The Nebulous Nature of Invisible Pain

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I felt a "pop" in my hamstring as I swung my left leg into pigeon pose, then waves of what felt like electricity swirled up and down my thigh and calf. My leg went numb for about five seconds. I hadn't been to a yoga class in over a year, and the numbness evaporated once I switched positions, so I chalked it up to muscle tightness. Also, while the class was resting in the pose, the teacher had said, "We often carry our emotions in our hips; a lot may come up for you in this position," so I thought, Wow -- maybe that was a real emotional breakthrough.

Haha, no. The reality was that I had just experienced the most significant injury of my life. A day later, searing pain suddenly shot through the back of my thigh. I grabbed it and squeezed, trying to massage what I believed to be a muscle spasm. When the pain hadn't abated a few days later, I frantically Googled my symptoms, ultimately diagnosing myself with a pulled hamstring. I'd been a dancer and athlete my whole walking life, and I figured I knew from a muscle injury, so I iced, rested, stretched, and heated for the next few days. Weeks went by, then months, and things only got worse. Icy Hot fumes invaded every inch of my apartment (and my sanity). The pain spread to my glute and lower back, through my calf, down to the arch of my foot and the tip of my third toe. The sciatic nerve informs all these body points, and I had traumatized it, though I didn't know it then. Multiple MRIs showed nothing off-kilter, physical therapy yielded no results, ENGs showed nerve irritation, but "probably no permanent damage." Panicked and desperate, I dove headfirst into treatment options: NSAIDs, steroids, narcotics, acupuncture, chiropractic manipulation, massage therapy, epidurals, Botox injections, finally a surgery... nothing helped but time.

Invisible diseases and ailments are uniquely difficult, and nerve pain is particularly nebulous. I use "sciatica" now as a simple blanket term; it doesn't fully explain the far-reaching pain in my back, sacroiliac joint, and leg (no doctor has been able to give me an exact diagnosis), but it saves me a long-winded and convoluted description. Not being able to name, show, or concretize my pain for the first miserable two years I dealt with it strained my interactions with others and left me feeling incredibly isolated. It was such a relief when, after I finally had surgery, I had a cane -- a visible, tangible object that told a story -- one that varied depending on the individual's imagination and assessment -- but at a base level it said to the outside world, "I am wounded, I need help, please be gentle." (Also, "Give me your subway seat.") Nerve pain, depression, Attention Deficit Disorder, chronic fatigue, to name just a few "invisible" conditions, however, do not send immediate signals to the world. So it was easy for the people in my life to forget about it, and I obnoxiously overcompensated for the fact that they saw nothing wrong and they did not understand.

For months, my pain was all I wanted to talk about. Because I wanted the sympathy, yes, but also for slightly less-narcissistic reasons: I felt as though I was actually lying, in a way, if I didn't mention it. How could I describe a book I read (or tried to read), what I did last weekend, or what my plans were for next week, next summer, life, et al., when I didn't feel like I was present for the reading of the book, when I had no vision of the past or future? I couldn't even see as far as the conversation, a conversation I wasn't truly in. Didn't they need to know that?

Maybe not, I see now. With my former roommate, I had this compulsion to always tell him when he'd start a conversation after I had just taken my contacts out. "Wait -- I just need you to know that I can't really see you right now. Keep talking; I just need you to know that. Okay?" His reaction never seemed to read as, "Got it, thanks!" but more like "Okay, weirdo. Anyway..." Telling people about my pain was a similar impulse, but amplified. Hey, just know that while you're talking to me, I am not actually here. My attention is with my pain only, and I can't really see you right now. As a good friend who experienced years of debilitating chronic pain once said, "It's like you're being forced to watch a movie of your own life while sitting in a dark room being tortured." There's a quality of removal, of near disembodiment -- while ironically, you feel imprisoned by your body -- that comes when the mind cannot plant itself firmly in the present moment. Consciousness, identity, self-possession all seem lost.

You also feel certifiably psychologically damaged (read: bat-shit crazy), often.

