Where It Hurts and Why: How to Gain Control of Your Pain

Introduction

"W hen I was growing up, my mother always said life begins at forty, recalls Evelyn. I always found it a strange saying because at age forty, I had already surgeries for endometriosis and then a total hysterectomy. In the days following her surgery, Evelyn began to have a burning feeling all over her body. She says it felt as though I’d been exposed to freezing weather, where your face burns and feels cold and hurts all at the same time." Her body would at times be stiff from the pain.

This was the beginning of Evelyn’s long journey to find the answer to what was going on in her body, a search that took her from Tallahassee, Florida, to the Mayo Clinic in Jacksonville, and on to Atlanta and Philadelphia. She was willing to try anything or go anywhere to find relief from her pain; however, none of the medicines that were prescribed helped. I told one doctor that the medicine wasn’t working and he told me to just take more, she recalls. One day shortly after that, I woke up and couldn’t move. I just lay there and cried. I didn’t want to live on drugs—I wanted my life back. When I was finally able to get up, I flushed all the medicine down the toilet and started yet another search.

One day, Evelyn, stiff and barely able to walk, ran into a friend. Her friend had an appointment to see me (Kim) in an hour, but she had Evelyn take her place. On her first visit, she had very limited range of motion in her legs. After years of living in pain from her gynecological problems and the burning sensations, Evelyn’s body kept holding on to the pain. As Evelyn said, I see it as a peanut-butter-and-jelly sandwich: the muscles are the bread and the pain is the chunky peanut butter getting stuck between the muscles.

As I worked with Evelyn, we went through layer by layer, releasing the pain. I taught Evelyn step-by-step how to stretch and why stretching is important to help rid her body of pain. She was ischemic and the stretching exercises promoted blood flow, which enhanced the healing process of the muscles. Stretching also took the tension out of the tissue and allowed the muscle to move more freely with less stress on the joints. I developed stretching and strengthening protocols for her to do at home regularly and while traveling for her job.

I also emphasized the importance of proper diet and exercise and offered motivation and encouragement. After the first session, Evelyn walked out of the office pain-free, which inspired her to do her homework. Over the next year, her range of motion greatly improved, her pain was reduced by 95 percent, and her diet was much healthier. She now exercises daily and has lost over thirty pounds. By changing her diet, she has been able to control the burning feeling as well. Evelyn also started acupuncture, which has been another effective therapy for reducing her pain.

Evelyn is a new person with a new outlook on life. It’s a journey—sometimes one has to take control of one’s own health and seek out alternatives, Evelyn reflects. I still don’t have all the answers, but I feel you have to take action in overseeing your health rather than live on medications for life.

THE PAINFUL TRUTH

Pain is the number-one reason for doctor visits. If you live with pain, you are not alone—it is estimated that 100 million Americans live with chronic pain. This number does not include the millions of people who experience acute pain from injuries every year. Pain can be caused by a variety of sources, including mental and emotional stress, poor posture, repetitive stress injuries from work, accidents, muscle strains from exercise, as a side effect of another illness (arthritis, migraines), and, as Evelyn discovered, as a lingering problem due to surgery. Sometimes the cause of pain is unknown.

It is estimated that headaches, back pain, arthritis, muscle aches, and joint pain lead to over $60 billion in lost productivity and missed workdays every year. And while conventional therapies such as medications can provide temporary relief, they often fail to address the root cause of pain. As you’ll see, much of this suffering and expense is unnecessary.

Pain is a very subjective experience—each person perceives his or her own pain differently. How pain affects a person is influenced by their emotional and mental attitudes, earlier experiences with pain, other health conditions, and even spiritual beliefs. Often, both physiological and psychological factors must be addressed to alleviate pain. We believe that it is vital for the person suffering with some form of pain to understand its causes and take an active role in his or her own therapy.

