Anyone else have an experience like this?
Near the beginning of the year, I did something (I don’t even remember what) and I immediately knew that I had made a mistake. Something pulled in my back and I knew I was in for a few days of pain.
No biggie, right?
Bodies are built so they can heal, right?
I gave myself a couple of weeks for it to heal. Eventually it hurt less, so I took that as a win and moved on.
But, it never really stopped hurting.
At least, not permanently.
The pain would come and go. There weren’t any specific movements that made it worse or better. It wasn’t tender to the touch. It was almost impossible to pinpoint exactly where the pain was. For all I could tell, maybe it wasn’t even the same pain every time. And the pain really wasn’t that bad. I’d say it was maybe a 4 or a 5 at the worst. I mean, yeah, sometimes the pain would drain me of all my energy so all I wanted to do was lie down. Sometimes it ached enough it made me want to cry. But, like, bodies are weird and sometimes they hurt. And mental health is weird, and sometimes you just hurt. So no biggie. I took painkillers when I couldn’t handle it anymore. I used a hot pad once in a while. (In retrospect, it was more than once in a while. Sometimes it was every day, even multiple times a day. But patterns are easier to see in retrospect.)
Cut to summer. It’s still going on, but I haven’t really, like, identified that this is a problem. In my mind, I’m experiencing discrete events that are unrelated to each other. And feeling unexplained pain sometimes isn’t alarming to me (as, I’m sure, is the case for many of you). A vast majority of my pain is unexplained. Headaches, joint pain, muscle tension, nausea, sore throat. It happens. I had a moment during the summer where I finally connected the dots. I realized that this pain I was having was always in the area of my right scapula and I was getting radiating pain down my arm and up my neck. And, because I dabble in anatomy, I knew that those things were all connected through the brachial plexus1.
Shortly thereafter, I called and set up an appointment with a sports medicine doctor. I explained my symptoms, to the best of my ability, he tested my strength and range of motion (it’s been great for my ego to have people say “You’re plenty strong, weakness isn’t a problem” even though they are mostly meaning I’m not pathologically weak, but I’ll take the wins when I can get them). He couldn’t identify any problems there. He explained that it would be hard to determine exactly what was causing the pain, as there were three or four scenarios that could explain my symptoms. 1) I had a rib that was popping in and out of place, 2) there is some sort of nerve issue (bulging disc or something), 3) my muscles have been brainwashed into thinking that chronically contracted is “the new normal”, 4) there is some sort of anomaly on my scapula bone that is causing me grief. We discussed my options and went with trying physical therapy. This physical therapy would include manipulation, to help get my rib back in place (if that was the culprit).
My rib got put back in place and the pain went away within a few days. I was also doing some PT exercises. I went back to the PT once more and basically everything was feeling fine, so he told me to just keep doing the exercises at home.
Fast forward once more, and it’s been probably three months when I realize that I have increased pain on the days after I do PT. The pattern has been there, but I just haven’t noticed it. Why? (Let’s say it in unison) Because random pain is not an uncommon occurrence.
One of the other options the sports medicine doc and I discussed was trigger point injections. I go in for that. At the same time I schedule to get back to the physical therapist. The trigger point injection appointment came first. Since he couldn’t find any specific knots or anything (like I said, there hasn’t been any tenderness with this pain, so even if you push on the spot where the pain is, I don’t have an increase in pain), he suggests getting a few tests. I get an x-ray and MRI of both my cervical and thoracic spine. (The MRI was two days after I met with the sports medicine doctor. I was shocked at how fast they got me scheduled. It was amazing.)
All tests come back normal.
In the meantime, I’ve gone back to the physical therapist. He is baffled, but says if I’m getting more pain with the exercises, then I should stop doing those exercises.2 He gives me some milder exercises (literally just shoulder shrugs and shoulder pinches). Wouldn’t you know it? These also exacerbate the pain. So he tells me to stop doing those as well. At my next appointment he asks more questions, tests more things, and really tries to figure out what is wrong. He’s poking and prodding, watching me move my arms, making me hold odd positions and then asking if the pain is worse *here* or *here*. You know, the whole nine yards. But I’ve got him stumped. And I feel terrible (emotionally). I feel like I’ve done something wrong. In the days before this most recent PT appointment, I spent a fair amount of time and energy trying to pinpoint the pain and figure out how to describe it.
I got to thinking about that, and was able to take a step back and ask myself, “Why on earth am I thinking that way?”
Why did I prep for my PT appointment the same way I’d prep for a final exam? Why did I feel bad that the PT was stumped by the gentlest of exercises exacerbating my pain? Why did I feel the need to tell the PT that the place he thought should be tender and painful was painful, even when it wasn’t3? While he was trying to find tenderness or whatever he was trying to find, why was I elated when he found a spot that actually was a little tender to the touch?
Because I’m used to being told my pain is either normal or in my head4. Because I’m used to experiencing pain and problems that are hard to duplicate for the doctor (kind of like when you bring your car to the mechanic and the weird noise stops). I’m used to getting normal labs and exam results that leave both the doctor and me wondering if I’m just being overly-sensitive.
To be clear, neither medical professionals (PT and Sports Med) actually indicated their belief that there was no root cause for my pain. The sports med doctor even acknowledged the limitations of testing to uncover certain types of problems, implying that lack of positive test result does not mean lack of problem. The physical therapist was baffled and said that both my strength and mobility were fine (he seemed to forget from appointment to appointment that hypermobility could be a confounding variable), but he didn’t every say that there was nothing wrong with me.
I did that to myself.
Does anyone else wonder what it would be like to go to the doctor feeling confident that they would be able to definitely identify the problem and treat it?
Footnotes
- You better believe I thought it was super-duper cool that I could identify the anatomical structure based on the location and type of symptoms. ↩︎
- I know it seems like it should be intuitive: if it hurts, stop. But lots of things hurt, and I’m not very good at determining if that pain is indicative of tissue damage or not. ↩︎
- I felt like I should do that, but I mostly managed to not do that. ↩︎
- Don’t even get me started on that. Pain is pain. It doesn’t matter if the source of the pain is tissue damage sending signals to your brain or if your brain is interpreting innocuous signals as pain. They are both legitimate kinds of pain. One is significantly harder to treat, but that doesn’t make it any less valid.
One day, I will internalize this message. I hope.
↩︎
Emotional Support Sisters 
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