Central Sensitization, Chronic Pain, Creative Writing, My Story

How I developed central sensitization: Part 2

Continued from Part 1

My doctor said I had what was called “glass back” syndrome.  Every muscle, from my neck to my lower back, was locked in spasm.  Even the smallest movement could set off a domino effect, each muscle triggering the next, until my entire back would feel like a blaze of pain.  I was so sensitive to movement, it’s as if I was made of glass.

The only time of day when things didn’t hurt was when I first woke up in the morning.  For those few seconds before I moved, I would feel okay.  Then, when I turned to roll out of bed, bam!  The blaze of pain would return.

I learned to keep my bottle of painkillers next to me when I slept.  That way, when I woke up, I didn’t have to reach very far for a pill.  I would gingerly edge my fingers along the mattress, grab the bottle and open it.

That would be it– the only motion I’d perform.  Reach over, take out a pill, put it in my mouth, swallow.  And then wait until I felt it set in; everything would become dull, and a little less horrible.  I was a little farther inside myself, but at least I was also farther away from the pain.

Tramadol, Tylenol, Advil, and a muscle relaxer.  And Bengay cream.  And heating pad at night.  These were all the things I needed to make it through– if you can call it that.

***

Part of what made it worse is that I was treating my back pain like it was a running injury.  That was the only type of injury I’d had before, and with all of those injuries, the important thing was to rest.

I later learned that with a back issue such as this (it wouldn’t be accurate to call it an injury) it’s actually really important to move, and strengthen the back muscles.  To an extent, you have to keep moving in spite of the pain, because if your muscles get weak, things only get worse.

But I was young, and I didn’t know.  In fact, I was tough; I was an athlete.  I’d never had “injuries” before that hadn’t been caused by a serious amount of force travelling through my body, my feet pounding into the pavement at sub-6-minute mile pace.

I was not at all familiar with this kind of pain– the kind of pain that kept spiraling beyond my grasp, beyond my wildest efforts to control it.  The kind of pain that seemed to be caused by almost nothing.

So, I thought, I needed to rest.  That’s what I’d done for all my previous injuries.  I didn’t want to strain anything, or break anything.  With this amount of pain, rest.

***

In the midst of this, I was due to start at the new school I had transferred to; a small liberal arts college in Western Massachusetts.  I contemplated not going, but ultimately I decided to take the plunge. I didn’t want to miss out on yet another experience.

Luckily, I could physically make it to class– the campus was walkable, and my legs had healed completely from the surgery.

But a lot of the time, I couldn’t concentrate.  I remember being in class knowing I was feeling the exact moment when my last dose of tramadol wore off, counting down the minutes until I could go back to my dorm room and take another.

And then, once I was safely back in my room, I’d briefly fall asleep.  Not from the tramadol (my body got used to it after a while) but from the sheer exhaustion of trying to stay awake through something so excruciating.  It was as though my conscious mind needed a break from experiencing this much pain, and sleep was the only way out.  So I’d fall asleep, and leave reality behind for a little while.

***

The way out, as I learned in physical therapy, was to get out of bed and keep moving as much as possible.  I started going for walks– long walks, which I might have once thought impossible before my leg surgery.  This, as my PT explained, helped to increase blood flow, flushing out some of the pain-producing chemicals in muscles, and also “acting like a giant heating pack from the inside,” helping the muscle to relax.

Additionally, I started doing specific exercises to strengthen my back muscles.

And you know what else?  I took my painkillers.

***

Contrary to what you might expect, my doctor at school totally understood what I was going through and encouraged me to actually take the full amount of tramadol she had prescribed (up to 6 pills a day), if it would help me move more.

From her, I had my first real experience with understanding pain science.  She explained that, with “glass back syndrome,” the pain sort of became its own cycle.  As the muscles would spasm and create pain, this would actually cause all of the other nearby muscles to tighten up as well, to protect the area.

The painkillers, it turned out, were actually helpful in reducing those pain signals telling the muscles to spasm.  When I took them, I was able to go for walks, and do my exercises, and get stronger.

(This experience is one reason why I will always believe in the power of prescription pain medication to help chronic pain patients.  Without it, I truly believe my recovery would have taken much longer).

***

Eventually, my back got stronger, and the all-encompassing muscle spasms finally stopped.  I found I no longer needed the tramadol, and I stopped that too.

However, though my “glass back syndrome” eventually subsided, the pain would never fully go away.

To be continued in Part 3!

6 thoughts on “How I developed central sensitization: Part 2”

  1. Also, there are new studies suggesting that diet has much to do with over sensitisation.
    If you experience strange skin sensitivity too (rashes, nervous prickling sensations, itching, etc.), I would start looking into the research into diet and digestive issues.

    Our whole defence system (autoimmunity, cell health, ability to repair), comes from our diet. If our digestive tract becomes unhealthy, it will manifest in lots of terrible and often autoimmune responses.

  2. Tramadol is addictive though (even if less so than other pain medication).

    I would recommend finding a good ‘injury’ or ‘sports’ trained massage therapist and an equally good osteopath.

    These are effective therapies at addressing the functional causes of dysfunction and pain, rather than hiding it with pain killers. Strengthening exercises while on pain killers can be detrimental as more strain worsens some conditions.

    I do agree with your advice to ‘keep moving,’ within pain tolerance levels only.

    I am an ex-massage therapist, who also happens to suffer joint problems and low back pain (due to hypermobility) resulting in sciatica occasionally. I do not take pain killers, but happily, because of my training, can treat myself to a large extent using my own techniques. I will only take an Ibuprofen tablet very occasionally if I go into an ‘acute’ inflammation.

    When I had my practice in 2000, I used to work with people to improve their condition and reduce their reliance on harmful antiinflammatories like ‘Vioxx’ ( Rofecoxib), a non steroidal anti inflammatory or NSAID… It is now banned here in the UK.

  3. Thank you for this post. It makes me happy to know there is a name for what I have been feeling. The pain kicks in from activity, I push through it until my whole body is on fire and in spasm, and then the tears roll. Then, like you, I stopped to rest, because I knew no better.
    It does make me sad to know I have to keep pushing through though. That is some HORRIBLE pain and I have been so frustrated lately about not being able to have an active life because of this “glass back syndrome”. I see my doctor at the end of this month, and I was prepared to talked to her about this, because my current meds are NOT cutting the pain. But I also don’t want to sound like I am seeking drugs. I just want the pain to be manageable. I mean, are epsom salt baths and muscle rub what I am going to need for the rest of my life? Probably if that is the only thing I can do to quell the pain. :( Thank you again for this post!

    1. Hi Iggy– so glad my post was helpful to you, and I’m sorry you’re going through this! I totally know what you mean about not wanting to look like you’re seeking drugs– looking back, I’m lucky I happened to find a doctor who took my pain seriously. (Tramadol is supposed to be less addictive than other similar drugs, so I think that was part of why she was comfortable offering it to me). It sounds like you’re trying everything you can, which is good. I think we are more likely to come across more seriously as patients if we can demonstrate that we’ve exhausted all of the options that have been available to us (Tylenol, Advil, etc.). Even if they don’t help that much on their own, it’s still good information to have.

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