THE JOURNEY TO BETTER HEALTH

Do you have to live in constant pain? No, you have a choice and a role in your recovery and healing. In this book, we will guide you on a journey to understanding pain and achieving better health using these action steps:

• Gain a better awareness of yourself (mind, body, and soul)

• Take charge of your health care and become proactive in your recovery

• Become motivated and inspired to achieve a better quality of life, regardless of your condition

Where It Hurts and Why illustrates these important aspects of wellness and health through easy-to-understand text and user-friendly anatomical diagrams. The diagrams will help you locate areas of discomfort, while text and illustrations will help you implement self-help techniques to ease your pain—stretching, strengthening exercises, and massage. You will also discover the profound importance of a positive mental attitude, a healthy lifestyle, and sound nutrition. Inspirational true stories—the stories of our own clients—and humor highlight the action steps included in this book. Our goal is to help you increase your awareness of your own body, boost your self-esteem, and encourage you to take control.

In Chapter 1, we discuss the physiology of pain and explore why the body hurts. The first step in healing is to gain a better awareness of yourself and what is causing your pain. Physical, mental, and emotional stresses can all contribute to pain; a worksheet is included to help identify these factors in your life.

Chapter 2 looks at how to manage the underlying causes of your pain. Eliminating pain means creating a healthier lifestyle. A positive attitude can greatly alleviate your pain and lead to a quicker recovery. Other actions you can take include eating a healthy diet, getting enough sleep, removing stressors from your environment, and finding humor and inspiration in your life.

In Chapter 3, we’ll show you the action steps you can take now for pain relief. A number of simple strategies have proven remarkably effective in relieving aches and pains, including stretching, strengthening exercises, and massage techniques. The chapter also has instructions for immediate treatment of acute pain.

Chapters 4–9 provide detailed recommendations—specific stretches, exercises, and massage techniques—for pain in different areas of the body:

• Neck and shoulder

• Torso

• Arm, wrist, and hand

• Hip and low back

• Knee and upper leg

• Lower leg, ankle, and foot

Finally, Chapter 10 provides advice on when to seek professional help if your pain doesn’t go away. We’ll explore topics such as what questions to ask the doctor and how to avoid being put off by your doctor so that you can get the information you need.

Where It Hurts and Why can help guide you to a better quality of life: active, healthy, and free of pain. By combining the sports medicine fields of athletic training and massage therapy in an inspirational, humorous, and motivational way, we hope to assist and facilitate your healing and well-being.

Chapter 1

Why the Body Hurts

The body never lies.

—MARTHA GRAHAM (1894–1991)

As the crowd roared, there was an electric vibration in the air—it was a beautiful afternoon for a college soccer game. The score was tied and there were only a few minutes left in the game. Suddenly, one of the players from the home team stole the ball, broke away from the other players, and quickly moved up the field toward the goal. Janet, the goalie, was left alone to defend against the oncoming player’s shot on goal. Janet quickly reacted and lunged toward the player in hopes of preventing the game-winning score.

In the attempt to block the shot, Janet collided with the other player and dropped to the ground in excruciating pain. The coach and athletic trainer rushed onto the field as Janet clutched her lower leg. A silence immediately fell over the crowd as it became obvious that her injury was very serious. As the ambulance transported Janet to the nearest hospital, it was whispered through the crowd that she had severely fractured her tibia, one of the bones in her lower leg.

The orthopedic surgeons at the hospital repaired the broken tibia by placing a metal rod in the middle of the bone to support the fracture site. Janet was then placed in a recovery room where she would stay for the next several days. The day following surgery, she experienced labored breathing, and diagnostic tests revealed that she had developed a blood clot in her lung.

This complication was only the beginning of Janet’s long struggle to overcome what was perceived as a routine surgical repair. During the next several months, Janet would suffer from blood clots in her lungs, mononucleosis, and repeated surgeries to cleanse wound infections due to incisions and stitches. Janet’s body began to reject the first metal rod, thus requiring several subsequent surgeries.

Janet’s injury serves as an example of pain. Even if you have not suffered a severe injury similar to Janet’s, you have no doubt experienced pain to some degree—back pain, headaches, muscle strains, athletic injuries, fractures, and so on. While pain is a natural mechanism the body uses to protect itself, it can also become a debilitating, chronic problem that interferes with daily life.

