I am in the middle of a discussion with three patients regarding pain. Pain that is horrible, pain that might not be resolved any time soon. The pain is coming from a 1. disc 2. a dislocation and 3. a tumor. In each one, the goal is to figure out how to overcome this pain without a surgical option because either the option looks horrible, or the option just isn’t an option.
Tough situations, all three. But there is something so important in these similar yet dissimilar stories. Pain is NOT THE PROBLEM.
It is so easy to be focused on the pain, and if you know me, you know I have been through my share. A combined eight shoulder separations, one Grade III (all ligaments torn), ruptured my eyeball and received 28 stitches in an attempt to save my eye. Mission accomplished, eye saved, but blind in my left eye (I should tell you sometime how painful it is to have that many stitched in an eyeball…). My point is, I fully understand how we can think the pain is the issue… but it isn’t.
So, when the disc is painful, I can tell you how easy it is to feel like you have no hope and no solution other than surgery. And indeed there have been many people in my career whom that is the case. Too late, nothing to do but hope for surgical help, and in most cases, the help doesn’t last in these situations. Neglect your spine too long, this could be you.
The good news however, is that most disc issues have some hope of getting well, hard work is what it takes. Hard work.
The good news about most dislocation, is that it can be resolved, however in some cases, if ligaments are torn too dramatically, you can end up with an unresolvable problem. The issue with a problem like this, is that pressure on the nerve can feel unbearable, like there is no end in site, but the good news is that the body is very “plastic” and will learn how to find the right place for soft tissue and nerve. It just takes time. Similarly, when a tumor is putting pressure on the nerve, we are in the most vulnerable place.
Unbearable pain, coupled with a disease that carries so much fear. It is this place where it becomes easy to think that the disease progression is one in the same as the pain, even though they are two entirely different things. I have seen this many times, and in some of those cases I have seen a person strong, and committed to the belief that their nervous system will re-learn, and that the plasticity will decrease pain over time. This positive outlook allows the patient an opportunity to recover from the disease, because they stay confident in a positive outlook, vs. associating the pain they feel with the amount of disease progression.
In all situations, disease and pain are unique. One may be tied to the other, but neither are connected in a linear fashion. Just like most deadly diseases carry no pain until it is too late, most pain in itself is not a deadly disease.
Stay focused on the grand prize. Healing.
Blessings to you all on this week leading into Thanksgiving… be well and be blessed! – Dr. E