A question about pain. Several, actually.

[xiphias]

So, Lis and I were talking about pain, and how I sort of consider pain to be a normal state of being, and she doesn't. So I decided to make a poll to ask all of you how you think about pain! This is PHYSICAL pain I'm talking about here, not metaphysical, spiritual, or emotional -- I happen to think those are all interrelated (DARN YOU CARTESIAN DICHOTOMY), but I'm only talking about the physical stuff right now.

[Poll #439638]

Feel free to make more comments, too.

Comments

[tylik.livejournal.com]

One of the results of the gruesome spine injury is that I hardly notice pain that doesn't stop me from doing something. I had to think about this.

[kalmn.livejournal.com]

yeah. a lot of my pain i only consciously notice when it goes away.

[bluepapercup]

Yeah.

what you said.

[matociquala.livejournal.com]

I notice it when I stop to do a self-assess, or do something to aggravate it, or it goes away.

Frex, I have a headache right now, and actually took some naproxen, because it was bad enough I noticed it over the background noise.

[elisem.livejournal.com]

I hardly notice pain that doesn't stop me from doing something. I had to think about this.

Yeah; I mostly notice stuff that keeps me from functioning. (Then again, there's pain it's easy to ignore at the workbench that might keep me from sleeping, so it changes as tasks change, too.)

[papersky.livejournal.com]

I have this thing I do about that, which doesn't work for some people but which I find very useful. When I wake up, I try to lie flat on my back and check out my body for pain and for aches and for pre-pain signals and such -- not touching it, just lying still and feeling it all from inside. This gives me a good start on what my physical limits are likely to be that day, and if there's something wrong below noticeable thresholds, like a dehydration headache or just starting cramps, I can do something about it. I also do this sometimes when I come in tired -- just flop down for a moment and assess status. Giving my conscious mind a chance to assess what's a good idea lets me keep little things from getting ignored in the big things and making everything worse.

I've been doing this for a long time and it works for me.

[xiphias.livejournal.com]

Sorry about leaving out menstrual cramps, folks . . . my only excuse is that I'm male. . .

[burgundy.livejournal.com]

And if you'd posted this quiz three days ago, that would have made a big difference to me.

I'd also like to note that I fall somewhere between weekly and daily as far as frequency. I picked weekly, because I just don't think of it as a really frequent occurance, even though it happens more often than that.

[mitchellf.livejournal.com]

Man, I totally forgot about those--I would have remembered last week, though. ;-)

[sarianna.livejournal.com]

I'd also be interested in the age range of the folks responding. Heck, I've had arthritis severe enough to require a fitted knee brace since I was 17, and I feel like a weirdo for it.

[cheshyre]

I'd love to see it correlated with age. Also with time of day -- I'm a bit more achy before bed than I was earlier in the day.

Also, for your next poll, Ian, how about a question on when the last time you weren't in pain? Within the day, week, month, year, decade...

[elisem.livejournal.com]

The accident that messed up my hip was when I was five. I suppose there must have been times I was pain-free before I was five, but I don't really remember them.

There are a lot of times when I think of myself as not being "in pain," when I am nevertheless experiencing pain, or would be if I paid attention to it. I guess I've learned to interpret the phrase "in pain" as only being when I am stuck in the pain, i.e. only when the pain stops me. Pain that can override me is when I am stuck in pain. However, that doesn't take into consideration the long-term erosional effects on temperament/willingness/ability caused by chronic pain, so it's most likely more complicated than those sentences I just wrote.

I'm loathe to look at it too much more just now, as I don't want to get tangled in a centipede's dilemma. *wry grin*

[griffen.livejournal.com]

That'd be a big ol' "never." I've had some form of chronic pain ever since I was old enough to remember anything.

[psu-jedi.livejournal.com]

how about a question on when the last time you weren't in pain? Within the day, week, month, year, decade...

I don't know if I can even remember the last time I had *no* pain whatsoever...

