Living with pain

The past year for me has seen a slow ratcheting up of pain from sciatica.  Before that I would not have believed its all-consuming force.  Even so, I am well aware that I am lucky not to have worse, and the exercise of trying to stay positive is both constructive and interesting.  When we arrived in France Mary spent months with severe tendinitis in a shoulder which she would otherwise have used to bow her cello - upsetting and frustrating but ultimately thank goodness cured.  Since then we have both had joint pain, and sod's law says that at our age this is usually in a place linked to your most creative and important activity.

Treating pain is a complex obstacle course full of blind alleys and treatments which have worked for other people, enthusiastically advocated, but they seem to have no effect when you try them yourself.  Ultimately painkillers are OK, but they kill more than the pain you are trying to treat, and if they do not upset the digestive system or attack the stomach lining they are more or less addictive.  I take them anyway, and they work at least for periods of time.  'Alternative' treatments work if you believe in them, and I tend not to which makes me a poor patient!

With the sciatica I have also been through the gamut of steroid treatments which are very good for a day or three, then just stop working, back to agonising mornings.  Surgery is something I've had with one knee replacement, with mixed results though I can walk - it is like having a posh new hinge on a door, but someone forgot to oil it properly.  Since sciatica involves eroded discs in the spine it is another level of complexity and risk altogether, and I'll go some distance to avoid it despite our appreciation of the talents of Supervet Noel Fitzpatrick.  The animals he treats are after all much less heavy than I am!

But exercise and physical treatment are another matter.  I enjoy cycling, and riding my bike around our lovely flat town or using my exercise bike at home are both constant parts of my life.  The pain goes down, and either I can read and listen to music, or enjoy passing scenery, whhile I finish a session or ride with less.

I've just got back from my latest session with a physiotherapist.  I have had several of these over the past 5 years or so, before and after knee surgery, and my expectations were low.  I'm not the only person, patient or doctor, who recognises the description of being left hitched to a machine (pulley, electrodes, whatever) for 20 minutes while your therapist attends to 2 or 3 other clients.  An hour in a treatment room with only 10 minutes' direct treatment is not uncommon.

I'm not writing to moan about bad examples of physiotherapists because this time I think I have finally found a good one.  A young man who spent 29 mins of the allotted half hour with me, pushed and pulled me both to check my limits and push them a bit, and most importantly left me with exercises I should be doing several times a day at home.  To be fair to the last man he proposed something similar, but not very well explained.  I know now what stretching I need to do and how often, and I'll do it even though my rubber mat on the floor is less convenient and comfortable than his therapy couch.

I'll see him regularly over the next 6 weeks or so.  But in the end the answer is going to be in my own hands, or legs maybe - profiting from my enjoyment of cycling outdoors and in, putting together the advice of my GP, the rheumatologist, an osteopath who tweaked my vertebrae once, and my new physiotherapist that the best treatment is going to be more exercise.  And overcoming my innate laziness to get down on the floor and do the spinal stretches every day.

Incidentally, I was puzzled about the link between the term rheumatology, all things connected with rheumatism, arthritish and pains generally in joints and muscles, and the original French/Latin root rhume meaning cold or sniffles.  Apparently ancient medicine regarded these painful conditions as linked to watery humours - who knew?  The Oxford Dictionary certainly did and does!

At the same time I remember all the time that other people (family, friends and those I meet around the place) have more serious difficulties.  I was reminded of this again this morning seeing others arriving at the physio centre as I left to ride my bike home in the sunshine.