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Pain Levels, Chronic and Acute

Centurion45CCenturion45 Posts: 648
edited 06/11/2012 - 8:35 AM in Chronic Pain
Morning, Serious subject here.

I am going to ask a few questions, because as my PCP has said, chronic pain is hard to treat and at the same time, for years up until I kept pushing every week to 2 weeks for answers to this -underlying condition, I just thought I had a perpetual Flu. I never imagined that I had developed a chronic condition, after living with my back for so many years. BTW - I was told for 22 years, that there was nothing wrong with my back. LOL, 1 CT Scan and I have a Dr apologizing for missing this, for an hour. Another scan-12 months later and I am stable, but still in pain every day, with no answers except to do what makes you comfortable.

I have been looking after my self care for the last 20+ years and really looking for information for 3 to 6 years. I guess that is when I began to realize that something was not normal and my pain levels were increasing more than I could maintain comfort. I was developing an outside focus of care. Rather than being completely active in my care, I had switched over, unintentionally to have my Dr tossing me the ideas.

For the last 4 months, I have intentionally taken back- my self care. I know how to fix my spine when it injures itself. For me - its best description is- "Like a software glick, that forces a computer to crash and the mess left behind, causes pain perceptions in my brain". It is how my back has always let me down in the past. Except that now that I know that this happens, I can watch for it and see if I can "reboot" things beforehand.

Knowledge has provided me with an understanding that I have some serious mechanical issues that cause ACUTE pain and this contributes to the chronic pain as the path-ways to the gates stay open and are hard to shut off.

My self care involves a host of both actions and MBM, so it is really a mix of things and I use all of it each day, to make things better.

Question 1- Has another noticed that, over the time that they have been, on meds, to control the pain, that the pain levels from the chronic side, have decreased significantly, to the point where at times, the chronic pain is quite literally in the "background". level 2-4

Question 2 - If you have noticed the above, have you noticed the Acute pain, from Severe Stenosis, Disk Bulges at Lumbar, Sciatica -- change or get modified - to the point where they are dropping off as well.

Cheers - David


  • I think what happens is that we become "numb" to a lot of what goes on. It's like tuning out the noise of machinery operating around you. Initially it seems incredibly loud and annoying, yet over time you don't really notice it anymore until someone says "wow, doesn't that noise drive you crazy".

    So it's there, but pushed to the background. Or you can say that it's like building up a callous.

    Once a person gets to this point, the perception of acute pain can change in a few ways. For some it becomes horribly more severe and "pointed", because pain receptors are so affected by all the years of meds and chronic pain.

    For others the acute pain comes, is recognized and then the "wharehousing specialist" comes in and grabs it and puts it into the storage facility while waiting to see if it calms down enough.

    I hope this makes sense.

    Our brains are complex mechanisms with the ability to do incredible things. Most times to our benifit, but sometimes to our detriment.

  • I like your analogy of back pain to computer glitches. That gives me the impression that certain things can be "fixed". Unless it involves a computer virus (of sorts).

    I have noticed (after years of pain meds) that the chronic aspect has lessened; not quite sure if it is due to the medication or that my body has become accustomed to the pain (thereby decreasing the perception of pain). BUT, the acute pain seems to me to be more extreme. I notice it more.

    For instance, sitting at the desk for, oh, 10 minutes (tops), then getting up to more or less stretch out my back - getting up causes an acute pain that is excruciating. I can't straighten my back for a full 10 - 15 seconds. It's kind of embarrassing. I feel like it looks like I have bad stomach cramps and should be headed to the ladies room. But it goes away eventually. Until I sit down again, in which case the whole vicious cycle begins again (like the song that never ends).

    I reboot by laying down. Or elevating my legs. Or heat. Or "Activ On" or other topical analgesics. Whatever it takes.

    I, too, have learned to plan my day, my activities. I will "store up" energy for things planned in advanced - or after.

    I was very naughty the other day. I wanted to see how long it would take to wash my car (my husband has my SUV now). 15 minutes. WOW! But within 20 - 30 minutes I knew I can never do that again. Pity. I used to love washing my vehicle. Small guilty pleasure. Just like mowing the lawn.

    Live and learn (and hurt for trying).

  • I like the analogy to the noise. I think over time the chronic pain is something we expect and know it is there. Then you have the acute episodes of pain. I think we learn to become more in tune with out bodies and what to expect from the chronic side of pain. When something different happens in the pain(acute), we notice it so much more.

    Now the debate of chronic and acute pain, I am finding is hard to treat. Hard to treat as the doctors see us with the chronic pain and don't realize that we are explaining something newer that is separate from the chronic pain. It was told to me chronic pain meaning there is nothing other that can be done to treat it other than meds. Acute meaning that there are other alternatives, other than just drugs, that can resolve it. The explanation involved a broken bone at a joint. The bone can be immobilized to treat the fracture, but the impending arthritis that is going to set in will become the chronic.

    So why they know you have a issue in your spine causing chronic pain has something also happened to be causing acute pain episodes. Many of us take plenty of meds that in a since could be covering up other acute pain issues, that could be treatable and not lead to a chronic situation. Which is such a important reason to have open lines of communications with your doctors.

    Great topic Centurion. I think acute and chronic has been explained to all of us in so many different ways.
  • Thanks . The software crash analogy is based on leading research from U of Waterloo, back in 1997. I just found a copy of the book covering it in a discount store last month. Since our nervous system is made up of many electric connections, and all of these things need to work in concert, it makes sense that if there was even a minor glitch, the result would or could be catatrophic. Hence the back injuries that I have enjoyed. Consider the number of actions the liver has to make each second, to keep us regulated, and how many times does it have to be a wrong signal before we start to feel ill? I don't think Dr's understand it very well either as thier training in pain and other things may go back many years and they have not updated thier information and internalized it into thier practice.

