It took me a long time to realize what was happening.
For the fourth or fifth time in my life I have had the experience of visiting a doctor because a body part was not functioning well (e.g. couldn’t walk without a limp) and being turned away for treatment because I was not exhibiting enough pain. I have only recently figured out that my unusually high pain threshold may be the result of avoiding analgesics and narcotic medications like the plague. In other words, since I no longer take them, my body uses its own internal pain control mechanisms to manage pain.
Let me explain. I stopped taking all analgesics about six or seven years ago, after discovering their dangerous side effects. Since that time, I have had what would usually be considered debilitating problems with major body parts, but with very little pain. In addition to low levels of pain, I have been able to maintain functionality well past what my doctors were accustomed to seeing. But it hasn’t been without a few bumps. I am hoping that by sharing my experience, and the science behind it, other people will consider more carefully their use of opioids but also over-the-counter analgesic medications.
I will start with my knees. Over the course of the past 10 years walking became increasingly difficult until about a year ago when I was only able to walk two blocks and then limped most of the way because my right knee no longer supported the weight of my body. I had been going to doctors searching for help with my knees for years. The doctor’s reactions, based I think almost exclusively upon the fact that I reported little to no pain, was to dismiss the problem and/or discourage treatment, especially surgery.
The advice across the board was to try aspirin to manage the pain. I was already working out, getting massage, eating clean, supplementing and keeping my weight at or below 125. I am not criticizing the doctors, as it is to their credit that they did not rush to do knee replacement surgery which is a major event and not something to be taken lightly. So this is not a rant about the doctors, just an observation of how my presentation differed from what they were accustomed to seeing and how they advised aspirin.
Meanwhile, my issue was loss of function which was getting worse, so I would either keep going to a doctor hoping for a different outcome or switch to another doctor. When diagnostic tests were performed, they revealed considerable deterioration and the term “bone on bone” was often used to describe the state of my knee joint. At times such as these the doctor and his staff would struggle with my pain reports, often asking the same question over and over again. I could tell I was giving the “wrong” answer but had no idea why or what the right answer was.
In terms of treatment, which is partial or total knee replacement, it always came down to pain level. No pain, no replacement. Never mind that I could barely walk, working out was less and less of an option and forget about going up and down steps to unload groceries. I wasn’t in enough “pain” to make surgery an option from their point of view.
Sometimes I thought they suspected me of abusing drugs to manage the pain and other times I thought they believed that I was under-reporting the pain, though to what end I do not know. In any case, I finally got a clue and realized that if I was ever going to have surgery on that knee and have it replaced before I was too old to enjoy the results, I was going to have to over report my pain level in order to match up with what they viewed as the “normal” amount of pain required for such a surgery.
Last year, when I could no longer walk 2 blocks, I realized that the time had come and I did what I needed to do to get the surgery scheduled. In other words, I lied and over-reported my pain level. I am not recommending a strategy such as this to anyone.
I had the knee replacement surgery 8 months ago. Much to the chagrin of my treating surgeon I stopped the pain medications, which were opioids, within two weeks of the surgery along with the antidepressants and other medications designed to help me sleep and manage the pain. A surgeon’s nightmare for a patient. The surgeon, upon hearing this news, insisted that I continue the medications for at least 2 1/2 months, and although I kept it to myself, I declined to do so.
I didn’t experience much pain post surgically. Stiffness, a great deal of stiffness for sure. By not what I would call pain. I had virtually no pain in the first two weeks, as I was on the opioids and then even once I discontinued the opioids, I wasn’t really experiencing pain as much as weakness and stiffness. My surgeon said the best thing I could do was walk and walk I did. Starting with 10 minutes and working up to an hour. No pain.
When things got more painful, was after physical therapy sessions started. While I could see that physical therapy was giving me more mobility and strength, I would also experience a fair amount of pain a day or two post therapy, making it virtually impossible to walk at all.
As an aside, my physical therapists’ seemed to get incredibly excited that no matter how far they bent my knee I didn’t report pain. At least not while they were bending my knee, but afterwards, Geez Louis, I was very uncomfortable. I was in PAIN. At such times I had a hard time walking, a great deal of stiffness, as well as weakness and tenderness. It took me a while to realize that I was doing too much during PT and that I needed to pull back a little bit. Once I managed the exercising and PT better, I was no longer in pain.