[tylik.livejournal.com]

I'm thirty one. The in pain every day has applied for at least the last five years or so -- maybe a bit longer (the first two car accidents were almost ten years ago, and I'm not sure I was out of pain after that, but I certainly mostly recovered before really blowing my spine out).

It's actually gotten significantly better. Studying martial arts and quitting Microsoft have helped a lot. Ripping up the ligaments around my SI joint a year and a half ago set me back a lot, though.

[kalmn.livejournal.com]

i've had rheumatoid arthritis since i was 16, and am now 32.

[linenoise.livejournal.com]

I'm 24. I've had off-and-on chronic lower back pain since I started high school. There have been a few times when it's been to the degree that it was affecting my daily life. There have been a *lot* of times where it was a real effort to get my mind *off* the pain in order to do what needs be done. It's rarely not there. Although it's also something that I have learned, over time, to simply pay no mind to.

pain should not be normal

[wolfdancer.livejournal.com]

Have been in some form of pain for near 2 years or more but that should not be the norm. sigh.

Re: pain should not be normal

[fallenkalina.livejournal.com]

I got a lesson in chronic pain the day I woke up unable to walk due to a hip bursitis. Not a fun couple of weeks, I tell you. Esp when my usual pain is jaw and back related (TMJ, Scolosis) and I'm fairly used to it.

I swore, if I was in chronic pain, I'd be the happy go lucky, grin and bear it type. Nope, I'm bitchy as all hell.

[ex-serenejo.livejournal.com]

Before two years ago, I rarely had any pain at all. Now I deal with chronic pain, and I *hate* it. I don't think it's normal, and I wish I knew how to make it go away. (But how I deal with it in real life is to mostly ignore it, and try to rest when rest feels like it will help.)

[adrian-turtle.livejournal.com]

I think it comes down to how you define "normal," more than how you define "pain." I agree with Wolfdancer that people should not be suffering continuous or daily pain. But a lot of them DO. A reasonable argument can be made that anything becomes "normal" if it is common enough, regardless of whether it should be happening that way. We have great words like "healthy" and "optimal" and "good" to talk about the way things should be, regardless of how common or uncommon they might be.

Speaking about pain for a moment, I find it's often hard to talk about pain in general terms, because different people can perceive the same physical sensation in such different ways. This applies to pain from illness or injuries. Or chronic pain, which is really its own thing -- I think a lot of it is practically a false alarm from the body, and the strain of the continuous pain is harder on the body than whatever is structurally wrong to cause the pain in the first place. If anything.

I'm not sure this is an appropriate place to talk about chronic pain and serious masochism. The overlap makes a lot of people uncomfortable, even folks who don't flinch at other kinds of kinked discussion.

[xiphias.livejournal.com]

Well, "normal" means:
1. Common, or expected
2. In perfect working order, no matter how rarely that actually happens in practice (that's medical terminology there)
3. A force perpendicular to another force (that's physics)
4. Having a concentration of one gram-equivalent per liter (but I suspect you know that one, as you're a chemist and all)

What we've got is a confusion between meanings 1 and 2. Does "normal" mean its everyday meaning of "common, expected, the way things usually are", or its medical meaning of "in perfect working order"?

In any case, I don't have a problem talking about chronic pain and serious masochism. I haven't done really serious masochism in, like, ten years, and I DIDN'T really have chronic pain THEN, but I do now. And I wonder if it wouldn't help.

Hell, I was just reading an article about using capascin as a painkiller, in the "burn out the pain receptors" theory. I think a singletail would be more effective.

[vvalkyri.livejournal.com]

Heh. In the post I accidentally closed before posting I was planning on linking to that article about capascin. Singletails aren't as good at spreading evenly over an area :*P

Why is chronic pain + serious masochism squickful?

[beckyzoole.livejournal.com]

I get the "normal" menstrual cramps and occasional headache. I'm also prone to heartburn. I'm 44, and my knees have the over-forty achiness. My right ankle is arthritic, ever since I shattered it when I was 15 (skateboarding in platform shoes -- I looked HAWT for about thirty seconds).

