activity does help with my mobility as inactivity can make matters worse), medications, rest and reframing of the situation.
While being doped up is not the best of situations, sometimes opiates/muscle relaxers can really aid in allowing some form of normalcy as well as a temporary relief from pain. With continued usage, one gets use to the side effects and drowsy becomes less of an issue. Be aware that opiates disrupt deep sleep, and that alone can exasperate the pain you are in. I find some days are worse than others but taking some time out and listening to my body screaming 'STOP' can be helpful. Heat pads can do wonders as well aa hot showers for 20 minutes with appropriate stretches. I will second the marijuana, while I don't know if you live in one of the 14 states that allow it, marijuana can do wonders in the evening! I've also found avoiding alcohol to be a good thing.
Take care and I do understand your frustration. I hope you get better!
posted by handbanana at 8:05 AM on September 13, 2010


I had inflamed tendons of the hands for about a month and couldn't cook, barely wash my hair, etc etc. I understand the impatience with getting well. Some things just take time.

For the emotional / mental part, I suggest meditation. If you're not already practicing this, try yoga nidra--you just listen to a recording and it really relaxes me.

Part of what I hated was that I wanted to do so much but couldn't do because of my hands. If you are type-A-ish, like me, try to have a project like listening to a book on tape that will make you feel like you are still living your life.

I hope this helps!
posted by beautiful at 8:17 AM on September 13, 2010


I have chronic back pain. It sucks. If you are already on pain pills and they're not helping, ask your doctor about muscle relaxers, for sure, but also ask about Lidoderm patches. They were designed to treat the pain of Shingles, but work for any kind of pain. It's just slow-release lidocaine in a patch that you can put directly on what hurts. Not addictive. No particular side effects. Just sweet, sweet absence of pain.
posted by hydropsyche at 8:22 AM on September 13, 2010


I recommend the book "Full catastrophe living", together with the accompanying CDs. The book is basically about using meditation and mindfulness for dealing with problems of everyday life, being especially focused on people who have various long-lasting health problems. It has much material on dealing with pain (including specifically lower back pain) when medication doesn't work, advising among other things a mix of meditation, body scanning (a kind of meditation where you focus on your body's sensations) and yoga (to the extent it is possible for someone). This combination has very good results proven by extensive studies described in the book and it really helps to deal with both physical and emotional pain on many levels. You can get a taste of what it is about, by watching this video.
posted by jarekr at 8:28 AM on September 13, 2010


Seconding the acupuncture suggestion. I went to a traditional Chinese doctor and it was incredibly effective for my back pain. (Which made me feel savage even though, unlike you, I didn't have anyone to blame.) I did this after seeming my excellent MD, whose pain med prescriptions just did not work for me.
posted by bearwife at 9:53 AM on September 13, 2010


Coping emotionally is important, but I would focus on coping medically first. You need to go to your doctor and tell him/her exactly what you told us: "it's getting to the point that I am almost in tears about the pain and limited mobility every day." Tell the doctor what you've tried (I assume you've tried ibuprofen and/or acetaminophen?) and ask what would be more effective. Or see if you can get a referral to a pain management specialist. If your doctor doesn't take you seriously, find someone else. Managing pain is part of their job. There are no magic bullets and chances are that no drug is going to make your pain vanish (at least without debilitating side effects), but you should be at least trying to manage the pain aggressively from a medical context as well as an emotional one.
posted by zachlipton at 10:37 AM on September 13, 2010


I'm here to suggest acupuncture as well. Flexeril didn't really do much for me other than make me dopey; I could only sleep with an icepack on my leg; I could only stand or walk for a few minutes before I had to sit down. I had immediate relief from acupuncture, and by the 3rd session was almost symptom-free.
posted by mogget at 11:25 AM on September 13, 2010


Before letting any kind of therapist touch you have an MRI scan to understand why you are in so much pain. The last time I was in terrible pain (with everything fine on X-Rays), MRI scan revealed a very damaged disc.

That being said, what helps me get through a bad bout of back pain is getting an injection of Voltaren with Flexin.
posted by mirileh at 11:31 AM on September 13, 2010


I sympathize.

Beyond medical pain management, consider weed. If you know someone who has mellow stuff it can help a lot.

It never was hugely pain-relieving for me, but the big thing was that it made me NOT CARE that I was in pain. Being hurt is really stressful and sad, you can't do the things you want to do, everything is tainted by pain. Weed helps take the tension and sadness of that away for a while.

