It's Like Caramel

July 11, 2007

My favorite ice cream topping is a toss up between caramel and butterscotch. Part of the attraction, for me, is that the cold of the ice cream changes the consistency of the topping, making it gooey, then gummy, and finally brittle.

This thickening of the topping is the best analogy I can think of to describe how my back feels when the arthritis flares up. Normally my back is fluid and flexible, like warm caramel topping. Some days it is a bit thicker, like topping freshly poured over cold ice cream. I can still move, but there is a band across my lower back, about the height of a tuxedo cummerbund that feels sticky and prickly. It is sort of an itching sensation.

A moderate arthritis episode resembles the caramel or butterscotch when it has been on the ice cream for a while. It is thicker and far less pliable. You get the feeling that if you moved to fast or too far something would break. The itching sensation is more of a burn, and tends to be localized in one spot rather than across my entire back.

A bad episode, like the one I've had the past couple of days, results in loss of mobility and flexibility. The arthritis "coating" has now hardened into a rigid shell that cuts and bites when I move. Relaxing actually helps to lessen the sensation but as that is often accompanied by a change in posture, and movement equals pain, you are left trying to hold still, hardly daring to breathe.

Where the thickening ice cream topping analogy breaks down is in the treatment of a bad episode. Heat, which would soften the topping, is the wrong way to treat arthritis. In my case the nerves are pinched in my bad due to degenerating disks; the pinch makes the muscle sore. Sore muscles contract and, since they are attached to the spine, they pull the vertebrae out of alignment, pinching the nerve even harder. This spasm builds on itself - a really nasty feedback loop. Using ice to numb the muscles and deaden them to pain allows them to relax breaking the feedback loop. A strong all-day painkiller is truly a Godsend.

A severe arthritis episode leaves you flat on your back. Literally. Fortunately I've only experienced one of these, and it was the result of some well-intentioned massage that was done without awareness of my condition. At the time I thought I was still experiencing the lingering effects of a pulled groin muscle and that a massage would help. Instead it produced massive pain as every muscle, and every nerve, in my lower back was sore at once. Had I known that I had arthritis I wouldn't have had the massage. And I would have used lots and lots of ice afterwards.

The other thing that is not intuitive about this condition is that some movement is good. When it hurts to inhale deeply and you aren't able to bend forward to put on your own socks and shoes, the idea of moving to feel better is very counter-intuitive. However, movement that doesn't add to the pain helps to circulate blood and the body's natural responses to pain to the afflicted area. Talking a short walk can make a huge difference in how tight or painful the hardening shell of arthritis feels.

Today my arthritis is nice and warm, loose, not impeding me at all.

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Mark H. Nichols

I am a husband, cellist, code prole, nerd, technologist, and all around good guy living and working in fly-over country. You should follow me on Twitter.