Oddly the most bothersome pain has been a chronic dull ache in the trapezius muscle of my right shoulder. I tore it almost five years ago in an auto accident. It's a very low-grade ache, but it spasms and grabs my attention more than cramps or arthritic joints do.

The very best cure for this is light flogging on the shoulders and upper back. A good flogging leaves the muscle relaxed and pain free for days!

[(Anonymous)]

There's a related word in statistics, "norm." This is the result that shows up most frequently in a statistical sample. It isn't always the average, or even close. For example, in the set (1,1,2,3) the average is 1.75 and the norm is 1.

In sociology, which uses statistics and, often, bell curves, you would expect the average and the norm to be the same a lot because in bell curves they are, or at least they are very close. However, socilogists did not find this to be the case... many times what's normal (what we expect) turns out not to be average, or even the norm.

So sociology also uses a definition of "normal" that's different from any of the definitions you've given above. Although I suspect that your definition #1, above, may have originally derived from sociological jargon.

A sociologist would tell you that, regardless of how common pain actually is, we treat it as an abnormal state. It is "normal" to treat pain as abnormal, and it is "deviant" to treat pain as normal. It is socially appropriate to assume everyone we meet is not in pain, unless there's a reason to believe otherwise (ex: they are in a hospital, or bleeding). Likewise, it is socially appropriate to treat our own pain as abnormal when it occurs, regardless of how often this occurs, or how many of our friends suffer from chronic pain.

I am, of course, oversimplifing, but I hope you get the gist.

[elisem.livejournal.com]

I'm not sure this is an appropriate place to talk about chronic pain and serious masochism. The overlap makes a lot of people uncomfortable, even folks who don't flinch at other kinds of kinked discussion.

Well, when you find the right place, send me an invitation, OK? I would find such a discussion interesting and possibly useful.

[patgreene.livejournal.com]

Something I forgot to include in my "other types of pain" response is fibromyalgia. Sometimes when it flares it feels like my entire body has been beaten with a large stick. Other times when it flares it's just my arms.

[bikergeek.livejournal.com]

Pain should not be normal, but I'm astonished at how many people in our crowd, most of whom are under 40, suffer from chronic pain of one sort or another.

[hangedwoman.livejournal.com]

I'm actually pretty good on the pain front. Most of my problems have been manageable. Up until about my mid-twenties, I had menstrual cramps that were the stuff of nightmares. Nothing like crawling to the bathroom to throw up, or even better when you're a teenager: interrupting your long-winded teacher to tell him you have to leave the room now to vomit, and then not making it to the bathroom. I started loading up on anti-inflammatories before my period started, and if I didn't get the drugs in my system in time, it was good ole' Tylenol 3. So I spent a great deal of time feeling like I had swallowed an acid bomb and/or slightly woozy - all the while exhausted from effect the pain was having on my body whether I was well-medicated or not. I taught myself breathing techniques similar to Lamaze to deal with it, because it wasn't like there was some position I could lie in or move or not move in such a way as to lessen the pain.

Damn, I'm feeling ghost pain just from thinking about it.

[greenlily.livejournal.com]

I've always been of two minds about pain. On the one hand, it hurts, and you should obviously treat the symptoms ASAP because, well, it hurts. On the other hand, pain is (can be?) the body's signal that something may be wrong, and rather than merely treating the symptoms you might want to take a look at what it's trying to tell you. (Yes, I've been re-reading the holistic section of my herbal medicine book lately, why do you ask? :)) What interests me is how people with chronic pain learn to define 'wrong'--how you tell the difference between the wrong you've learned to live with, and the wrong that means intervention's needed.