Good luck. This sucks so much but you'll make it through to the other side.
posted by the young rope-rider at 5:21 PM on September 13, 2010


Thank you all very very much for all the suggestions. ^_^

They left me feeling that I have more options available to me than I thought that I did when I asked the question.

One thing I realised as a result of all your comments - at a shop, rather than reach across a wide counter to hand the clerk money, which causes me significant pain, instead I should say "I can't reach that far" and just put the money down on the counter close to me or ask her to step around the counter to me.

They also helped me realise that it is normal to feel upset about being in pain - I had been mentally chastising myself for being so 'negative', sad and not optimistic just because I was in pain. (!)

Re: pain relief: I am taking 16mg codeine phosphate with 1000mg paracetemol. I try to avoid taking it because:

a) it means that I can't drive.
b) it makes me feel groggy / vague / out of it, which I strongly dislike, because I don't feel like 'me'.
c) it causes constipation.

But, clearly given how much the pain is upsetting me, I should be taking it more often than I have been.

I am also taking 50mg diclofenac, but this is more an anti-inflammatory than a pain reliever.

It was really helpful for me to hear people talking about asking my boyfriend for help with physical tasks. ^_^

Until July 2010 my boyfriend and I lived in different cities and I lived alone, so I am used to being very very self reliant and not being able to ask anyone for help.

So thinking "I can ask for help with X task" does not come naturally to me, especially when I am tired and in pain and not thinking clearly.

Also, I had an irrational fear that if I asked him for help, he would think that I was faking or exaggerating or being lazy, and he would think less of me, even love me less.

We had a conversation last night, and he reassured me that this was not the case, he was very happy to help me.

He also reassured me that he was not upset that we are not having sex at the moment due to my back pain.

I was afraid that because we aren't having sex due to my back pain, he might feel that I no longer loved him or desired him, but he assured me that he does not feel that way. ^_^
posted by Hot buttered sockpuppets at 10:03 PM on September 13, 2010


You asked about coping emotionally.

First of all, I suggest admitting that it sucks. And that it's hard to ask for help and that pain can be overwhelming. And that's ok. And it's ok to be upset about it and be mad about it and throw pillows or whatever. Pain is tough. Long term or even medium term pain sucks worse. And it's ok to admit that. It's also ok to know that doctors tend to be lousy about knowing about pain.

Two, find something that distracts you. Sometimes just focusing on something else for a while (in as comfortable a position as you can get into) helps immensely. A whole season's DVD of your favorite show? Trashy novel? Whatever works to put your mind in a different place.

Three, breathing helps. Pampering yourself as much as possible helps. Listen to the people above who said that it's ok, temporarily, to let other people do stuff for you. Slow down. Listen to your body.

Four, Sleep and tea.

And do pursue the medical stuff. It can help more than it's helping now.

I deal with chronic pain and I have been where you are now where someone accidentally causes a huge problem and you're just stuck in that horrible pain place, so I empathize. If you want to talk, MeMail.

I hope it gets better soon.
posted by eleanna at 10:37 PM on September 13, 2010


OP,

re: your follow up, to be in pain is a total libido killer. And yes, it is a complete damper on ones spirits, but just be persistent and follow up with doctors, and hopefully with time, things will get better.
posted by handbanana at 11:12 PM on September 13, 2010


Hi there Hot buttered sockpuppets,

Firstly I'm so sorry you're in so much pain. I have actually just been through almost exactly your situation a few weeks ago (gratuitous link here and an update about a fortnight after, here.)

It's now been 3.5 weeks for me, and I'm only just starting to be able to sit for longer than 40 minutes and am now managing to be off the mattress for about half the day. I am on 30mg codeine painkillers and anti-inflamms twice a day, and I totally see where you're coming from about not wanting to take them, but just do it. I didn't want to either and it greatly hampered my quality of psychological state!

I can totally relate to all the anger, emotion, and frustration you are going through - in some ways, it is almost as bad as the constant pain. Here are my experiences and what I did, hopefully some of it will be helpful:

I was able to cuddle my partner after about 10 days. I too went through the same issues of wanting to be self-reliant and fearing he would resent the lack of intimacy, as well as having to help me so much. It turned out, after a couple of tearful conversations, he was more upset that I was in so much pain and wasn't my usual happy self.

