The Enigma of Pain: a journey towards healing

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Those of you who have been following the blog for a while know that I’ve been in pain for some time. It’s been a journey of several years to discover and treat the psychological, emotional, and physiological causes. I’ve written about it previously in this post. Here’s the next installment.

Dec 2016
I never believed I knew how to stay healthy. It feels like everything I’ve ever read or heard about what to eat to be healthy has been contradictory. There is so much information out there that it is overwhelming. I was put in charge of this body with a mandate to take care of it, with no manual, and no idea how to do it, so although most of my life I’ve eaten “healthy,” and rarely eaten junk food, there has always been an underlying stress: “am I doing it right?”

Then I woke up one morning suddenly remembering that I’ve always been healthy. In the midst of all the resistance to the body, and the fears about not taking care of it properly, I’ve always believed that I’m basically healthy and that I heal quickly. I’d gotten lost and had forgotten that ingrained perspective in my relationship with my body.

I’d forgotten it because of two things. The first was getting older and all the attendant deep-rooted unconscious beliefs about aging – the body deteriorates, there’s no cure, you’ll lose function, etc. These beliefs were trolling around in my psyche without being challenged. The second was the diagnosis of arthritis and all the beliefs that come from conventional wisdom about that – there’s no cure, you’re wearing out, you just have to manage it, it will only get worse.

The day I remembered that I’ve always been healthy, and that I heal quickly, I had almost no pain.

Jan 2017
A few days ago my entire left leg from hip to ankle was so painful I could hardly walk on it. Then that pain gradually went away. Then yesterday I got out of bed and the right leg from hip to ankle was so painful I could hardly walk. I walked with Don almost all the way from our hotel to the Water Gate in Campeche to get bus tickets. Suddenly I was just in too much pain to keep going so I started walking home by myself. I walked very slowly, easing into the pain, slightly changing positions to accommodate it, and as I moved it diminished somewhat. I knew I’d be able to get home, very slowly, but it was still really painful. Then I came to a church – they were unloading mountains of white flower arrangements from a van and taking them inside. I was captivated. I spent several minutes inside looking at and photographing the church and the gorgeous abundance of flowers. When I finished I realized that I’d not been in pain the whole time! With being taken out of myself the pain disappeared.

The pain is like a phantom, and when I’m not focused on it it disappears. This is not the first time I’ve realized this, but now I can’t deny it. One day the left leg is so painful I can hardly walk. Then that subsides. A few days later the right leg is so painful I can hardly walk. Then I’m so engrossed in enjoying and photographing something captivating and beautiful and the pain goes away altogether. It’s like a phantom, a chimera. How can I take it seriously?

23 April 2017
A revelation: just because I’m in pain doesn’t mean I have to be unhappy.

6 July 2017
If I can just get distracted enough the pain goes away, except when it’s the searing pain in my knee or down my shin. This being human is such a bewildering mix of suffering and joy. I have pain in my right leg from hip to ankle coming and going, moving around like a wild drunk looking for home, and then pain arising in the left knee. Suddenly something clicks, a clarity that I can simply accept it, that I don’t have to react to it. This is not new. It is a lesson to be learned over and over.

7 July 2017
For as long as I can remember I’ve been running headlong into life grabbing it as hard as I can, each experience a gift, a blessing, and a bundle of stress. Each goal, each project, each relationship, inhaled whole until I was rendered shattered and useless by the extravagance of it all. I never seemed to learn how to do things by half measures.

Three years ago I was diagnosed with arthritis in the right hip.

In August of 2016 I saw a physiatrist. He sat behind his big brown desk, looked me in the eyes, and said “join the club, you have arthritis, take anti-inflammatories”. He told me I was a long long way from needing a hip replacement. He put in a referral to an orthopedic surgeon with the idea that I could have a replacement sooner rather than later even though I didn’t need one yet. He thought the surgeon would get back to me within a couple of months. He showed no interest in looking into other possible causes of my pain. He did not suggest tight muscles, he did not suggest muscle imbalance, he did not suggest that it could help to work with a physiotherapist or personal trainer despite the fact that his specialty is nonsurgical treatments for the musculoskeletal system.

In April of this year I saw a rheumatologist. He told me I had arthritis. No kidding. When I asked him the cause of all the pain he said he didn’t know, and that he didn’t know what kind of doctor I should see. He was dismissive to the point of being rude. I suspect he thought I had psychological problems. As he left the room he suggested Synvisc or cortisone injections.

Later in April I was referred to a sports medicine specialist. He suggested a couple of exercises to help strengthen the core, and talked about the nature of chronic pain. The idea resonated somewhat as I’m aware of the brain-body connection. I’m aware of being in pain in the past, not knowing what was wrong, and carrying on anyway, and subconsciously being afraid of the consequences. I understand that this kind of fear can set up confused signals from brain to body and I continue to explore this.

In a later visit he insisted again that my problem was chronic pain. He did not suggest tight muscles, he did not suggest muscle imbalance, he did not suggest that it could help to work with a physiotherapist or personal trainer. I do understand that his specialty is sports injuries, but I would have expected that a sports medicine specialist might at least look at muscle imbalance and soft tissue injury.

