Pushing through pain

"I bet this chair's hurting!"
Ruth smiled and wrenched my left wrist backwards again as my right hand squeezed the leg of the chair till my knuckles shone white. An experienced sports physiotherapist, she knew how far she could go and how important it was to push through the pain barriers to produce a result. The screaming pain from my arm told me different… but I trusted her.

RSD produces unreasonable pain. It usually starts when the original injury is nearly healed. Or completely healed, like mine. My x-ray revealed a perfect mend to the fracture that started me down this road. A perfect mend, but bucketfuls of pain. People experience pain in many different ways, but RSDS pain is usually described as "burning". That's how it feels when at rest. But, with an athletic physiotherapist pushing my wrist into shapes I didn't believe it could manage, "torture" would be a better word. I didn't scream, but that's because I swallowed the sound. What's more, I gripped that chair so hard it must still show the marks.

I took painkillers, of course (I didn't know they made analgesics that strong) but four doses a day was barely enough to let me sleep, or work, or carry on with life. I kept going because I knew how bad this condition might get if I let it gain control. I remembered my childhood hero, Douglas Bader (the 2nd World War flying ace who happened to have no legs) and I determined that, like him, I wouldn't be beaten. Ruth encouraged me and urged me on. She related, with regret, the tale of one RSD patient whose only aim had been to get a certificate that would qualify him for disability allowance. What a trade-off… a few measly years off work in exchange for a lifetime of pain! I couldn't accept that.

The most important lesson Ruth taught me was that I could get past the pain. Or, I should say, through it. At the other end of that dark tunnel was a bright prospect of relief from the agony, regained movement, and the ability to drive again, to use both hands on my PC, to play my guitar, to return to normal life. So I did what she told me.

Between my visits to the cilnic, I pushed myself through the exercises at home three times a day and put one session into my lunchtime at work. It hurt a lot; so I used a bucket of cold water or a special 'sports' freezer pack when the pangs became unbearable. Every few minutes I would stop and cool my hand and arm. The coldness brought enough relief for me to continue the exercises. Each week, Ruth would measure how much my range of movement had increased. Sometimes we would celebrate a big improvement; sometimes the change was imperceptible; but we never went backwards.

Ruth reassured me that I couldn't do any damage. My fracture was healed and there was no chance that these exercises would break it again. The pain was a lie that I had to prove wrong; the lie that my arm was still injured… Pain is useful when it alerts us to disease or injury but, with RSD, it is a false alarm. My original injury was history, but my sympathetic nervous system was still 'crying wolf' with increasing stridency. I had to teach it the truth.

Pushing through the pain was an excruciating experience. It hurt. It really hurt. But each time I gained some movement in the limb I lost some of the pain. When my index finger first touched my thumb (a momentous achievement) my wrist screamed its objections. By the time I could bend my wrist backwards I felt little more than a dull ache. I had pushed through the pain.

Reflex Sympathetic Dystrophy has no mercy. If we lie back and let it get hold it will take over our lives and trap every nerve in a prison of pain. Unsympathetic observers sometimes suggest that it's all in our mind. They are wrong. However our minds do hold the key to beating this monster. It is a messenger from our nervous system telling us we are sick and disabled, but this is a messenger we have to 'shoot'.

©Derrick Phillips
February 2001