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Five Tips to Stay Active with Chronic Pain

fibromyalgia workout
Chronic pain sucks.

Chronic pain can keep even the most dedicated exercisers from their daily workout. Over the past year, the pain in my back and right hip was so debilitating that I couldn’t get comfortable anywhere. I gave up running (but recently made a comeback!) and weightlifting on top of everything else I’ve given up to fibromyalgia and dystonia over the years. But almost every day, I made a point to get myself out of the house to walk, with the exception of a few days when muscles spasms kept me locked in a fetal ball in the bedroom. My trial and error workouts through fifteen months of low back/hip pain helped me come up with some advice for people who also deal with chronic pain but still want to exercise.

Get Outside

Unless weather-prohibitive, getting outside is often the first step to activity. Chronic pain is depressing and disheartening and can feel like it steals your soul. Stepping or wheeling outside to feel fresh air and hear bird sing is instantly uplifting. Once you’re outside, you’re more likely to at least walk/wheel around the block.

Find Something That Works For You

Maybe you’re a lifelong athlete like me, and “exercise” means soccer, running, or other high-intensity sports. Recognizing that your body no longer cooperates with your mind’s desires is no easy pill to swallow. Find something that works for you. Swimming and water aerobics are usually great workouts for people with chronic pain issues because there’s little impact on the body. While it doesn’t carry the same adrenaline rush of running fast down a hill, walking around your neighborhood can be mentally cleansing and physically uplifting. Just because you can’t do what you used to do doesn’t mean there isn’t something out there that will work for you.

Mind Your Medications

I’ve experienced medication side effects that were worse than the original problem I suffered. Even medications that you might have taken for years can suddenly start reacting differently in your body. Take a few days to list all the medications you take, the time(s) of day you take them, and how they effect your mind and body. You might find that something either doesn’t work for you at all anymore and you need to call your doctor, or that a certain prescription makes you feel exhausted. Once you’re more aware of what you’re taking and what it’s doing to you, it can be easier to decide on a time of day that’s best for activity.

If At First You Don’t Succeed…

Keep trying. Chronic pain is a nasty demon, but some days you might be capable of things that other days just won’t work. I’ve started running again despite feeling for a year that I’d never be able to run a step. I stuck to a strict stretching routine every night, and eventually the flexibility gained in my legs helped me return to running about 20 minutes every other day. That’s nothing compared to the 2+ hours per day I used to run, but it’s empowering to be back in action. I was afraid to hurt myself and took my return very slowly and carefully and definitely got bad results the first few times I tried. But, eventually, I ran for 5 minutes and felt pretty good, then used that short run as a steppingstone.

Stretch

Flexibility is so important for everybody, but especially for chronic pain patients. Range of motion in joints can be severely limited by tight muscles, and the less you move around, the tighter those muscles become. Many medical conditions contribute to severe muscle spasms (I have cervical dystonia) that can’t be undone, but for the most part, at least some area of your body is probably accessible to stretch. I found that even on my worst days, stretching my hamstrings helped relieve low back pain. You don’t have to do anything drastic—just gentle stretching will help. A physical therapist can be a great resource to set you on a safe path to a more flexible body.

Good luck to you! Chronic pain is awful, but reclaiming your life and moving your body can do worlds of good.

Of course, like all things health-related, ask your healthcare professional before undertaking anything out of the ordinary. Everybody’s medical conditions are different and should be respected as such. Exercise is great medicine, but make sure you get cleared to participate first!

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Whole30, Day 3

Current fibromyalgia symptoms: Right buttock/ low back/ hip pain still hanging on. Stiff neck but better than two days ago. Major brain fog—possibly related to switching to Whole30 from vegan. Tired but not exhausted, and worried I won’t sleep again.

Today’s exercise: 20 minute run; 30 minute walk; 30 minute light weightlifting and stretching routine.

