Guest Post: My story with chronic pain

It was 2013 and I was 41 years old. I completed my first Spartan Sprint race in June and was feeling physically at the top of my game. My weeks were filled with gym workouts and running outside. Most likely, I was training for a half marathon that my husband and I do in Philly every September. Everything changed one weekend when seemingly nothing out of the ordinary sent me on a (so far) 2 year journey of chronic pain.

Being part of an active family, my then 7 year old son and I rode scooters the mile and a half distance to his Jiu Jitsu class on a Friday night. Ok, a little awkward on a scooter, but doable. Saturday, I went for my regular 45 minute run through my neighborhood. As usual, it was uplifting and energizing to be able to run in a city that houses millions of people, but allows me to be the only one on the street at 5 in the morning. Like I said my weekend was nothing out of the ordinary. . . until I went out for another run in Central Park on Sunday morning. My right leg just wouldn’t allow me to run. I thought I was just sore or at most just overdid it with the scooting and then a run the next day. I gave myself the standard 5 days off that runners give themselves to get better. Well, the next weekend came and I still didn’t feel well. My right hamstring was killing me – right in the area where it attaches to my sitz bone – way up high in the middle of my bum. Weeks and weeks went by with no relief. Only when I ingested 800 milligrams of Motrin was I able to be somewhat pain free. I couldn’t let the entire summer go by without running, so what do many stubborn runners do? They run through their injury not thinking of the consequences. In fact, not only did I run regularly, I did a 10 mile race over the summer too. Nothing was going to stop me! I was tough! So tough that during one 5am morning run when it was still dark out, I tripped over something and caught myself with my left leg and injured it in the same exact spot as the right. Hmmmm, do I sense a weak link here? So now I had two high hamstring injuries. I finally stopped running and thought that a complete break would help me heal. It wasn’t until December of that year, 6 months after my original injury, that I sought out medical attention. I was given an MRI and a prescription for physical therapy. The MRI showed a partial tear on the right and inflammation on the left. I had PT from January to August of 2014, which was of limited benefit. At first I went to a place where I had a different therapist every session. I felt like I was just on a conveyor belt and any therapist that was available would pluck me out and give me substandard therapy. I found myself explaining my issue over and over to every therapist and getting more frustrated every time. There were a lot of hot packs, cold packs, and other modalities that did absolutely nothing for me. Being a therapist myself (occupational therapist), I knew this wasn’t what I wanted or needed. I did a little more research on other PT clinics and I found another one in my area. I called and explained my concern about just having one therapist. I was very hopeful after the evaluation and along with PT twice a week, I also received chiropractic care at the same time. After a while, the therapist I was working with wasn’t listening to me anymore and the chiropractor actually stepped up his game. So I ditched the therapist and kept the chiropractor. My right leg was actually starting to get better, but my left leg was still very achy, stiff and sore. So sore that it hurt to go up and down stairs, sit, stand or walk on any kind of incline. I just felt it ALL THE TIME.

In August of 2014, I decided to get a cortisone shot in my left hamstring. The injection itself was not that painful and let me tell you, it was short of a miracle. I felt like my normal self again and I decided not to go back to the chiropractor. I was cured!! Can you guess what I did mere days after the injection? You guessed it, I started running again. I felt great. I thought that after 3-4 pain free weeks, I was in the clear. It was literally 3 months to the day that I started feeling that familiar achiness and pain in my left hamstring. I was devastated. I have a word of advice to every pain management clinic that delivers pain management treatment. Please tell your active and athletic patients who are otherwise smart and educated people that a cortisone shot could make you feel like the person you were before the injury. This does not mean that you are. The injury is still there. You are just not feeling the pain. By no means should you go back to your regular routine, quit treatment and think everything’s hunky dory. Sigh.