I learnt to ask all my friends for help. Having been in the role of caretaker myself, it's much easier if the burden is split. About 7 of my closer girlfriends came over every evening in turns to assist with simple things like bringing me food, keeping me company and doing my laundry/everyday tidying. This also took the load off my partner who was run off his feet working, running my business for the moment and coming home at 10pm to a needy me! It also kept my emotional state in check, because I was able to vent to them and they were very understanding!

I slept a lot, because of the debilitation. I'm still doing 8 - 9hours a night and if I've gone out, a 2 hour nap is needed.

On recommendations of my doctor, I didn't drive at all (I did try, and ended up wanting to cry at the end of it. Being seated and pulling a steering wheel around is not good in these early tender times!)

To help with intimacy issews, my partner helped bathe me and washed my hair. This went such a long way to helping me feel physically close to him and sensual again. I went through a huge period of feeling unfeminine and unsensual. It helps if your partner is happy to do something nice for you, a date night - mine set up a picnic in the living room and fed me whilst we watched a movie, and he moisturized and massaged my body bits that were not my back. VERY helpful for emotional state.

We set me up a laying area in the living room so I could stay connected - when my partner was cooking or friends visited, I was right there in the thick of things. YMMV with this if you don't need to lay a whole lot but I find lying flat is really good for the back as much as possible and sitting is the WORST, so I lay whenever I can. Our setup is a mattress, a stand to put my laptop on, and phone, drinks, snacks in easy reach. I moved as little as possible and I think this helped a lot in the first week. The first weekend I tried resuming some normal activity and was duly punished by my angry back.

I used the first week to do all the things I had put off for a long time. Watch tv shows, catch up on emails, read books. The great thing about catching up on emails is that it keeps you in contact with people whilst you are going through this. Try and find reasons to lay, things to do you can do when lying down. then you are being productive AND rehabbing!

Expect to be angry and accept that it'll come. I had whole moments of angry tears, and I would type out all the rageful feelings I had and email it to my closest friends. I'm a professional dancer so this has been fairly damaging not just to me but my career, my business and my ability to plan for future gigs. You will feel like it's super unfair. You will feel sad. You will feel pathetic, useless, and like you can't do anything adequately. This is normal. (And will linger!)

At the moment I'm typing this to you from my laying area. As I said, it's been 26 days and only now am I managing basic stretches and exercises, and short trips out of the house. I'm going to try driving tomorrow, and I managed a 3 hour excursion on Sunday without too much backlash (ha! did you see that??).

But overall, the overwhelming advice I have been given and I'll give you is to let it heal as much as possible. Backs are iffy things and I've pushed through many injuries in my time as a dancer. This one scares the holy macaroni out of me so much that i'm giving it the full time it needs. And I'm already seeing the results in that I'm feeling like I can now do some things because I'm genuinely better, not because I'm pushing through the pain.

Don't do anything. Your back will thank you for it.

Sorry for the essay - Memail me if you want to commiserate!
posted by shazzam! at 1:12 AM on September 14, 2010 [1 favorite]


We had a conversation last night, and he reassured me that this was not the case, he was very happy to help me. He also reassured me that he was not upset that we are not having sex at the moment due to my back pain.

If he's a fixer, like my husband (and like many, but not all, men), he probably actually really appreciates the chance to GET to do things for you. "Here is the person I love hurt, here are ACTUAL CONCRETE THINGS I CAN DO to make her life better!"

My husband doesn't like it when I'm hurt, of course, but he loves feeling like he can do things for me to help ... and I, too, am normally pretty self-sufficient like you, so I think he likes the chance to baby me a little and get to be the fixer. :)
posted by Eyebrows McGee at 9:13 AM on September 14, 2010


Listen to shazzam! Your life should more or less look like that right now, and from what you've written, I suspect it doesn't.

Backs are tricky. They require rest and a lot of it. If asking for help for 2 - 6 weeks to get to full recovery seems like an impossible hurdle, remember that it beats the snot of having to ask for help every single day forever because you did not give yourself the best possible chance at recovery and your back is now truly fucked.

Please add the very explicit phrases "I need you to help me" and "I can't do that" to your vocabulary. Use them, often.

And yes, better drugs for the win.
posted by DarlingBri at 11:34 AM on September 14, 2010


"Ten days ago...
it's just a muscle thing
"

Please don't hesitate to go back to the doctor or to a different doctor to check this out. You sound like you're in too much pain for too long for this to be a small muscle strain.
posted by mirileh at 7:57 AM on September 17, 2010


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