Acute vs. Chronic Pain Revisited

Yesterday felt like a good day for me physically. I should stop there and celebrate that. But the day flipped later on. I was on a road trip with my mom to come down to LA to visit. I did almost double my normal steps. I got ready in the morning with showering, breakfast, finished my packed bags, and walking to the car. I met my mom and got in her car, and we stopped 3 times and I got out and walked around. It was the perfect pacing and resting combo and I got to practice going from sitting to standing a lot, which I’m trying to do with the strength of my legs without pushing off with my hands. So at least I want to celebrate a day where I felt physically good and capable. 

Then we went to the grocery store and I used the wheelchair. Getting up from the wheelchair at the car I got a sensation at the top of my knee with chronic pain. It was probably a normal sensation of using something I haven’t in a long time and challenging my knee. However driving home it just got sorer and sorer. By the time we got home it had boomed into a flare with lots of buzzing sensation in the chronic pain area. I pretty much rested all night with little walking. I woke up this morning with a ton of soreness in the area and am being careful and cautious.

I hate how a good day suddenly gets flipped with chronic pain. It’s like, now all bets are off and plans go out the window.

I tried to use all my good thoughts and I looked back at my acute versus chronic post to help me with my pep talk. (I have a feeling I’ll keep posting about this- seems to be my loop.) Here are the two sides of my brain arguing:

Side 1) I feel really sad, powerless, angry, and have lots of fear. I guess the fear is that I’ve injured myself or if I keep walking I’ll feel that pain I felt when I injured it before. Basically if I had to recover from an injury like the one I had before I get the image of falling down into a bottomless pit. I’d give up and let go and I don’t know how I could handle that again. It’s reliving trauma and memories and I’m projecting. 

Side 2) Now is the time to apply everything I’ve learned and all my tools! I have chronic pain and I’m having a flare. It’s really unlikely that I injured myself with getting up from sitting. My body is much stronger than that. This will pass. Meditate, do a deep relaxation, use heat, self soothe with my senses, talk to a loved one, journal, take care of myself, practice gratitude and joy, and rest if that’s what I need. Use evidence like, I’ve always recovered in the past and it’s always turned out to be a flare and chronic pain. Use radical acceptance of the situation: I am having an incident of pain and need to stop and rest. Time will tell. Use willingness: I’m willing to be in reality as it is and not as I think it should be and will do what I can. I could use my CBT skills like see what thought distortions I’m using, like catastrophizing, and find a more balanced thought process. I can recognize Side 1 as a narrative that is so deeply embedded and automatic that it seems like the truth, but it’s just a story. I can see that having Side 1 as my strongly held, underlying belief only hurts me. I can choose a different belief, like the fact I have chronic pain and it will pass and these things happen. I can just stop, observe and breathe and be in the present moment and see what’s really up.

I tell myself the Side 2 story half believing it, but it’s always turned out to be the helpful and correct one. I hope half believing is effective somehow. I think it helps with neuroplasticity and giving my brain a few new options.

I think I’ve gotten a lot better at this whole loop I get stuck in, but it’s hard when something happens that is more sudden. At least I have Side 2 as a ballast for Side 1, which was the only perspective I had before the pain clinic. 

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