Breakfast: 1 egg; 1 apple

Lunch: Ground beef cooked with onion and tomato; sautéed broccoli; and raw carrots

Snack: Smoothie made with canned coconut milk, ½ frozen banana, ¼ cup frozen blueberries, 2 tablespoon almond butter, and ½ scoop Garden of Life Perfect Food. Between lunch and dinner, I had four small sheets of Sea Snax seaweed.

Dinner: Ground beef sautéed with onion, green pepper, and jalapeno pepper served atop 6 big leaves of buttercrunch lettuce; Wholly Guacamole; and ½ roasted sweet potato.

General Feelings So Far: This is the most radical diet change I’ve ever made so quickly, and I definitely feel weird—like I’m living on a level somewhat removed from reality. Perhaps this is the “carb flu” spoken of in It Starts with Food.

I’m still not morally on board with eating animals, and that’s going to always bother me no matter how this diet change goes. I think it’s definitely a good idea to look for health benefits by cutting out wheat, corn, and processed food. But I’m still unsure about the rest of it.

I didn’t sleep last night and got out of bed at 3:45 a.m. to eat several spoonsful of almond butter. I found out the hard way that it’s easy to accidentally consume too few calories on Whole30. I remedied that today with more sweet potato and avocado, plus a coconut milkshake. I definitely don’t feel like I’ll be hoofing it to the kitchen in the middle of the night tonight. I’m not one to wish life away, but I’m definitely eager to see how I feel in a few days. The second week is supposed to be when more of the positive feelings (and less carb flu) happens.

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Physical Therapist and Chiropractor to the Rescue

I sometimes undervalue the effectiveness of physical therapy and chiropractic work. In my latest bout with back and hip pain, I was reminded of something that I ironically tell my patients and friends regularly: non-invasive treatment can be the best kind of medicine.

After my sacroiliac joint pain progressed into gluteal spasms and a rotated pelvis, sitting became impossible. I stood for as many hours of the day as I could, and laid prone with a pillow under my hips for the remaining hours. I couldn’t sleep because of the pain, and I finally had a “duh” moment. I work at a spinal rehab clinic. My bosses are a top-shelf physical therapist and an awesome chiropractor. Time to ask for help from the best.

I’m sometimes too passive in asking for help because fibromyalgia makes me feel like I need help way too often. But when I couldn’t sit or sleep, it was time for intervention. My boss /physical therapist put me through a thorough evaluation, and I started treatment two days later. It can be a little strange to be a patient in my own clinic, but the tradeoff is knowing that I’m getting great treatment. The decrease in my pain, progress in flexibility and mobility, and renewed ability to sit (and sleep) are testaments to how well chiropractic care and physical therapy can work together to heal even chronic pain suffers.

I’ve been to two PT/chiro sessions this week, and am currently able to sit pain-free on the floor. I had no idea how important sitting is until I couldn’t do it for a few days. I ran 6 ½ miles on Monday and was able to concentrate on the blue sky over the beach rather than the pain in my back and hip. Tuesday, I could do light weightlifting at the gym and actually sit down for dinner rather than standing through meals. Today, I ran 5 miles, walked the dogs, and was able to sit for 15 minutes in the hot tub without feeling like my sacrum was about to stab through my skin.

Forgive the pun, but fibromyalgia is a pain in the ass. I think the best way to sum up fibromyalgia to people who don’t understand it is to say this: it’s not just a cluster of random and sometimes unexplained painful symptoms (although there are definitely those). Normal injuries happen, but the aftermath is abnormal. The consequences from a healthy runner falling on a trail run are usually some bruises and scrapes. The consequences from a fibromyalgia-suffering runner falling on a trail turn into weeks of muscle spasms, misaligned bones, and exhaustion. It’s like fibromyalgia makes a worst-case scenario out of every situation.

The longer I live and the longer I fight chronic health problems, the less faith I have in pills and surgery. While those things are good options for some people, I prefer to stay as minimally invasive and drug-free as possible. Luckily, I have access to extremely competent and like-minded health practitioners who can stretch, massage, and manipulate my body into a good enough place to keep me out of the pill bottles and out from under the knife. I’ll never again underestimate the power of a physical therapist and a chiropractor—or the convenience and comfort of sitting.

