Pain Management Strategies

Some of my pain management techniques. 

As a sufferer of a Rheumatic disease (Ankylosing Spondylitis suspect no.1) and an avid hiker, I am no stranger to pain and ‘overuse’ injuries. It is my opinion (after discussions with many doctors, physiotherapists and specialists) that rheumatic diseases are very poorly understood, and a few of the specific problems I have encountered are equally poorly understood. This presumably makes diagnosis (and treatment) of said rheumatic condition tricky. The usual solution is pills, but I really dislike having to take pills.

Here I will share my approaches on reducing the amount of pain suffered and my attempts to minimise ‘bench time’ – or rest time. We all need rest of course, but I like activity more! Please be sure to read my disclaimer at the bottom of this page. I am not a qualified healthcare provider – I am merely sharing some strategies that I have learned and employ regularly so that I am able to function like a normal 30 odd year old human being, at least physically – to varying degrees of success I might add!

Rest is a word I am not particularly fond of, and when I was told by my physiotherapist and Rheumatologist to rest for 3 months last year – I was not impressed. A huge black cloud moved over head, and I was wondering when it might lift. I felt that I had been robbed of something. Of course, I was right – I had been robbed of my freedom to hike. I had to quit hiking for a season to allow my body to repair.

Some of my absolute favourite conditions are listed below, along with strategies or coping mechanisms to help alleviate some of the pain. Your Mileage May (probably will) Vary. I think the key to managing pain is very individual, and I am only sharing what I found to be helpful, in the hopes it might help some of you. I am also going to start looking at nutrition as a mechanism for alleviating some of these problems as I am sure it plays a part. I shall update this page with my findings. I am a strange person, I think, in that I do not particularly enjoy food all that much (unless it is chocolate of course!), as I am a very fussy eater so I am probably missing out on some vital nutrients!

Plantar Fasciitis/fasciosis

This is the big one. This was the cause of my 3/4 month ‘rest’ period.
A poorly understood condition from my research, and in my experience the problem can be really helped with extensive stretching of the calf muscles. My favourite stretches include (and are not limited to) the Standing calf stretch, Wall calf stretch and Calf stretching Exercises using a belt. Start the stretching slow and if it hurts, slow it down/stretch less – do not overstretch and do not stretch after icing. I did these stretches for 6 weeks religiously then I do them occasionally now if I feel discomfort or after a hike. I.e. I should do them more!
Ice application numbs the pain and ‘reduces the inflammation’. This is where things get complicated though, hence the Fasciitis/fasciosis subtitle. The ‘itis’ suffix (from the Greek – meaning inflammation) would insinuate that there is inflammation present.Yet where there is pain, there is not always inflammation. An ultrasound of my Plantar Fascia yielded only a low reading (nothing to be worried about) of inflammation.
Fasciosis implies degeneration (deterioration) of the plantar fascia which often occurs as a result of repetitive stress. Overuse. Add arthritis into the mix, and it becomes very easy to ‘overuse’.

I was in agony! But make no mistake, ice numbs the pain. But you need to really ice it. 5-10 minutes is a good starting point – never apply ice directly to skin.

I also found alternate hot/cold therapy extremely useful in pain management. I’d relax my feet in a warm foot bath for ten minutes or so (with added Epsom salts & Lemongrass Oil) and then immediately after apply ice. I’d then switch this back to the nice warm foot bath and continue. I always finish with ice though. I learnt the hard way also, do not stretch an ‘iced’ ligament/muscle/tendon. It is not a good idea.

Achilles Tendonitis/tendonosis

An irritant, to say the least. Again, stretch those calf muscles and I found heat therapy great for this – more so than cold therapy. This is an odd condition for me, it flares up once a month or so- injecting some much needed agony into my life for a few days then I move with haste to warm foot baths with Espom salt and lemongrass oil, and then I don’t hear from the condition again for a few weeks. It’s nice to have guests.

Shin splints (Medial Tibial Stress Syndrome & anterior shin splints)

Another misnomer. But a pure joy to behold!
I actually find swimming (particularly front crawl) very helpful for this, followed by a jacuzzi and some very gentle stretching in the sauna.
I have found the shin muscles quite tricky to stretch, but I find toe taps quite helpful for this. Sitting on a chair, I ensure my lower legs are at a right angle and then I raise and lower the toes of each foot rapidly whilst keeping my heel to the ground. This hurts a lot when these muscles are aggravated. My suggestion is not to power through the pain, if it really hurts on day 1, don’t do it and wait until day 2 to try again.
Guess what helps the pain? ICE.

Morton’s Neuroma

My new best friend. Again, this one is an absolute gem of a condition.
Sleeping with toe seperators (oddly) really helped this and I am now free of the condition after one week!

Also Ice, ice, ice.

 

My feelings on these problems, can be summed up in one sentence:
If your feet are unhappy, you are unhappy.

 

***Legal disclaimer: I am not a Doctor or a qualified healthcare adviser/provider. Please seek professional medical advice before undertaking any news exercise/stretching regime. This is not medical advice. I am purely sharing my techniques for pain management that work for me.***

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