I mean, I have chronic headaches. Have had since I was in my teens. I've seen various doctors and they've confirmed that there's absolutely nothing wrong, neurologically speaking, and that it's probably not a food allergy or bona fide migraines. (I do get migraine-like symptoms once in a while--sensitivity to light and sound, mostly--but that's really rare, thank God.) Over the years, I've identified a number of factors that trigger the headaches. Some of them (lack of sleep, too much time spent staring at a computer, incoming low-pressure weather system, Roommate M playing the Cure at top volume for 3 hours straight) are things that'll go away on their own, and I tend to just whine a lot and wait them out, unless I'm about to be involved in a situation that requires me not to have a headache. Other times, the headache is caused by something (jaw tension, inflamed sinuses, major stresses) that isn't going to go away, and I have no hesitation in reaching for the Advil to treat that kind of headache. But with a headache like that, I'm also going to take a good long look at what I've been doing to cause the stress (or, in the case of the sinuses, to see if I've been unwittingly inhaling an airborne irritant).

The rest of my pain can be described as occupational--sore knees and ankles from sitting in one position too long, sore hands and wrists from too much data entry, 'folder shoulder' (sore pectoral muscle on weight-bearing arm from holding a choir folder at reading height for 3 hours). I don't regard these as chronic because they're specifically tied to an activity and when I stop the activity, the pain goes away. If one of these kinds of pains became 'chronic'--it hurt even when I wasn't doing the thing that makes it hurt--I'm not sure how long it'd take me to notice.

[(Anonymous)]

Hmm... polls doesn't seem to be working for me, so I can't take yours...

...but if I did I'd want to know what you meant by "noticable pain"

If someone asks me to think about pain, for example if I'm taking a poll about it, than I'll do a kind of internal assessment like Papersky, and I'll come up with a lot of minor irritations. I usually do that about 3-4 times a day, and most of the irritations are the kind that hang around.

But, most of the time I don't notice them. And I don't know whether that counts as "in pain" or "not in pain."

So I don't know whether it's normal (for me) to me in pain...

Although I seem to be in the happy position that most of my pain is very low level - barely a one - and I can often alleviate it just by changing position.

[the-siobhan.livejournal.com]

I wonder if your poll is self-selecting for people who say yes?

I was originally going to respond no - but then I realized, my skin hurts pretty much from November to May, I'm so used to it I just don't notice it - unless I go someplace humid and all of a sudden it stops.

Plus I usually have sore muscles from something and often bruises from something, so yeah I guess I think of a certain amount of pain as being "normal".

However, my scale is definitely influenced by having been through the experience with adenomyosis. When the doctor asked me what the pain was on a scale of 1 to 10, I told him 25. My entire sense of the universe and my own body dissolved when I was in that much pain.

(Childbirth, on the other hand, was a cakewalk.)

[mixedborder.livejournal.com]

Most of my pains are just twinges at this stage--joint twinges (both my parents have arthritis), muscle knots, skin problems. The only severe pain I get is when my chronic ulcerative colitis acts up, which isn't very often, thank Goddess.

By the way, I saw in another LJ that this is your b'day, so--
Happy Birthday!

[mitchellf.livejournal.com]

Honestly, I think that much of my chronic back pain comes from that sledding accident my first year at Brandeis--when I made the mistake of allowing JB-S and BW talk me into going on that horrific jump they made out of ice and snow (the one that, if you traveled down at the correct velocity, you would hit the jump, be shunted into the air, and land upright, on your feet). Should have known that I'd never make it.

I also remember having a horrible concussion from that stupid stunt, and I recall Freak saying "I told her so" in regards to whether I would die or not (in all fairness, he *had* told me I would die if I went on the jump).

Ah, the memories I have of my first year at Brandeis.... ;-)

[nolly.livejournal.com]

One aspect I don't see in your poll that I think makes a huge difference is type of pain -- not what hurts but the difference between "I worked out last night and have sort muscles from that", "I have some mild gas pain that will pass soon" (or a zit, or any sort of low level, short term pain), and "Something is wrong with my body and it hurts" pain.

I also think it would be interesting to construct a poll matching "what hurts" with "how bad".