Showing posts with label chronic pain. Show all posts
Showing posts with label chronic pain. Show all posts

Friday, April 29, 2011

Chronic Pelvic Pain Syndrome and Me

Not long ago, I got a phone call from someone who read one of my blog entries.  He's a young man suffering from chronic pelvic pain syndrome, or CPPS.  Listening to his story, his frustration and grief, took me back to the point in my own life five years ago when I started experiencing CPPS symptoms, to when I received my diagnosis and was told there's no effective cure or treatment.  The isolation, the anger and shame and depression and hopelessness--it all came back to me.  I truly did experience helplessness at that time.

I muddled through the pain and the emotions, and somehow, I felt my way into a set of practices that slowly but steadily gave my life back to me.  Feeling very fortunate, I put up a couple of web pages about my experience, in hopes that it might help someone else.  So I'm very grateful to this young man, and to the handful of people who've emailed me about CPPS.  I very much appreciate your feedback.  As a result, I've revised, updated and expanded my CPPS web site--it's here.  Thank you, all of you, for your helpful comments and questions.

CPPS is isolating.  At the worst point, my CPPS kept me from traveling more than a half an hour by car.  I had trouble sitting through movies.  I didn't feel like going out.  The isolation fed into the sadness and hopelessness.  So, when I hear from anyone who has CPPS, I respond as quickly as I can.

If you're suffering from CPPS, please take a look at my CPPS web site.  I hope you find something there that helps.  At any rate, it's free, and it's the best information I have available to me at the moment, based on what works for me.  And if you have a question or just want to communicate with someone who's been there, please write me.  You should be able to find my email address on my blog.

Friday, July 2, 2010

What is the Alexander Technique?

In India, sadhus (ascetic students of yoga) sometimes practice austerities, committing themselves to difficult, long-term observances.  One example is hand raising.  A devoted sadhu may decide to raise his hand and never lower it.  We in the West look at a practice like hand raising and wonder how a person could do that.  We would never choose to deliberately contort our bodies for years at a time.

But in fact, like the hand-raising sadhus, we do practice bodily austerities.  The difference between us and the sadhus is that they consciously choose to practice mindfully.  But we develop our bodily contortions unconsciously, mindlessly, seldom realizing what we are doing to ourselves.

As young children, we are taught to sit still for long periods of time, often in chairs or desks that don't quite fit our growing bodies.  We learn to focus our minds and ignore bodily sensations.  At home, we learn how to slump on the sofa and watch TV or play video games, remaining out of touch with our bodies as we lose ourselves in the sounds and images.  We learn how to deal with tension and unwanted emotions by holding them in our bodies.  We graduate and take jobs that demand continual repetition of bodily movements, maybe on an assembly line, maybe at a desk.  If we have a career devoted to abstract mental tasks, we sit for hours at a time in poorly designed office furniture, working with our minds and ignoring our bodies. 

In our 20s and into our 30s, our youthful bodies can adapt remarkably well.  Somewhere in our late 30s, however, our bodies most likely begin to try to get our attention--a little twinge here, a small ache there.  By the time we're in our 40s, after a couple decades practicing the Western equivalent of hand-raising, our bodies raise the volume of their protests.  The aches and pains are more intense and last longer.  We might have a sleepless night once in awhile or miss a day of work now and then.  Pain relievers and sleep aids begin appearing in our medicine cabinets.  A chiropracter or massage therapist might find a place in our address books.

And then one day, our bodies finally demand our undivided and complete attention.  The pain reaches a level of intensity that cannot be appeased, and it does not go away.  We discover that the medical community has no good answer for our suffering.  We wonder how this happened, and we begin searching for a way out.

If you are as lucky as I am, you may find an Alexander Technique instructor.  The Alexander Technique has been a very important part of my way out of chronic pain.  An instructor can see unnatural patterns of muscular tension and knows how to help the student perceive them, too.  She gradually, patiently guides the student to release muscles that have been held dysfunctionally for years.  Instead of trying to teach an idea of correct or good posture, which really is just another form of bodily holding and rigidity, she instills the idea of ease of use, of the body as a dynamic, ever-moving system.

