Coming apart at the joints.

I mentioned this past summer that I Did Something To My Hip while running routinely around the lake up here.  It was the first time I'd ever had a running-related injury, and I couldn't stop exclaiming in shock and surprise about how odd it was that something like an easy jog around the lake might, for weeks, send pain shooting down my right leg and up into my back.

At the time I tentatively self-diagnosed the problem as bursitis and decided to treat it with NSAIDs, iliotibial-band stretches, and ice for a while.  I resolved to go see the sports medicine doctor if it didn't get better in about six weeks.  

And it did!  Mostly.  There's still a little bit of irritation there, but I've apparently gotten used to it as it's receded in to the background; I only notice it if I concentrate while I move the joint, and then I'm not sure that I'm not imagining it.  

So I never did go to the sports medicine doctor.

(Why can't I just say "sports doctor?"  It sounds wrong.  But "sports medicine doctor" sounds redundant, although clearly there should also exist sports medicine nurses and the like.  If there is such a thing as "sports medicine" and doctors practice medicine, there should be "sports doctors."   A quick look at Wikipedia has taught me just now that the preferred term is "sports and exercise medicine," abbreviated SEM.  "SEM doctor?"  "Sports and exercise medicine doctor?" "Sports and exercise doctor?"  Whatever.  Mostly Mark and I get around it by calling her Dr. F.)

+ + +

On a Monday three weeks ago I found myself absent-mindedly rubbing my left hand and twisting my rings.  The ring finger felt very slightly sore.  I commented about it to H -- "I wonder if I caught my ring on something" -- but didn't think much more about it until one morning a few days later.

On that day I woke up with my whole left hand stiff and sore -- curling the fingers hurt.  I flexed it experimentally and as I moved each finger I thought I could detect that the pain was in that left ring finger, and the pain in the other fingers was just an accident of the nerves, referred pain.  The pain seemed to get better as I worked the hand, and indeed, an hour after waking up it was completely gone.

The experience repeated the next day and the next, and rather than going away slowly as I'd expect if I had "caught my ring on something," it only seemed to get worse.  But every day the pain was gone after a couple of hours of being up and around.  One night I got up several times in the night with a sick child, instead of sleeping straight through; that morning I didn't have any pain, but it was back again the next morning that I'd been well-rested.

Hmmm.

I moved my rings to the other hand, in case the knuckle swelled up, and started reading and taking notes.

+ + +

If you Google "joint pain in the morning," you get lots of arthritis links.  This seemed to be a premature possibility.  Really?  I'm only 42.  But on the other hand, I have a bilateral family history of psoriasis (father, mother's sister) and also a family history of connective tissue disorders (oldest son).   So.  I called the nurse hotline provided by our insurance company and asked whether to wait and see, go to my primary care provider, who is a family doctor -- family medicine doctor? -- I guess by analogy sports doctor should work -- or go straight to the sports doctor Dr. F.  They sent me to the PCP, so I went.

I got a hand X-ray.   I didn't get to see it because I didn't have time to stick around that long, and instead agreed to be telephoned with results.  The results came back:  nothing visibly wrong with the joint.  No visible inflammation or deterioration.

I guess that's good, although, you know, it still hurts.

So my instructions are to "monitor, ibuprofen if helpful.  If worsening, swelling, catching, locking, other changes, then see sports medicine specialist."

Hey!  "Sports medicine specialist."  

At least the doctor's visit solved that problem.

Now I guess I just wait to see if it gets worse.  

+ + + 

I suppose we are all aging at the rate of one second per second.  I have enjoyed many years relatively free of injuries, for which I am grateful.  Mark has not been so lucky:  he is constantly rehabilitating one thing or another.  He's just gone ahead and made the sports medicine specialist his primary care provider -- did you know you can do that?  A good idea for active individuals whose biggest problem is joint and muscle injury -- and this week he consulted a physical therapist for the first time, and will probably start going in for weekly appointments.  

When you are relatively pain-free and flexible, as many of us are when we are younger, you can interpret most pain as a warning sign and as a signal to stop what you're doing and rest.  But when pain becomes part of your daily life, it no longer makes sense to calculate:  "If I am in pain, that is not a good day to exercise, or to do my daily work."  Provided that the pain is not disabling, it becomes necessary to do the daily things despite the pain, that and the exercise we do to maintain fitness and strength.  For a long time I have been able to say, "I will skip my workout, because part of me is hurting; I'll rest, and get better faster."  But those are the words of someone who is privileged with confidence that there will be a day without pain, quite soon.  

Maybe I am now entering the phase of life where I cannot use a little pain as an excuse to take a day off, because the days without a little pain will not be numerous enough.   I suppose it happens to a lot of people eventually.  I suppose, too, that the more active you are in conjunction with your pain, the more easily you can see which activities seem to help and which activities seem to make it worse, and maybe the quicker you can be to adapt your activities to best manage your strength and flexibility and comfort.

We are planning to go to the climbing gym tonight -- a very finger-strength-centered sort of physical activity! I guess I'll take a page from Mark's book and start today, managing soreness and activity simultaneously, instead of either-or.  And beginning to find out what makes it worse and what makes it better, without being focused on making it go away.

Comments

[Jenny]

Feeling your pain, literally. My hips, as you know, have hurt for years. But just the other day, I, too, awoke with a left ring finger strangely hurting for reasons I could not discern. Weather changes, maybe? It got better after a few days, but this getting old thing is for the birds, but better than the alternative.

[mandamum]

Every time I notice the toll of age, I get a little more excited for the Resurrection of the Body. Of course, my teeth have been a great reason to look forward to it for years....!

[Joseph]

I've been piling up for 83 years so many aches and pains that my doctors told me to stop being so anxious and pray the Rosary more along with taking aspirin and water now and then.

[bearing]

Anxiety makes pain worse, for sure. It feels better to have a plan of action than not to have a plan of action, even if there isn't much you can do physically about it.