When Determination Wins: A Chronic Pain Warrior’s Journey through Hand and Arm Pain

The author shares how he used education and mind-body techniques to overcome his chronic pain experience.

Repetitive Strain Injury – I’d heard about it, but little did I know that it would soon take over and change my life forever.

It was the year 2010, and just like any other day, I was hard at work typing away at the computer, when all of a sudden I felt pain running up from my right hand and throughout my forearm. An unusual shooting pain that dissipated quickly, I didn’t think too much of it. I shook out my arms and continued working.

But the same thing kept happening over the next few weeks. I powered through my work and through the pain, knowing that I had deadlines to meet and I could not afford to take a break. That was until taking a break was the only thing I could do. Within the space of a few weeks, the pain had spread to my left arm and any fine-motor use of my fingers caused ripples of pain.

The Treatment Merry-Go-Round

After self-managing the pain with ice, heat, and over-the-counter medications for around 6 weeks, I finally made an appointment with my doctor. He confirmed the diagnosis I had searched online: Repetitive Strain Injury (RSI). The medical advice: rest and take ibuprofen (a non-steroidal anti-inflammatory drug or NSAID) up to three times a day to help relieve the pain.

The visit didn’t do much for my pain-related anxiety, however; I was afraid of how long it would take me to get back to work. But, at least I had a diagnosis and could work on getting better.

Little did I know, that for the next two years, the situation was only going to get worse.

I tried resting for months. Since I run my own Internet business, I was fortunate that my team could handle most of the daily tasks at the office. I visited specialist after specialist and tried all that was suggested or available. From strengthening and stretching to diet changes and chiropractic adjustments, from deep tissue massages and acupuncture to CBD oil and transcutaneous electrical nerve stimulation (TENS) therapy.

Nothing offered lasting relief, and I was no longer able to take ibuprofen as several months of use had led to a stomach bleed (Editor’s Note: FDA Drug safety information on NSAIDS notes that long-term use may be associated with stomach or intestinal, bleeding, ulcers, and more). At this point, I could barely type, drive, or flick the page on a book without feeling like lightning bolts were ricocheting inside both my arms.

As treatments continued to fail, I went to see an expensive, but highly credentialed hand and arm specialist. He conducted a fancy ultrasound scan and nerve conduction studies. His diagnosis was “cubital tunnel syndrome” (ie, pressure or stretching of the elbow’s inside ulnar nerve, also known as the “funny bone” nerve) and the suggested procedure was submuscular ulnar nerve transposition on both arms. This surgical procedure is meant to release the pressure through decompression and repositioning of the nerve as needed. Basically, a surgeon moves the chunky ulnar nerve that runs through the elbow to under the forearm muscle. It’s an invasive surgery, but I felt like I had nothing to lose, so I gave it a shot.

The author having a meal after his surgical procedure for cubital tunnel syndrome (chronic elbow and arm pain).

Once I recovered from the trauma of surgery, to my dismay, I found that the pain was still present, in the same areas, and with the same intensity that I was all too familiar with. I didn’t even achieve a placebo effect.

I started to accept that I may never be able to regain full use of my hands and arms. The situation was dire. My doctor believed that the repetitive motion of typing was the cause.

My Lightbulb Moment

I started to give up hope, but my family insisted that I continue to visit National Health Service, a free healthcare service in the United Kingdom where I reside, to see a physiotherapist. (Editor’s note: A physiotherapist differs from a physical therapist in that the clinician may apply more hands-on, manual manipulation of the patient compared to helping the patient complete certain exercises. Both types of practitioners complete a graduate program and can choose but are not required to complete a medical doctorate.)

I reluctantly went to see what I thought would be the last physio I'd visit. After a couple of examinations, Sally—my physiotherapist—felt that there seemed to be nothing mechanically wrong with my hands or arms. She explained to me how, quite often, people can feel 100% real pain, despite the absence of tissue damage, for example, in the case of phantom limb pain after an amputation. Essentially, people can become sensitized to pain.

I asked (and secretly prayed) if there was a pill or technique that could “desensitize me.” But of course, it wasn’t going to be that easy, and my short-term mindset was what got me here in the first place.

Sally mentioned that the neuroscience of pain sensitization was still emerging, and that from a physiotherapist's point of view, there wasn’t much more she could do for me.

It didn’t matter. This was enough. Her words ignited a spark of hope in me and, I thought, “surely if my body is sensitized to pain, I can desensitize it.”