    I figured that if the acute pain, caused in myself from the Disk, stenosis,Facet joints, SI, Sciatic was quieted down for a period of time, the pathways in my system would also mend. Going to gate theory, the gates would close and the pain would at least get stopped once in a while, instead of screaming in the mind-central at full speed.

    I don't want to jinx my present experience, but am finding a complete - across board - lowering of pain levels. To the point where I have dropped off 50% of my meds, and am in the process of dropping my ER meds slightly as well. Pain levels still are low, about 2-3 compared even to my flare-up in July, when I was using all up and still considered hitting the ER cause my BP and HR was sky high.

    I still meditate for long stretches, especially when I am going to be out. I feel like I have a night's rest in about 30 min or so.

    I am in the process of watching myself very carefully cause I do not wish to incur an injury after coming this far ahead.

    I have found in my experience that nothing gets masked in me. I only use meds to cut my pain levels so I can function. I never have been pain-free, so why try now with the meds. I would just increase my activity level back up to a point where I was hurting at the same level ,even with the meds. So in effect, they would become ineffective, because I was still abusing my body. If I have a new ache, I feel it, my arthritis gets me more each year and shows up in various places. Dont you just love that - 3 am and my hips are just aching, but once acknowledging it, I find I can drop back to sleep.

    Overall though - pain is down and I don't have an explanation. As I have said before, I am very much blessed.
  • I have actually thought a lot about this subject over the last several months. I use the following analogies to define pain:

    Acute Pain[/u]
    Try thinking of a pool of water that is very still. Now throw a rock in the middle of the pool. The waves will flow outward from the point of entry and eventually the pool will be still again. The bigger the rock, the bigger the waves and the longer it takes to reach a calm state again.

    The pain is usually very violent when it occurs (like the rock hitting the water) and easily grabs your attention. Fortunately, the effects quickly dissipate (relatively speaking).

    [u]Chronic Discomfort
    Take that same pool of water and put a drain in the middle on the bottom. As the drain sucks water in, the water starts to circle its way down the drain. The more suction on the drain the faster the whirlpool will go.

    This type of discomfort just grabs you and holds on. Think of the filter analogy, when the motor is on low you barely notice the water moving but when the motor is on high it's very evident that the water is moving.

    The key is to find a way to turn off the motor or at least make it run slower and don't throw any rocks. Of course I could be full of crap and have no idea what I'm talking about. Wish someone would turn my motor off cause I'm unable to ignore the whirlpool anymore.

  • "C" - I like that noise thought too, you describe very well, how I felt years ago. I kept ignoring the pain and just kept plowing along, regardless of how I felt, no matter what and now - today.

    I stop - sleep in if I need to, get up and get going when I have to and try to maintain my work schedule for those responsiblites. After that - it is back to looking after me again and then I can look after my sweetheart.

    Thank you - David

    EDIT - Dave - I like your comment about the drain and "discomfort". I don't like giving pain too many words, as I dont want the sub-conscious to read too much into this and then turn what it thinks is reality - into a reality for me, in the conscious mind.
  • dilaurodilauro ConnecticutPosts: 9,846
    pain always catch my eye. I do like the way you said that you have taken back control of your situation. Over the years, I played a lot of yo-yo with that. For a while, I would be the one in charge, but when I got lazy, my doctors dictated what was going to happen. Considering the start of my surgeries was back in 1978 and 10 before that when I started having some real back issues, it has only taken me until 2006 to really gain control. But this time its a joint control, My Pain Mgt Doctor and me!

    When you mentioned chronic pain and for whatever reason that pain level doesnt 'appear' as bad as it was before. Even though it hasn't changed, our bodies are basically adjusting. After all our bodies should be able to make some changes after 30 years or so.

    Its the acute pain that drives me up the wall now. In the past 3 months I have had 3 situations with acute pain:

    1- Subluxed Knee ACL
    2- New back molar cracked, needing root canal and crown
    3- Last night I dropped a bottle of one on my toe, and my toe is about twice the size it was before and all sorts of colors (but I saved the wine)

    It just seems that these acute pain situations are more painful. They are but they arent, if that makes any sense. For instance, my tooth, the oral surgeon who will be doing the work sometime next week asked me if I needed some pain killers or something to numb my tooth and gums. I told him, no , I will be ok. Then he tells me that I have a exposed nerve root, he put an ice cold pick on it to check my reactions, and I basically had none.
    He was a bit amazed by that.

    So my pain tolerance has increased, I can handle more, but I am more of a baby with acute pain than with chronic pain now.

    I used to think Chronic pain was the Hard Machine crash and Acute pain was just a software abend.
    Nowadays, chronic pain is more like incorrect output and acute pain is when the POR button was pressed.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • LOL - it really was not intentional on the PC comparison except that it makes the analogy work for me and descibes my experience to a T.

    What I am leading to is this. We can have what I call pain ruts. We act in certain ways, due to the injury, we feel certain ways, due to the expectations of that injury and we keep "REACTING" [me bad for this] in the same way and so it sets up a continuation of the pain rut.

    With the concept of Neuroplasisity[sp?], the brain is suppose to over time be able to re-wire itself, without us being involved in the stuff under the hood. I have not seen any reports or studies on this, at least not double-blind stuff, but it keep showing up in print from some NS and others that feel that this can be accomplished.

    So - I guess that I will get out my soldering iron and do some more re-wiring and see how it goes!

    Cheers and good night - have a great weekend!
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