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Pain Relief in a Hot Tub

After hitting an all-time low of muscle spasms and pain, I’m feeling optimistic and seeing major progress, no drugs required. I’d heard about warm-water therapy and had even helped my patients utilize it when I worked in a clinic with a pool a few years ago, but I thought it was out of reach for me. We can’t afford an in-ground spa (estimate $27,000!), and the natural water around here only reaches 80-85 degrees in the summer. We started pricing hot tubs, and they, too were expensive. Then we found a local company with no-frills hot tubs and great service, and we took the leap and made the purchase.

I’m not sure if this is true in other states, but where I live in Florida, if you have a valid prescription for warm water therapy, you don’t have to pay sales tax on a hot tub. When you’re spending a couple thousand dollars, the lack of sales tax really means something. I’ve also heard that we can claim the hot tub on federal taxes as a medical device, but we’ll see about the possible truth in that once tax time arrives.

The hot tub is a lifesaver. We were able to fit it on our screened porch, so we don’t have to swat mosquitos while trying to relax. I keep the water between 101-102 degrees, and sometimes I use it three times per day. It’s a simple setup—two low bucket seats and one long bench—and it’s perfect. We got a small set of steps to make getting in and out easier, and we put a bathmat under the steps to soak up extra water.

The miracle is the warm water. When we first bought the hot tub, my back was killing me, my neck was hurting, and my knees were aching. The warm water didn’t cure me over night, but it was soothing, and the cumulative effect is incredible. I had to take muscle relaxers and steroids to get me through the worst times, but the hot tub has helped me stay drug-free for the past two months, except for occasional ibuprofen.

I’ve heard that heat bothers some people with fibromyalgia, but for me, cold is the worst. When I sink down in the hot tub, I feel instant relief, and even though it sometimes only lasts a few minutes after getting out of the water, other times it helps for hours and even all day.

At night, my new routine has been to use the hot tub a few hours after dinner, then stretch my muscles on the carpeted bedroom floor. I’m seeing improvements in flexibility, pain, and anxiety. I even started running again two weeks ago—something I’d worried had been taken away from me forever after the latest bout of back and knee pain. I’m increasing the amount of weight I do each week at the gym, and I’m even returning to some high-intensity activities like jumping. I’m nowhere near 100%, but the hot tub is helping me feel closer to normal. I’d hit the point of not being able to do anything I wanted or needed to do, and the feeling of hopelessness is an awful thing. The hot tub wasn’t cheap, but it’s already paid for itself a million times.

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Patellofemoral Syndrome

I had a doctor dry-needle my left knee pain yesterday, which is an experience I can only describe as having an MD treat my body like a voodoo doll. It was extremely painful, but I think it did some good. She said I have patellofemoral syndrome, which I’d guessed, but she also said the words no athlete wants to hear—“stop running for a week.”

It’s hard to know whether athletic injuries that I accumulate are truly as bad as they feel, or if fibromyalgia exaggerates the pain. That aspect of fibromyalgia—the intensified sensitivity to injury—is one of the ones that makes me crazy. I never want to back off a good workout if there’s not much of an injury, but on the other hand, I don’t want to keep going to agony if there really is something badly wrong. It’d be nice to have a more normal sensory pattern so that I could have a better gauge of how bad I’m hurt.

I won’t be able to run for a week because of the knee, but I fully intend to walk, lift weights, and do lots of stretching. I’m not sure if other fibromyalgia patients experience extreme inflexibility, but I do. My tight hamstrings make it difficult for me to even sit upright with my legs extended, and my neck is barely capable of side-bending. I’m planning to use this latest painful setback as time to develop a good, long-term plan for improved mobility. I just hope this knee pain lets up soon, because it’s making me a little nuts right now.