Pain Scales & Chronic Pain

I have had back pain (upper to lower) since 1995, yep, that is correct. It started with a cartwheel I failed to land on cement where I bruised my tailbone and later learning that my lower 2 discs had actually slipped forward slightly.

I had the benefit of the pain increasing slowly over time so I didn’t really know any other way of living. “My back hurts” was a constant with mixed in days of certain areas hurting more than others. Different types of pain depending on weather, activity, and various other factors.

For me, the pain was always there, over the counter meds took a tiny little edge off but it progressed so slowly over such a long period of pain I didn’t actually know how bad it was until it was gone for 15 months. I had a stem cell treatment done for my MS, the happy side effect was my back pain was completely gone, such wonderful freedom. Until it was back, I didn’t get the luxury of it happening little by little over decades again though. The pain was gone one day and the next day it was full force back. Oh boy, how had I lived like this for so long and not notice? I finally understood why people used Vicodin, I didn’t use it daily, or even weekly, but boy did I understand the urge when it hit me.

For doctors, the pain scale may be a useful tool, but as every patient is different, unless you know what their 10 is you really cannot judge it properly. Thankfully (or not, I don’t know how to think of it) my personal 10 is when my medication wore of mid c-section with my first child. Yes, that is correct, they told me I was only feeling pressure when indeed I actually felt every internal stitch they took screaming until they stopped and gave me more medication. So, when I am asked what my pain level is I always start by telling them what my 10 is so they know my personal tolerance. My 9 was when I tore the cartilage in my right hip, in case they feel like I may be exaggerating I have that at the ready to inform them.

Knowing what my highest two levels are, I am able to better represent my daily pain, on a good day it might be a 4 or 5 and on a bad day it can be an 8. My back is in constant pain, and then my MS will throw in a painful muscle spasm that feels like the worst charlie horse ever that lasts for 90 seconds and you are not sure if you will ever be able to walk on that leg again. Or perhaps I get the “banding” MS Hug spasms, around the torso putting pressure on my chest so fierce I am never 100 percent sure whether or not I am having a heart attack.

If that wasn’t bad enough, I get 5 different types of migraines and headaches and there doesn’t seem to be any rhyme or reason to when they hit. While waiting for the medications to work my migraines make it so light and sound feel like torture devices and even lying in a dark, quiet room with a cooling mask on my face I have to battle the vomiting that sometimes accompany them due to not taking the right meds at the right times or failing to fully notice the warning signs before it is too late.

How do you accurately describe your chronic pain to a doctor you see for 15-30 minutes when they don’t live inside your skin and cannot actually understand the subtly of your pain variation. You may fear telling them it’s bad because other people have it worse or you don’t want to look like your seeking medication. Just like with Multiple Sclerosis and other chronic illnesses, you can’t worry about the “other people” you need to compare yourself to your best day and your own personal pain level. You might be a bad ass (Heather) who only registers a 6 when slicing of a finger cooking dinner, or you might say 8 when you stub your toe. The only thing you can relate it to is your own personal experiences in your own body.

If there was a better sliding scale for people, I think the medical field would be a better and more productive place. Instead of begging for relief because I cannot take 5 more minutes of this we could have better, more informed conversations with our medical team and perhaps find a better solution for our particular problems. I don’t care if it’s medication or acupuncture, if it offers relief I would gladly try.

 

Additional Reads:

https://charleighwrites.wordpress.com/2018/11/16/why-pain-scales-are-unhelpful-for-chronic-pain-sufferers/

How to Cope with Back Injury and Chronic Pain

Bulging Disc Symptoms

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