I have a love-hate relationship with pushing through my pain. Sometimes pushing through the pain ends in great results. Other times, it is disastrous. And the uncanny problem that I am trying to wrap my brain around is that there is no forewarning or way of knowing ahead of time which direction this deadly dance will swing.
For example, there are days I find myself lying on the couch in moderate to severe levels of pain until I am forced to go to work in the afternoon. I get up, go about my job, and when I come home later in the evening I am rejuvenated, my pain levels have decreased slightly, and my spirits are infinitely higher from the personal interaction. Sounds great, right?
But, no. It gets confusing, because this best case scenario only occurs about 50% of the time. On other occasions, I do my best to push through the pain and I find myself in a mild to moderate flare for the next few weeks or a full-blown setback that will take 2-3 months to get back to baseline.
Sometimes I am required to push through, as in the case of going to work. In those instances, the choice is easy – I get up and go to work regardless of how I feel. But, what about those situations when I have a choice? To push through or not to push through? That is the unanswered question that I have yet to wrap my brain around.
The common train of thought that I hear from most pain management resources is that pushing through is the better option. If you have the choice to go out – do it because you need to live your life. If you are participating in any sort of pacing program – keep going and increasing on schedule regardless of your pain levels. If you are doing housework and feel an extra twinge in your back – don’t stop and rest, keep going.
As a specific example of this, I was recently reading an article published this past January on NPR entitled, “Pain in the Back? Exercise May Help You Learn Not To Feel It.” The basic premise of this article revolves around a boot camp for individuals with chronic back pain, many who have experienced pain for years without relief. Under the guidance of a trained professional, participants are put through what seems to be an intense exercise program and encouraged to continue pushing through, even on many occasions when pain increases.
The underlying thought behind this strategy is that pain does not equal damage. Participants push through the pain, and over time, as their body strengthens and becomes desensitized to pain, many see moderate to large improvements in their condition.
I just struggle with wondering how translatable this is to various chronic pain and illness conditions. I struggle with believing that pain does not equal damage for my specific diagnosis and for my body personally. My ligaments were literally sprained in my initial chiropractic injury, and I keep getting the feeling that every time I have a huge setback that lasts several months, it is because I have re-sprained the already damaged and vulnerable ligaments from overexerting myself. I have talked about this before, but situations such as moving boxes, vacuuming, increasing my exercises too quickly, etc… have all been triggers to set me into full blown setbacks, often after periods of relatively steady progress.
I came across an interesting article in The Journal of Manual and Manipulative Therapy that gave some credence to this viewpoint. The article entitled Evidence-based Diagnosis and Treatment of the Painful Sacroiliac Joint states the following:
“Inflammatory processes such as those found in ankylosing spondylitis87,88 are known to affect the SIJ [sacroiliac joint]. In addition, instability secondary to trauma or childbirth may well be responsible for repeated minor traumas producing, perpetuating, and increasing inflammatory activity in the joint.”
So, number 1, there are inflammatory processes going on, which confirms my decision to participate in a strict anti-inflammatory diet. And number 2, there is evidence that repetitive minor traumas to the SI ligaments perpetuate inflammation in the joint. I can’t describe how much sense this makes to me based on my personal experience.
This research seems to support my caution in not always pushing through the pain. Perhaps pain does equal damage in my case, damage in the form of “repeated minor traumas” or re-spraining of the damaged ligaments.
I have found that pushing through the pain poses a huge risk for me. When I start to do too much too fast, or if I ignore sudden increases in pain, I can immediately lose months of hard work in the span of a night. This is not worth it to me. For me, slow and steady leads to the most progress. Now, if I can only manage to learn how to keep this progress.
How about for you? Does pushing through the pain help or hurt? Do you have any strategies for knowing ahead of time when you should or shouldn’t push through?