Another six months went by with no improvement in my left hamstring and in February of 2015, I attempted a treatment called Prolotherapy, which involves injections of dextrose solution or other irritating substances into the joint, tendon, or painful tissue in order to provoke a regenerative tissue response. The process wasn’t actually that painful, but I was a bit sore for the next 3 days. Unfortunately, I did not experience any improvements and being that each injection was $600 out of pocket, I was just not willing to pay for any more. A few weeks after that I scheduled an appointment with an orthopedic surgeon at NYU to get a fresh look at what was going on with my hamstring and to discuss my treatment options. At this point he ordered another round of physical therapy. I expressed my concern with PT not helping me as much as I had hoped. He gave me a list of NYU affiliated PT clinics and told me that when I pick the therapist, to have them call him for what he suggests, which was a lot of pelvic stabilization and core exercises. I picked a therapist that just happened to have a clinic inside my gym. To my surprise, this therapist was amazing. As I noted before, being an occupational therapist myself, I’m fortunate to understand the lingo and the clinical reasoning for my treatment. This guy was no joke – when he called me in, we went straight to work. Not once did he waste my time with an ice pack or with e-stim (electrical stimulation-a modality used in PT that sends electrical signals to the tissue being treated). I was way beyond this point as I needed treatment would make long lasting changes. Unlike all of the other therapists I had, this guy started me off slowly and never made me do anything that sent me above a pain level of 3. This told me I was going to the right therapist. He had me doing specific muscle strengthening focusing on my glutes, pelvis, core, hamstrings and gave me a home exercise program, which I diligently followed. Slowly, but surely, I got a lot stronger and started having days that were less painful.   Eventually, my therapy sessions ran out and I needed to decide what to do.

I went back to the orthopedic doctor at NYU and he spoke to me about my options, which were PRP (Platelet-Rich Plasma) and surgery.

First, though, he ordered another MRI of my left hip to see how things were looking. The results were in. . . NOTHING. There were no changes in my MRI from the previous year. How could that be? I was stronger. I could do more. I was in less pain. So I decided to go for the PRP injection – my third kind of injection. This procedure is done by taking blood from the patient, spinning it in a centrifuge, which is a machine that separates the plasma from the other components of whole blood. The platelet-rich plasma is then injected into the site of injury using ultrasound guidance for accuracy. In a very small nutshell, growth factors from the plasma supports healing to areas that otherwise have limited blood supply. PRP is still considered exploratory and even with a written letter and phone call from my orthopedic surgeon explaining his clinical reasoning for the injection, my insurance company denied it. Through the NYU Hospital in NYC, the injection would have cost me $1800 out of pocket and I just couldn’t swallow that. Somehow this same injection at his office in Jersey City would only cost me $600. I got on that Path train quicker than you could say, “On your mark, get set, Go!” This injection was far more painful than the other two, but I was a pro at it by this point. Plus, I found it fascinating to watch and learn about the whole process. As I write this, I am 8 days out from the injection. I was a bit sore about 2 days after, but now I feel status quo. Yesterday, things felt better than they do today. This is how things have been. One day my leg will feel pretty good – not to tight or achy and then the next day I take a few steps back and feel increased tightness and achiness. I just can’t figure out why it changes like that. I’m still hopeful though, that as time goes by, the PRP will do it’s magic. PRP continues to work for up to 6 weeks.

He did speak to me about surgery. He called it a debridement, which is an open surgery to remove fibrotic or scar tissue. As tempting as this sounds, I think I just want to rely on natural healing, however long that takes. It’s unknown where I will decide to go from here. I really miss running and all its benefits, but this injury will not define me. In fact, it has redefined me.  I am a person that likes to stay fit and active and can move her body in many other ways.  I walk, ride my bike, take spin classes, take pilates, practice yoga, jump rope, lift weights, use my exercise bands, do my therapy exercises and my newest interest, practice mindfulness which has done wonders for my spirit.  Never give up.  Keep finding ways to help yourself and maybe in the process you’ll find other things you enjoy you wouldn’t otherwise have known.

One Reply to “Guest Post: My story with chronic pain”

  1. Very informative and well written article, it makes me aware of treatment options I’ve never heard before. Thanks