Two months ago when i first was evaluated for the Pain Management Program I was taking 100Mg of Lyrica three times a day. One of my primary complaints and reasons for leaving work in March was the difficulty I was having with cognitive problems. I know this is a complication with chronic pain but I also wondered whether it was made worse by the medicine. So I started tapering the amount down to 100Mg that I took at night. Getting to that point really didn’t seem to affect my pain symptoms and if I had to say one way or the other, I’d say that my cognitive abilities had improved if only slightly.
This week, I had discussed with the PMP nurse that I wanted to eliminate Lyrica altogether. Since that had been a recommendation of my Rheumatologist earlier she agreed. She did suggest that I start with every other day before completely eliminating it. So, last night I left the Lyrica out of my medicine cocktail. My sleep last night was poor. I’m not sure if I was just anxious over the reduction or what. This morning at the beginning of our morning exercises I was flared up in all areas of the senses.
Exercise group was a real struggle. Every movement seemed to cause pain to race through every part of my body. One of the things I should explain is that in the PMP they don’t have any place to track your level of pain. In the words of one of the Physical Therapists “We don’t care about how much pain you have! It’s chronic pain, We know you hurt it’s not going to (physically) hurt you.” Sounds harsh doesn’t it. But it’s true. As we have learned chronic pain can cause an over sensitization of the central nervous system and we don’t want to limit our activity based on pain. The tail would be wagging the dog.
I should qualify the quote above. The PMP team is very aware of our physical limitations and they do not want us to physically hurt ourselves. The program is very well designed to that effect. The purpose is for us to understand the type of pain we are managing and not let the pain manage us.
The idea is that our activity and working despite the pain is one of the keys to our retraining our central nervous system. This seems counter to everything I had learned before but now as I understanding the icing, relaxation techniques, and pacing it makes sense as a multi-pronged approach to retraining the central nervous system. Most importantly I have learned that it works.
Later in the day we had more goal setting sessions, reviews of testing done earlier in the week, and training on the neuroanatomy of pain. I had a session with a Physical Therapy technician that repeated the flexibility measurements that had been done earlier in the week. I learned that my left hip and left should had improved 11 and 6 degrees respectively. That was good news and I received accolades from the staff for making progress so quickly.
Through the day today I had complained (to myself) of increased pain in my hips. I did learn that while the pain had increased my flexibility was improved. I also improved my times and repetitions in the endurance exercises. I experienced declines in pain several times as I applied the new techniques. All in all it was a good day.