Much about the Technique seems counterintuitive or just plain wrong at first.  The Technique is a form of undoing, of unlearning, of breaking habits, of changing the way the body is felt and perceived.  When the instructor first helps the body release into an easier state, it often feels odd, or even wrong.  Many times, my instructor has had to show me in the mirror that, no, despite the sensation that I'm leaning to the left, that I'm tipping forward, that my legs are bent, in reality, I am standing more nearly upright than I have in a long time.

The Technique can be an emotional as well as a physical exploration.  The body can hold anger, fear, embarrassment, shame, guilt.  Releasing the body can be like opening a shaken bottle of emotional soda.  The emotions can bubble up, memories can gush into consciousness.  The enhanced bodily awareness I've received from the Technique also is an enhanced emotional awareness.  When I feel my left abdomen tensing, I know I'm becoming upset.  When I feel my lower back become rigid, I'm aware that I'm feeling embarrassed.

The Technique is an ongoing education.  The lessons continue out in daily life.  I learn something new about my body and emotions nearly every day.  The Alexander work has given me a sense of curiosity about my body and its relationship to my mind and the world around me.  I'm feeling a pain in my jaw?  That's interesting!  I wonder what would happen if I invite my shoulder to relax?  I'm feeling tension in my hip.  Fascinating!  Could it be related to this deadline I'm working under?  What would happen if I took a short break and breathed deeply for a few seconds?

After a couple of years of working with my Alexander instructor, I am free of the chronic pain that led me to her.  But I continue the work.  As each layer of tension, each pattern of holding, peels away, I find a new layer underneath.  Lifting away the pain reveals new possibilities of a visceral joy and ease.  I can't wait to see what I'll find tomorrow.

Sunday, February 21, 2010

Claire Davies Saves My Life--Again!

What one book would I want with me if I were stranded on a desert island? Right now, that book would have to be The Trigger Point Therapy Workbook, by Claire Davies.  I've been working with a chronic pain condition for the past four years.  Self-administered trigger point massage is one of my primary tools.  It's relieved my pain and given me back my mobility.  Without it, I'd probably still be standing when I ride the bus, unable to drive for more than a few miles at a time, and swallowing handfuls of ibuprofen throughout the day.

And I wouldn't have healed enough to get back out on my bike last summer.  My wife loves to bike, and she's missed me for the past couple of years.  But last summer, I finally felt whole enough to dust off my bike helmet, pump up the tires on my Trek, and pedal.  We had a great time riding around Iowa City on weekends.

On Labor Day, we were flying downhill on Dubuque Street toward Waterworks Prairie Park, when the lip of the pavement caught my front wheel.  I crashed down onto my left shoulder and skidded along several yards of concrete.  Di said I was going about 30 when it happened.  I left a lot of knee and elbow on the road and had a lovely bruise on my left hip for quite awhile, but I didn't break anything.  And my bike was fine!  I had a little stiffness and pain in my left shoulder, which I figured would improve with time.  But gradually, the pain has worsened, and my range of motion has become more limited.

My theory about my pain condition is that it's primarily a mental disease.  The problem stems from the idea that the mind is primary and is the master of the body, that will alone can whip the body into line.  When pain flares up, the mind goes to work, trying to solve this problem, trying to diagnose and cure, trying to fix things.  But this approach almost never works with my chronic pain condition, and in fact, it can lead to worse pain and more limited motion.

After I'd been using trigger point massage awhile and had reduced chronic pain to a manageable level, I began seeing an ease of movement therapist.  She's helped me unlearn some of the body patterns that contributed to my pain condition, which has improved my life considerably.  With her help, I came to see that I'd been stretching incorrectly, tensing instead of relaxing into the stretch.  I've had great success with stretching the way she has taught me; I'm probably more limber now than I was before the pain condition developed.