Today, 8 months out, the only “pain” happens every once in a while if I trip. I do that a lot going up the steps. It seems as if my brain doesn’t know how tall the steps are anymore in relation to how long my leg is. Just FYI, the leg with the new knee is now 1 1/2 half inches longer than the other leg so no wonder my brain gets confused…This definitely creates tripping hazards. When it happens, there is a breathtaking stabbing pain which usually makes me scream involuntarily. I also occasionally have a stabbing pain if I move my leg the wrong way in the middle of the night. Both are fairly rare occurrences.
On to my neck. Beginning about 10 years ago, I started having issues with extreme pain in my neck. At that point I was still taking aspirin on a regular basis. I used it for pain and to help me sleep. I sought help from a chiropractor who used traction on my neck with good results. Right around the same time, I broke up with a pain in the neck boyfriend, and stopped taking all analgesics, as I mentioned above. Since the pain in my neck was no longer a factor because of the traction was helping a lot, (and no more pain in the neck boyfriend) I never looked back.
But, and here is how and where history repeats itself, I just had another one of those experiences where the doctor treating me is astonished at the degree of degeneration and the lack of pain I report. Finally, I am beginning to make the connection, duh!
What happened this time is that I had tingling in my left arm. Since I don’t have vascular disease or current problems with cholesterol or diabetes, I was pretty sure I wasn’t dying of a heart attack. That said, I still needed to know why I was having tingling in my left arm and suspected it might have something to do with my neck.
Same exact scenario ensued. I go to the doctor to report the tingling in the left arm, the physician I visited wanted to be sure that it wasn’t functional and did an MRI of my neck, got the results and was once again amazed, (his word) at how degenerated the discs in my neck were, and as in the case of my knee, described the situation as “bone on bone” to explain his surprise.
He actually asked me why I wasn’t reporting more pain. No beating around the bush, this one. Which was actually helpful. When I explained to him I wasn’t feeling much pain, just occasional stiffness, he was confused….amazed…I’m not sure. He rallied well, and said let’s get you into traction ASAP, and I mentioned to him that traction is what had seemingly fixed my neck 4 or 5 years earlier, so that seemed like a good idea.
When he started talking surgery and disc replacement, I told him that probably wasn’t going to happen unless I was at risk of complete paralysis. He wasn’t all that reassuring, to be perfectly honest, that that wasn’t a possibility. So, we’ll see. I am the eternal optimist and sincerely hope that medical technology advances quickly enough to save my degenerative neck disease.
In the meantime, and this is the takeaway and why I wrote this article. It turns out that pain management is a natural function of the body, which I will explain in a moment. Further, And I believe more importantly, that opioids and in my experience, analgesics as well, get in the way of the body’s natural ability to manage pain.
Perhaps most important of all, is the fact that foods, which is music to my little foodie ears, and certain supplements (I am known among family and friends as “the supplement queen”) provide natural pain relief as well. A lot of it. Huh 🤔
Here’s how that works:
In the US we have been taught that if we feel pain, a pill will make it go away. Unfortunately, what many people do not know is that if you use opioids for more than 4 weeks, it will make the pain worse. What happens is that after a period of time on opioids (4 or even 5 days according to some research) which are blocking the pain, the body simply makes more pain receptors to try to get the pain signal through, since that is the way the body is supposed (designed) to work.
Well that’s not good!
Technically, the term analgesic refers to a medication that provides relief from pain without putting you to sleep or making you lose consciousness. Many different types of medicines have pain-relieving properties, and experts tend to group them those together that work in a similar way. Two of the most common groups of pain killers are nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids (narcotics), but there are many more.
Sometimes experts will group analgesics together based on their potency, or how strong they are. The World Health Organization actually has an analgesic ladder that is as follows:- Mild-to-moderate pain – non-opioid analgesics such as acetaminophen and NSAIDs
– Moderate-to-severe pain – weak opioids, such as codeine, dihydrocodeine or tramadol
– Severe pain – stronger opioids, such as oxycodone and morphine
Understand that I was not discontinuing the use of opioids 6 or so years ago, but aspirin (NSAIDs). That said, I believe that I experienced the same phenomenon, i.e. that once I stopped taking aspirin every night, my body was able to develop a very effective way of managing pain on it’s own. Unfortunately, there is not as much info on non-opioid analgesics, but I will continue to investigate and certainly keep you posted.
See a list of food and supplements I use to combat pain HERE!!