As you will learn in this chapter, there are different kinds of pain that can be caused by a variety of factors. While injuries such as Janet’s are the most straightforward cause of pain, other factors such as stress or emotional upsets can also play a role. Not only that, but the actual experience of pain varies from individual to individual. We’ll explore these topics, and then we’ll help you discover what is causing your pain.

WHAT IS PAIN?

Pain can be defined as an uncomfortable sensation that indicates something is wrong. You could think of pain as a flashing signal that is alerting you to a problem. Those flashing pain signals can range from mild to moderate to severe. The signals travel via nerves throughout the body that communicate with the brain.

Your body has a complex network of communication lines (nerves) that transmit pain signals to and from the brain. This network serves as protection against injury and illness. For example, let’s say you stubbed your toe. The injury message is immediately sent to your brain, which serves as an emergency communication center for the body. In turn, the brain sends out a pain message that something is wrong and dispatches a rescue team to the injured area. In the case of a minor injury or illness, the rescue team may be made up of microscopic cells. These microscopic cells respond much like a clean-up crew would after a wild party. They repair damaged areas with collagen and other reparative materials and chemicals as well as clean up the trauma site by absorbing cellular debris to allow for an increase of blood flow in the damaged area. In a severe case, there may be the need for a human rescue team, such as paramedics.

Think of pain as a flashing signal that is alerting you to a problem.

Paying attention to your body’s pain signals is vital to improving your quality of life. The pain messages you experience should serve as a motivator for you to take action; pain is not something you should live with, work through, ignore, or avoid.

There are two basic types of pain: acute and chronic. Acute pain is like a sudden burst or explosion of sensation, stemming from an injury such as a sprained ankle or a stubbed toe. It happens quickly and causes severe or sharp pain that usually dissipates (resolves) in a short period of time. Acute pain resolves faster than chronic pain because the inflammation-and-pain cycle elapses much more quickly and without complications. On the other hand, chronic pain, such as arthritis, is like uninvited company: it hangs around for a long time and sometimes never goes away. Chronic pain lingers because of several factors, including severity of the injury or illness, inaccurate diagnosis, inadequate treatment, poor physical, mental, or emotional status, and a prolonged cycle of inflammation, pain, and spasm. It is estimated that over 100 million Americans suffer from chronic pain.

The brain sends out a pain message that something is wrong and dispatches a rescue team to the injured area.

THE EXPERIENCE OF PAIN

Pain is a very natural process and we all experience it. However, everyone feels pain differently. The way the brain interprets pain determines how we react to varying levels of pain. Tolerance levels will vary from person to person depending on a number of stressors placed on the body—diet, emotional stress, drugs, poor attitude, and so on.

For example, I (Kim) recently worked with a sixty-year-old man, Don, who has severely arthritic knees. His doctors have been after him for several years to get knee-replacement surgery. He walks with a cane and suffers daily from pain. His pain used to be bad enough that he would sometimes slide down the stairs on his backside instead of stepping down. Don began working extensively with a flexibility-and-strengthening program, chiropractic care, and acupuncture. As a result, he lessened his pain by over 80 percent, convincing him to wait as long as medically possible before having surgery (if at all). His experience triggered his enthusiasm to make a difference and feel better. Life is too short to hurt and I now realize I am in control, says Don. His pain is now manageable because he felt empowered with a positive outlook and took the steps necessary to improve his diet and exercise regimen.

Referred and Radiating Pain

Referred pain is pain felt somewhere other than the source area. For example, pain felt in the left shoulder (if you’ve had no previous injury) may be the signal of a heart attack, or it may be due to acid reflux disease or a hiatal hernia. The true source of referred pain can be very difficult to figure out. Radiating pain is pain that is felt from the source and all along the route of a nerve. A common example of this is sciatic pain, which is felt from the low back, through the buttocks, and down the back of the leg (along the sciatic nerve).

For diagnosis and evaluation of referred or radiating pain, it is important to consult a healthcare professional. If you are suffering from either of these types of pain, you could have a serious medical condition that should be treated immediately by your physician. In some cases, referred or radiating pain could be a sign of a life-threatening illness.

In other words, your experience of pain can be positively affected by taking a proactive approach to changing your life for the better. Many people who