And then through sheer good luck I found the beginning of a turn around. I chose to get the Synvisc injections. If I hadn’t made that choice none of the following would have happened.

During the times I saw the rheumatologist for the injections we developed a better rapport. He recommended me for a six-week course called Exercise is Medicine at a local University. It was a pilot program of four personal trainers working together. I saw them weekly for six weeks, and I was their only client.

The benefits of this course cannot be overstated. This is when I finally worked with people who addressed muscle imbalance and taught me exercises to redress it, and encouraged me to continue with deep tissue massage to deal with knotted muscles. I made great progress in the last month of the program, and it became clear to me, despite the fickle nature of pain, that there were indeed physiological causes for it.

In August 2016 I was told I was a long long way from needing a hip replacement for the right hip. I had no arthritis on the left side, nevertheless I was in pain from hips to ankles on both sides, and yet no one in the medical profession could or would diagnose the pain, let alone treat it.

In August 2017 I received a call from the orthopedic surgeon. It was a complete surprise. When I hadn’t heard back from him within two months, as the physiatrist had suggested I would, I assumed it was a non-starter and forgot all about it. Anyway I was not ready for a hip replacement and as Don and I made our way to my appointment with the surgeon we both agreed that a hip replacement was not wanted – at least at this time.

The surgeon showed me an x-ray I’d had taken that morning. My right hip was down to bone on bone. In one year I’d gone from “a long long way from needing a hip replacement” to bone on bone. I was flabbergasted! The wait time for surgery would be four to six months, but I put my name on the cancellation list.

I was lucky enough to get a cancellation and on September 25th I had it done: into surgery at 8am, in recovery by 9am. Overnight in hospital, home the next afternoon. I now have a brand new titanium hip.

It’s been nearly eight weeks since the surgery and I am recovering well. My relative youth helps, as does my general level of fitness and core strength from daily exercises for years, and especially more recently with the Exercise is Medicine trainers. I am anticipating a full recovery from the surgery and for all the other poor muscles that have been working overtime, and in the wrong way, to compensate for a gimpy hip. I’m not always a fan of modern medicine, and yet in this case it feels like a miracle. I am so grateful.

There was a time I ran without thought
along the bush paths of Canberra
around Hyde Park in London
round and round the oval at night in Tom Price
running and running and running
because the body needed to move
because the mind needed space
because the heart wanted freedom.

There was a time I cycled without thought
on an old heavy 21 speed mountain bike
pushing and pushing and pushing
up and down the hills
along the dirt trails around Whitehorse
along the gravel roads outside of Atlin
along the beach paths of Vancouver
along the bush paths of Canberra
my body straining against the pedals uphill
the wind in my face my body doubled over the handlebars
screaming with joy as I flew downhill
faster and faster and faster
because the body needed to move
because the mind needed space
because the heart wanted freedom.

There was a time I skied without thought
across the vast silent snowscape of the north
miles and miles and miles
my legs and poles in steady rhythm
swoosh swoosh swoosh
past fir trees and balsam and pine
across frozen lakes and through the woods
swallowed whole by the silent beauty
of the soft white landscape
moving in steady rhythm
swoosh swoosh swoosh
because the body needed to move
because the mind needed space
because the heart wanted freedom.

There was a time I walked without thought
all over the world
the body a happy willing vehicle
excited to know what was around the next corner
or to get to the top of the volcano
one step in front of the other
sometimes a slow ramble
more often than not a surging forward
to the next moment and the next and the next.
If I could no longer run or cycle or ski I could walk
and walk and walk
because the body needs to move
because the mind needs space
because the heart wants freedom.

And now that too
for now,
or forever,
is gone
and I grieve this loss of the best of being a body
this best joy of the physical vehicle
this freedom to move and move and move
without thought.

Wind in the face
sun shining down
the sheer joy of exertion.

It’s all gone for now.
Or forever.
It’s all gone
and grief arises
like a hot molten flood washing over me.

I have long believed that physical pain is, at least in part, a mirror of buried unfelt emotional pain. The gift in this journey is that the pain pushed me into wading around in the swamp of the psyche to heal what needed healing. Some fourteen years after her death, in my 65th year, I finally healed my fractured relationship with my dear mum. We were not a good fit, but finally I was able to forgive her, and to forgive myself, and to think of her with love. Much else feels different, softer: my relationship with myself, my relationship with my body, and a deeper acceptance of what is.

The pain forced us to give up our nomadic lifestyle. I think I’ve finally come to terms with that, though there was some grieving involved, along with grieving the loss of mobility beyond normal daily activities. The grieving has set me free. After what feels like a long time I finally feel at home again.

The hip surgery feels like a milestone, like the end of an era that I’ve been moving towards for three years. I am recovering well, and already walking more freely than before.

I have no idea what’s on the other side of recovery. That’s to be discovered. It will be a whole new era.





Photos: Last April we were housesitting for some friends who have an apartment on the 28th floor in downtown Vancouver – so a couple of nighttime views. Plus a couple of the vibrant fall colours we had this year.










Next post: A train trip to an abandoned sugar mill and a hike in Guanayara National Park, Cuba





All words and images by Alison Louise Armstrong unless otherwise noted
© Alison Louise Armstrong and Adventures in Wonderland – a pilgrimage of the heart, 2010-2017.