Here’s a post I’ve been meaning to write for a long time: the story of how I personally developed central sensitization.
If you’ve been reading my blog for a while, you’re probably aware that central sensitization occurs as the result of some sort of insult to the central nervous system. Basically, if the body gets enough practice sending pain signals, it gets “better” at it– meaning you start experiencing pain more intensely, with less provocation.
So. How did it happen to me?
As I’ve touched up in previous posts, my high school years were pretty rough. Basically, a bunch of bad things happened in my life, too close together for me to know how to deal with. When I look back on that time, it’s like my thoughts and emotions were tangled up in one big knot– a knot it would take me years to untie.
At the time, one of the ways I coped was with exercise. I struggled with depression, and the endorphins I got from exercise were one of the only things that made me feel normal. That one- or two- hour window each day after my workout was the only time I felt like the clouds lifted, and I could think clearly.
The other way I coped was by restricting my calories and keeping my body at an unhealthily low weight. I’d perceived myself as being a little bit chubby at the time the bad things started to happen, and being skinny was part of the new me. Paradoxically, with each ounce of flesh I was able to strip off from my bones, I felt I was adding a kind of layer of “protection” around me, ensuring that things couldn’t go back to the way they had been.
So, I was starving myself, and running an average of 40 miles a week.
I ran for my school’s cross-country and track teams, and before I go on, let me say that I loved running for its own sake. And I was good at it.
But I took it too far. For a while, my body’s natural ability allowed me to excel even as I got skinnier and skinnier. I was hitting faster and faster times– winning medals, even– as more of my skeleton became visible.
Obviously, this was a recipe for disaster, and eventually I developed compartment syndrome in my lower legs. It’s a condition that’s somewhat similar to carpal tunnel– basically, I had a lot of fluid being trapped inside of my lower legs. I’ll write more about compartment syndrome later, but for now, let’s just say that it got worse and worse until I’d gone from almost being able to run a five-minute mile to barely being able to walk.
I suffered from compartment syndrome for the next two years before finally deciding to have surgery, and wow– I really wish I could take that decision back. I wish I’d just had surgery sooner, because it really solved the problem almost immediately.
However, at the time, my orthopedist had suggested I try more conservative forms of treatment. None of them really worked, but on some level, I was lost in my own inertia.
I had been trying, and trying, and trying for so long– forcing myself up at 5 am to work out, when I’d barely been able to sleep the night before because I was so hungry. I was just done.
Those two years, from age 17-19, are somewhat of a blur. I was still struggling with depression, although things improved dramatically after I graduated from high school. I actually tried to work out in a pool but wasn’t really feeling it– ironic, because all these years later, the pool has become my second home. But at the time, I was just too depressed to think or function clearly.
So I waited those two years, sometimes trying conservative treatment methods, sometimes going to physical therapy, sometimes working out in a pool.
The compartment syndrome was not so much excruciating as it was frustrating. I knew where the limits were pretty clearly– how much I could push myself before the feeling of pressure built up in my lower legs, and my feet started tingling.
But it was still a constant buzz in the background, like an annoying mosquito buzzing around my ear for those two years. I couldn’t forget about it– couldn’t even stand in line at the movies. Whoever I went with had to stand in line while I waited on a bench.
I tried to go to college like all of my friends. I actually went to a large Division I school, thinking somehow I’d get back into running. But really, things were getting worse, and it was becoming harder and harder to walk. There wasn’t adequate public transportation around campus, and I’d have to decide whether I wanted to walk to the library that day to get my books for class, or if I wanted to actually go to class. My body couldn’t do both.
That’s when I realized this couldn’t go on, and decided to come home and have surgery.
The surgery itself was not very invasive at all. The place where my orthopedist had to make a few incisions was very superficial (aka close to the surface) so he didn’t have to dig around too much. I came home from the hospital that same day, and although I spent the following day completely knocked out with narcotic painkillers, by the second day I wasn’t even using my crutches (although I still had casts).
Everything seemed normal right after the surgery, although from what people have told me, surgery like that can be a big trauma to the body.
I didn’t notice anything right away– in fact, I was healing pretty well. But, as I later learned, it’s possible that everything my nervous system had already been through– the constant bombardment from the compartment syndrome, as well as the surgery- would have a delayed effect.
As luck would have it, I had developed acid reflux right around then. My doctor suggested I try sleeping propped up by pillows at night, so gravity could keep the acid down.
Big mistake. I woke up after one night in absolute agony. I had completely thrown my back out– the whole thing felt like one giant muscle spasm.
I had never had such a silly, simple little thing cause so much pain before. The only injuries I’d had before had been serious running injuries, that came from pounding my legs into pavement 40 miles a week. But this silly, little simple thing actually had me in excruciating pain.
And this– THIS. After everything I’d been through, this is how my chronic pain problem started.
Looking back, I can see that it probably wasn’t just the issue of throwing my back out. Instead, it was probably a combination of factors– everything my body had been through, coming together to create an overwhelming effect all at one time. My nervous system had just had too much.
Of course, I didn’t know what it was at a time. I had never heard of such a thing as central sensitization, and in fact, I wouldn’t– not for another six years. I had a long road ahead of me.
To be continued in Part 2.