So as the pain in my shoulder grew and my range of motion decreased, I decided to try to stretch my way back to wholeness.  I made what I thought to be an educated guess as to which muscles might be causing the problem and began stretching.  I should have known better.  This was my old mental pattern sneaking up on me again, convincing me that I could diagnose and fix myself.  In fact, I was most likely making things worse.  The pain continued to worsen, and I was having trouble putting on my coat or reaching for dishes in the cupboards.

Yesterday, I was on the road for four hours.  As I got ready for bed last night, I knew I'd be up again in the dark, knocking back some ibuprofen and sitting down with the heating pad.  And I was right.  As I sat on the sofa and waited for the heat and the pills to kick in, I dug out my Claire Davies and flipped through the section on shoulders.  For some reason, I spent some time with the section on the subscapularis.  And there were all my symptoms--why hadn't I seen this before?

I looked at the treatment diagrams and worked my fingers into my armpit.  A flash of excruciating it-hurts-so-good-I-can't-stand-it pain, and I knew I was onto something.  After I'd worked on my subscapularis for a few minutes, the pain was gone.  Remarkable!

So, of course, I've diagnosed and fixed my problem, right?  Wrong!  The tricky thing about trigger points is that the referred pain can create trigger points in other muscles, creating a complicated web of tension and pain.  The pain and limited motion affect the way I hold and move my body, which can overwork other muscles and lead to more problems--which can feed back into the original painful area.  I've learned from hard experience that searching for a single cause and a single fix is pointless and can in fact worsen the situation.  What works much better is a sense of curiosity and exploration, a sense of acceptance of the body as it is in the present moment and a willingness to work with it just as it is.

Right now, I'm typing this blog relatively pain-free.  My shoulder feels great!  I'll continue working with the subscapularis.  But I know I also need to continue massaging my other shoulder muscles, continue exploratory and tension-free passive stretching, continue checking in with how I'm using my body, with how my thoughts and emotions are interacting with my muscles.  It's a way of life, not a quick fix, like a pill, but a very interesting and remarkable journey.

But Claire Davies, you have saved my life again!  Thank you, thank you, thank you!

Thursday, December 3, 2009

Tooth and Consequences

About nine years ago, I had my first and, so far, only, root canal.  Of course, beforehand, I had to hear everyone's horror stories.  But I was pretty sure that, compared to my early experiences with dentistry, the procedure would be a walk in the park.  When I was a boy in rural Iowa, my old country dentist drilled without administering novocaine!  I was relieved that the root canal was anticlimactic.  As expected, the procedure went smoothly, and I had very little pain.  It took some trial and error to get what felt like a pretty good fit for the crown.  But eventually all seemed well.  The tooth occasionally felt a little odd, but not painful.

But earlier this year, I began to notice increasing pain in my jaw when I bit down on the tooth.  I tried to chew on the opposite side of my mouth, but whenever I accidentally bit down on the tooth, a stabbing, hot, agonizing pain would shoot up into my cheek, as if someone were jamming a red-hot ice pick up through my molar and into my eye socket--or as if my old country dentist were drilling my molar again.  The pain would last for a couple of hours.  I finally had to admit to myself that I needed to have the tooth examined.

My dentist x-rayed the tooth and saw what seemed to him to be a little bit of swelling between the root and the socket, so he referred me to a periodontist.  But the periodontist saw nothing unusual in the x-rays.  He said he could redo the root canal and it might relieve the pain--or it might not.  Back home, I decided I didn't want to undergo another root canal if there was little certainty of a good outcome.  I returned to my dentist and asked him to smooth down my crown to try to get a better fit.  He did, and I had some relief for a few weeks.  But then the pain came back.

