The Definition of Pain

Pain by Harsha KR mynameisharsha 5832815994 EDIT

"An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage."

~International Association for the Study of Pain [1]

I've been blessed with good health throughout my life, not to mention good luck. Nineteen years ago a motorcycle accident that should have mangled me resulted in nothing worse than a broken arm. A few years after that I avoided what would have been a useless lower back surgery when I realized that the increasing pain I'd been experiencing was stress-related, and a modest effort at managing my stress ended my lower back pain permanently. But the last six weeks have been different.

I've frequently been in pain since mid-January, when I experienced what felt like a severe muscle spasm in my upper back. I've occasionally had minor spasms in my upper back over the years, typically after working out too hard, but they would always disappear after a few days of rest. This time, however, the pain didn't go away, and I developed some new (and scary) symptoms, including a sore neck, pain radiating down my right arm, tingling and numbness in my right hand and fingertips, and significant weakness on my right side.

Thankfully, when I'm highly focused–most notably in a coaching session–I lose awareness of the pain, so it hasn't prevented me from fulfilling my responsibilities to my clients and students. But it's certainly affected the rest of my life, and I feel a lot less joyful and more somber than I usually do. After taking it easy for a few weeks, my condition improved a bit but eventually plateaued, and I finally realized I needed to see a doctor.

The definition of pain above was quoted to me last week by (the fantastic) Dr. Judy Silverman of St. Mary's, who diagnosed me with a herniated disk adjacent to my C-7 vertebra, which has apparently damaged the nerves running from my spinal column to my right arm and hand, resulting in the pain, tingling and numbness. The pain improved somewhat after the initial trauma to the nerves, but it didn't go away–and the other symptoms worsened–presumably because some specific movements and body positions continued to irritate the affected nerves. Dr. Silverman and I agreed that surgery and pain medication weren't warranted, and she's referred me to physical therapy, which begins this week.

So what have I learned so far?

1. I can be still–at least for a while.

In March 2009 I had perhaps the worst cold ever, and as a result I realized that, "I don't do stillness well…and perhaps I should find a way." [2] I was sufficiently rattled by that experience that I knew I needed to make some changes, and I did. After years of half-hearted efforts, I finally got serious about meditation, and today I have a capacity for stillness–both the voluntary stillness of meditation and the enforced stillness that this injury is imposing on me–that I never had before. [3] I continue to struggle with stillness, but at least I'm more comfortable with it than I used to be.

2. I'm better prepared for old age.

Another result of that terrible cold in 2009 was the realization that, "I'm less ready for old age–and mortality–than I thought I was." And while I'm still enjoying this existence a great deal, over the last four years I've devoted a lot of thought to death and meaning, to the importance of being present, and to the shortness of life, and as a result I feel much more in touch with my mortality and the impending indignities of old age than I was just four years ago. [4]

3. I need to find (yet) another gear.

I'm someone who's always thrived on pushing myself. That's not to say I'm a joyless worker-bee–far from it. I love to work hard (at work that I love), and I love to play hard, too. My illness in 2009 taught me that I needed to learn how to be still, and I did. But two gears isn't enough, at least at this stage of my life. I'm reasonably sure that my herniated disk was the result of both working out harder than usual in December and early January and just plain working harder than usual over that same span. I'll keep pushing myself, but now I need to find a third gear somewhere between Go Hard and Be Still that'll allow me to advance at a sustainable pace.

4. I'm learning the definition of pain.

The word "definition" itself has multiple meanings. It means, of course "the formal statement of the meaning or significance of a word"–as in the definition of pain quoted above–but it also means "the condition of being distinct or clearly outlined," and that's the meaning I refer to now. My wife Amy has suffered from chronic pain in her shoulder for the last four years which two difficult surgeries failed to fully resolve, and which she now manages on a day-to-day basis. [5] My experience over the last six weeks has made it clear how little I truly understood what she's been dealing with, even as I tried to be an empathetic caregiver. As Dr. Silverman noted, I'm still in the acute phase of post-traumatic pain–it hasn't become chronic and hopefully won't. But six weeks has been long enough for me to get a sense of what it means to live with pain and to have to accept the limits that are defined by the energy and the space that the pain consumes. I'm hopeful that my PT will substantially diminish my pain, but I also hope I never forget what it's been like to have pain be such a defining feature of my life.

 


Footnotes

[1] Terminology, International Association for the Study of Pain

[2] Things You Learn When You're Sick

[3] For more on meditation and mindfulness:

[4] For more on mortality and related topics:

[5] Caregiving and Stress Management

Photo by Harsha K R.

2 Responses

  1. Thanks for this – I needed it today.
    I am a serial self-injurer, pushing myself hard until pain stops me, learning (struggling!) to rest, recovering, and then when I don’t feel the pain any more, doing it all over again. Today I reinjured a hip muscle while running, and this post helped me see the wisdom of having more than two gears.
    I’ll take that away and noodle it.
    Looking forward to hearing what you come up with too.

  2. You’re welcome, Vickie–I’m glad to know it was helpful. Some keys for me in this process have been:
    – Exploring why I was pushing so hard. I was quite physically active and feeling very healthy at the end of the year–what was I hoping to achieve by working out harder? I had taken a break from writing in the fall, but December and early January were very productive–why did I feel the need to do more?
    – Recognizing that new problems may require new solutions, even when they look quite similar to old problems. The lower back pain I experienced in the late ’90s was entirely stress-related, and the solution was managing my stress + pushing past the pain to keep active. The upper back pain I’m experiencing now is certainly exacerbated by stress, but because it’s initial cause is nerve damage and irritation, I need to listen to, not push past it.
    – Giving myself (even more) permission to say “No” and to prioritize. Since this happened I’ve turned down opportunities that would have been rewarding and I’ve been slower to respond to requests because I realized that I had to prioritize my health and healing. I’ve gained a lot of experience in setting boundaries over the past few years, but I’ve had to kick it up a notch, because the calculus has changed: Right now I have less energy and capacity, and I have to respect those new limits if I’m going to heal.
    Hope your own healing goes well.

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