Here's the thing: It can be both helpful and dangerous to view chronic pain as a psychological issue. Recently I read that pain can be caused by subconscious rage, surplus emotional energy, and personality traits such as "goodism" (people pleasing) and perfectionism. To some degree, like all humans with a pulse and penchant for excessive self-involvement, I can relate to all of these qualities, and I've found that thinking of my pain this way can help me function better in my quotidian life and maintain a more optimistic, big-picture view of the healing process. Believing that pain is a direct result of how your mind is functioning is not a stretch, it's not a woo-woo metaphor; the body operates correctly when oxygen flows to all the right places. Things go wonky, shut down, can't heal, get stupid when your body is deprived of that oxygen (that's the official language, by the way -- ever heard of science?). So, if you're living in a state of constant, clutched fear, with irregular breathing and elevated stress hormones, things can easily go awry, and to change that, you'll just have to change who you are fundamentally as a human being in every moment of your life. EASY ENOUGH RIGHT. Ugh. Still, your psychological state can be good to keep in mind while you go about your everyday routines with chronic pain. With this awareness, you may notice when you're gripping, you can focus on trying to let go, you can do slightly better on the subway ride home and in the long meeting, and all these "slightly betters" add up to you truly feeling -- and doing -- better.

But, but, this doesn't mean you should blame everything on oscillations in your emotional states. I'd never say to my friend who recently had a flare-up after a 24-hour plane ride, "You know, this is really because you're too much of a people pleaser." No no. It's an emotional issue and a mechanical issue. It's both. They inter-exist. And in many ways, they are the same issue. "Pain is in the brain" -- yes, okay, fact. But that in no way makes it less real. It just makes it nearly flipping impossible to comprehend, is all.

Over a year ago, at a peak point of desperation, I bought a phone session with a psychic who lives in the backwoods of Ohio. He told me, "Nerves heal, you will get better, but it's going to take a very long time." I pressed him. "Okay. But can you tell me, like, how many months?"

And he was all, Please, dummy, no. Because -- wake up -- that's not how life works. Or, in reality, "No, I can't tell you, because I don't know, and even if I did, I wouldn't tell you, because the point of this, the lesson of this experience for you, is that it is a process. And you must have patience." And then he sent me off with a prescription to learn to live in the unknown, cherish the uncertainties in life, and accept that I will never be able to see the future, which was, incidentally, precisely what I was trying to avoid by calling him, the psychic. He also told me I needed to spend time around Norwegian firs and pines. At the time, I wrote off the session as NOT HELPFUL.

Still, notwithstanding my frustration and disappointment, after that call I started repeating that very famous, often meme'd Ovid quote to myself: "Be patient and tough; someday this pain will be useful to you." Now, over two years later, my pain is significantly less acute, and for the most part, I manage it well and no longer feel the impulse to dump the details on friends and colleagues. I've found an effective neuropathic pain medication. I take Epsom salt baths, use essential oils for nerve repair, and listen to guided meditations that tell me to "breathe in and feel the white light dance playfully around the uncomfortable spot." All of this seems to help just a tiny bit in the moment, but over the years it has added up to significant recovery. Since the pain is worst when pressure is on the nerve, I sleep on my stomach, use a standing desk at work, have painkillers to take for long flights or especially long shows, and am no longer (exceedingly) embarrassed to tell friends or colleagues, toward the end of a long meal or drinks, that I need to stand while we wait for our bill. I take care of it, like it's a pet. An insufferable, obnoxious, yappy one, but it's mine now, and I've learned how to handle its impetuous nature without going insane.

And as I chipped away at the pain, my life began to reemerge in a new and vibrant, but very predictable, way. I found myself fighting for experiences I once took for granted: intense exercise, long dinners, road trips, camping out at a coffee shop to edit a manuscript, conversations in which I could actually process what the other person was saying. These aspects of life crept back to me like hesitant lost kittens, and I timidly knelt on the ground to shepherd them back into my arms. Any sudden movements, and I was sure they'd dart off. But once I held them again, even for brief moments, I felt only relief and gratitude.

Pain recovery is not a linear progression, and gathering your "normal" life back is indeed like herding cats. But the most narrowing experiences are sometimes the ones that widen our scope once and for all. When everything in your life has yielded to itself, has bowed down to an aspect of the human experience, whether it be a stabbing heartache of loss or a particular piercing pain in the physical body, once the pain dissolves and you are able to zoom out again, the world opens itself to you anew. But only when you stop trying to make the experience visible to everyone, when you stop trying to unload it on anyone who might listen, once you become quiet and you turn inward, saying to yourself -- to your own body only -- "I am wounded, I need help. Please be gentle," can you finally hear, see, understand, and help yourself.