I was stuck.  I was facing the prospect of having to live with increasingly excruciating pain, without any hope of an effective treatment.  Fortunately, or unfortunately, this was a very familiar situation.  A few years ago, I was diagnosed with chronic pelvic pain syndrome--constant untreatable pain in the hips and groin and low back.  Thrown back on my own resources, I found ways of working with the condition that eventually resulted in my being able once again to be fully active without pain.  I knew from personal experience that undiagnosable, untreatable chronic pain can be workable.  So I sat down and began to puzzle through this tooth pain.

I used my mindfulness training to try to avoid chewing on the affected side, and to stay with the pain when I did mistakenly bite down on the tooth.  As I sat with the pain, I tried to release any thoughts it spawned and to relax into the physical sensations.  I gradually came to see that part of the pain involved muscle tension in my jaw and face.  I tried to be mindful of this tension, even when I wasn't in pain.  I soon saw that this tension was the result of a mistaken response to something my Alexander Technique teacher had tried to teach me.

I've been seeing my Alexander Technique teacher for nearly two years now.  She's been helping me recognize and release places where I habitually hold tension in my body.  My pelvic pain condition has melted away, and my sense of well-being and ease has increased.  In the course of her lessons, she pointed out that I tense the muscles that make my lips thin.  I responded by trying to force my lips to purse out more than they had, instead of trying to relax my facial muscles.  This increased muscular tension in the face and jaw was what seemed to be associated with my tooth pain.

I massaged my jaw muscles and used the tools I'd learned from my Alexander Technique teacher to relax my face and jaw.  The result was miraculous!  The pain melted away, to the point where now, I can bite down on my molar and only occasionally feel a little, short-lived twinge.  I remembered reading something about tooth pain in Clair Davies's book, The Trigger Point Therapy Workbook.  I looked it up, and sure enough, Davies wrote that trigger points in the jaw muscles can cause sensitivity in the teeth.

I'm increasingly amazed at the interplay among my mind, body and emotions.  Incidents like this are like windows into the connections among these aspects of self.  I'd rather not have had to deal with chronic pain, but I have to admit that it's given me new insights and opened new possibilities of health and well-being.

Thursday, March 26, 2009

The Muscle De Jour

The muscle of the day is: the infraspinatus! I worked it with the tennis ball this morning, and wow, it felt so good! I can usually tell when I'm working an active trigger point. The pressure reproduces some of the pain, along with a kind of energetic rush or tingling sensation.

I'm coming out of my latest step back, in the two-steps-forward-one-step-back rhythm of my dance with chronic pain. I've been through this cycle so many times that now I do not become too anxious or upset when the downward swing happens. I know that I will pull through, and undoubtedly, I'll learn something valuable in the process.

This latest episode started the same day that I had a fantastic session with Rachelle, my ease of movement therapist. I'd felt incredibly light and loose that morning, on top of the world. But that afternoon, my boss handed me an assignment that boiled down to "justify your position." Times are tough economically here at the U, as elsewhere, doubly so because of the flood damage. As I worked on the assignment, I could feel the tension tightening my back like a guitar string. The pain also fed back into the tension. Every twinge seemed to birth a litter of anxious thoughts and emotions. By the end of the day, the last trace of the morning's bliss had evaporated.

Over the next several days, the situation worsened. The pain and tension affected my stretching routine. Releasing muscles was nearly impossible. I felt a strong desire to pull against the already too-tight muscles, which aggravated the pain whenever I mindlessly gave in to the urge. I could tell that a new stretch Rachelle had suggested was triggering something in my left shoulder that sent waves of tension outward, into my low back and hip. I knew I would have to back off, but easing up proved to be a struggle against a rising sense of failure.

Throughout my descent, I managed to continue my mindfulness practice, staying with all the sensations and emotions and thoughts as best I could. I continued practicing the inhibiting and directing I'd learned from the Alexander Technique. I knew that, as bad as I felt, I still felt much better than I had on my good days a couple years ago. And this time, I was able to consciously see what was going on during the entire episode, what had triggered it, what made it worse, what made it better.