I went home and spent weeks digesting all of the pain science I could read. I was blown away that there was so much more to pain than I instinctively thought. Why had none of the health professionals I’d seen over the years not explained any of this to me? Ignorance? Negligence? Probably a combination of the two. (See also, Why You Should Ask for More from Your Pain Doctors.)

Armed with this new knowledge, I could now look back and make sense of my pain, my triggers, and how I would recover.

Making Sense of My Chronic Pain

The first step on my journey to train my brain away from pain was to get a deep understanding of what was going on in my body when something hurt. Pain, I learned, does not always equal damage, and when it does, pain can outlast the healing period. The brain creates pain, in terms of how we feel and respond to it, and we can influence our pain experience. Changing what pain meant for me started to change my experience of pain.

I quickly realized that my fear of pain and fear-avoidance of painful activities was hurting, not helping, my situation. I thought that by avoiding key triggers, like typing and texting, I was giving my arms more of a chance to recover. Whereas in reality, my body had physically recovered as much as it was going to. This fear and avoidance behavior was just making me more sensitive to these triggers.

Each time I avoided typing or texting out of fear of the pain it would cause, I was edging up my pain sensitivity and wiring my pain response a little deeper. I was giving my brain the impression that typing and texting were, in fact, dangerous activities and that pain was a justified protective response. As time went on, my brain and body became better and better at creating pain.

Known as central sensitization, I like to think of this response as the dark side of neuroplasticity. Our brains and bodies learn to experience pain. (Learn more about neuroplasticity and pain response.)

Overall, understanding modern pain science helped to get rid of much of my pain-related fear and anxiety. But these weren’t the only factors keeping me locked in a pain cycle. I also learned that the belief I held of damage done to my body, pain hypervigilance (an enhanced pain response), and catastrophizing (or negative pain appraisal) were also key factors keeping my pain system on edge. I had to overhaul it all.

Essential Pain-Relieving Techniques

I was determined to try graded exposure to my known triggers (Unfortunately, doctors never delved deep into my triggers so I had to figure them out for myself). I returned to typing by doing so for as long as it felt comfortable, shaking off the occasional twinges of pain, but not pushing it too far as to risk a major flare-up. This approach left me with a feeling of confidence and accomplishment, as opposed to anxiety and disappointment.

I met every twinge of pain with a visualization of pain leaving my body, rather than granting it attention. I also learned to focus my attention elsewhere, and when I needed it, to complement visualizations with positive self-talk and belly breathing. Every time I did this, I believed that the neural pathways creating my pain experience would grow weaker, and my pain-relieving visualizations would grow stronger.

I also changed how I thought about pain, including how I spoke about my pain to others. I stopped being careful and protective of my arms, and instead, put faith back into the proven healing ability of the human body. I spent a good amount of time thinking about my pain-free future, fully believing that I would get there.

Within 2 months, I was pain-free. It was incredible and something that still fascinates me to this day. In fact, I have been pain-free for over four years now. Occasionally, I experience a twinge of pain, usually when I’m stressed or have been working exceptionally heard. But when this occurs, I quickly return to my techniques (eg, belly breathing, self-talk, etc) and the pain does not last more than a few minutes.

The author has returned to martial arts training after years of chronic pain in his arms.

Life Beyond Chronic Pain

I’m not a spiritual person but overcoming chronic pain with mind-body techniques has led to a spiritual awakening in me. I feel more aware than ever before and in tune with my body and thoughts. I’ve developed a deep and humbling appreciation of how the mind and body are linked.

Overcoming chronic pain has also forced me to reflect on just how many people remain trapped by pain, unaware that they may find relief with mind-body techniques. I was lucky enough to meet a physiotherapist with pain science knowledge, but many are not. Because of this, I have dedicated my time to creating a product that could take someone with debilitating pain like me, to being pain free.

With 18 months of hard work alongside pain researchers, doctors, and physiotherapists, I developed a chronic pain relief mobile app called Pathways that focuses on mind-body techniques. I’m humbled to report that since launch, this app has helped hundreds of patients and I’ve received many positive reviews. This feedback has made my journey through chronic pain one of the most important and rewarding journeys of my life. Without suffering from pain, I wouldn’t have found my calling. For that, I am deeply grateful.

 

More on self-care for chronic pain.

Updated on: 06/23/20
Continue Reading:
My Seventy-Month Journey to Being Diagnosed with CRPS
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