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Most people know what it is like to experience acute pain. The pain when you pull a muscle, sprain an ankle, fall, stub a toe, get pinched. Acute pain doesn't last. You are often able to manage it with heat, ice, and avoiding aggravating activity while the area heals. You might take an over the counter pain medication or anti-inflammatory, to get relief. A few sessions with your massage therapist, physiotherapist, or chiropractor might also be of benefit.

Then there is the chronic intermittent recurring pain. I have experienced this pain mostly in my left lower back and hip. If I overdid an activity, the area might flare up. Generally, I have always been able to get the area to settle back down, either by stretching, or getting treatment from one of my physiotherapy colleges. It was only recently that I flared this area again, and required some physiotherapy intervention to settle it down. I was experiencing a good energy day, and decided to do an easier outdoor bike ride along the fairly flat gravel path where I live. It was so nice to be active and outside, that I ended up riding my typical 14 km. While it took me longer than normal, my muscles that were tight and de-conditioned from 2 months of significantly reduced activity, went into a full out protest.

Along with the physiotherapy sessions (IMS, joint mobilizations, contract-relax stretching), I have been using heat, positions of comfort and stretching/yoga to help with the discomfort in my lower back and hip area.

Until recently though, I never had to deal with constant chronic unrelenting pain. There was no position of comfort. Lying down actually increased the pain, especially if I was on my back or right side. The pain interrupted my sleep, and wore me down. I was unable to reproduce or pinpoint the pain. It was more diffuse along the right rib cage. The characteristics of this pain, indicated to me that it was likely from an organ. An oncologist told me he felt it was coming from my liver and not the lung.

Because of the tumours throughout my liver, I decided to try a more natural pain killer. I started taking some THC. While I did get some relief, I was very sensitive to this, and it left me feeling groggy and unable to function. I switched to trying extra strength Tylenol at regular intervals (one every 6 hours) throughout the day. This actually really helped. Then I was informed that Tylenol can be hard on the liver, and it was suggested I switch to Advil. Advil can be hard on the stomach.

Currently, I am managing the pain with a combination of products. I take the natural form of Acetaminophen, called White Willow Bark, twice a day; an extra strength Advil twice a day; and as small amount of THC at bed time. I have a CBD cream that I rub over the affected area once a day. At night I do the castor oil, with an added pain relief essential oil rub to the area, then heat over it. Daily meditation is also part of my routine, as is using LED light therapy. The homeopathic treatments have also proven to be extremely beneficial for me.

Though I am not pain free, this regimen, is helping keep the pain below a 5/10 level. Sleep quality can vary, especially because the liver referred pain is less when sleeping on my left side, but the left lower back pain is less when sleeping on my right side, which can increase the liver pain.

As a physiotherapist teaching about pain and pain management, I would say that there were a few good things about pain. One is that it let you know that you were still alive. Which this constant pain certainly does, but it also interferes with living. The second was that it kept me in business. While I am grateful to still be alive, constant chronic pain can be very tiring and depressing. It isn't so much the pain that limits activities (except for the left lower back pain did limit me until my first physiotherapy session - which did reduce it by about 90%), but that it leaves me feeling fatigued and depressed. The fatigue comes from too much pain medication (THC seems to build up in my system), or not enough and poor quality sleep.

Hurt does not always equate with harm. I know that. So even with the pain, I would manage to do some light activities such as walking, yoga, Qigong, and occasionally get on the spin bike with no resistance. Our bodies were meant for movement. To get moving, I often have to wade through the feelings of depression and lack of motivation. Both of which I attribute to the fatigue. I was used to being on the move 12-14 hours a day. Now on a good day, my tolerance is about 3 hours of light activity, before I need to rest/nap.

Life right now is very different for me. I am tired of the pain and of the fatigue. I had assumed that when I no longer was working full time as a physiotherapist, my time would be filled with kayaking, hiking, cycling, and travel adventures. That perhaps I would be doing more talks or lectures and teaching, while still seeing a few clients. I didn't anticipate being in the position of needing a nap most afternoons (which are between 1-4 hours depending on how tired I am). People don't see the fatigue. When I am out in the community running errands, it is when I am feeling good and have a bit of extra energy.

Not all pain is the same. Pain management, therefore is not the same for everyone. Each person has to discover what works best for them. There are numerous resources available these days, whether you are leaning towards a more natural method, or the medication route. Living with chronic pain is challenging. I am learning to appreciate each day for what it brings, even if it is 4 hours of napping.