Gradually, I found my way into a less painful, more relaxed state. And now, I have more insight into my condition, more confidence that I can work with it and can continue toward wholeness. And one of the good things that came from this latest bout with pain is the infraspinatus. I dug out my trigger point therapy workbook, got on the floor with my tennis ball, and experimented with my shoulder muscles, and now I know that the shoulder pain I've been living with for years can aggravate pain in my low back and into my hip, and I know how to treat it.

I know how to treat it for the moment, anyway. Dealing with chronic pain is like playing whack-a-mole. I've learned that if I let myself think that I've found the one true cause of my pain, the one thing that I can fix and make myself all better, that is when the trouble starts. The key for me has been to continue to listen to my body, continue to let it talk to me, and not let my mind get in the way. My mind wants to diagnose and cure, but chronic pain does not work that way, and in fact, the mind's need to be in charge and to fix things can lead to worse pain, not less.

So, the muscle de jour is the infraspinatus. It feels so good working with it. But it's just the muscle of the day. There will be another tomorrow.

Wednesday, April 16, 2008

I Need a Fix

I attended a Brugh Joy workshop over the weekend, a wonderful experience. It was my first Brugh Do. Working with Brugh and the group incubated a series of huge dreams for me Saturday night, which we worked with in group Sunday morning. I left the workshop with many new insights and a load of material to work with.

The first evening, Thursday, Brugh asked us to introduce ourselves and maybe mention something about the process that had drawn us to his workshop. I happened to be the person he picked to begin the introductions. I was new to Brugh's work and didn't know more than two of the other participants, and much of what I've been experiencing over the past couple of years has been physical and difficult to put into words, so I was not very forthcoming.

As the introductions wound around the room, some people would bring up some pretty big issues in their lives at the moment, and Brugh would work with them a bit, along with the group. They all seemed to be old Brugh hands, people he knew. For one person in particular, Brugh jokingly said he was going to have to hit her over the head.

Friday night, I had the following dream: I'm in a mall, vacant except for myself and a young man in black clothes. He seemed to be a high-school athlete. We stood beside a large pile of shipping cartons. I knew that each contained a large, black, soft, overstuffed toy, bats and boxing gloves, mainly. The man told me I had to donate a few thousand dollars to him, to buy the whole pile. He then would distribute all the toys among the townspeople, and they would hit me with them.

When I woke up, the dream didn't seem to make much sense. Saturday morning in group, Brugh asked who'd had dreams. As he began working with people's dreams, I leafed through my dream journal, looking for what I thought would be something deeper. But Brugh made it clear that he wanted only dreams from the night before. As he worked his way around the room, it began to dawn on me what my dream was about, so that by the time he got to me, the meaning was unmistakeable. As I related my dream to the group, everyone laughed, and I said, "And I know it's all about the fact that I need to share my process with the group"--which, in fact, was the whole point of the dream.

I did share with the group my struggle with chronic pain over the past couple of years, how it had drawn me into my body, and how that seemed very alien to me. And the sharing seemed to trigger a night filled with dreams, many of them very vivid and insightful and nearly self-interpretive, so that the next morning in group, when I related one of the dreams and Brugh and the group worked with it, I knew exactly what was going on.

One of the biggest insights I received was that in order to resolve the chronic pain, I'd had to move my mind out of the way. My body had had to heal on its own terms. It did not want to be diagnosed and fixed; it had to come into wholeness via its own internal wisdom. The pain condition was in one sense a teaching for me, that there are some things that are not resolvable mentally, and that throughout my life, in such situations, my mind had been more of an obstacle than a help. Thought can be seductive and addictive, but like all addictions, it creates more problems than it solves. This is maybe the largest and most difficult nugget I extracted from the workshop.

So, allow me to introduce myself. My name is Karl, and I am a thoughtaholic...