No Pain, No Gain. Wanna Bet?

By David Sherman

This is about joints. Not the kind you roll and smoke. But the rebellious connections of our aging bodies that complain you've been having too good a time. And now you have to suffer.

Most of us have what they call degenerative disc disease, which is neither degenerative nor a disease and doesn’t infect the discs. Rather, it’s about the little spongy material between the discs that cushions them when all is well. As we get decrepit, more of that little rubbery stuff decides it’s had enough of cycling, squash, sex, running and life in general and retires in Mexico. There’s a beach town south of the soon-to-be best wall ever called Esponja.

When the spongey stuff heads south, your discs get up close and personal, and, like most of us who spend too much time in intimate surroundings with another, they rub each other the wrong way. This causes them angst. Which they then decide to share with their host. You.

X-rays and MRIs can illustrate discs at loggerheads but they can’t tell anyone how much pain their enmity might cause. Like snowflakes, we’re all different. The pain is moody and comes and goes at its own rate and pace and, like some insensitive, visiting relative, stays as long as it feels like. It often resents that its barrier cousins are nestled in warm sand, looking at scantily clad bodies bobbing in the sea, drinking Corona with lime. So, they inflict what can be debilitating pain.

There are also, on occasion, abandoned, resentful discs in the neck from those of us who spent a lifetime staring at screens and typewriters. These discs are not only a pain in the neck, but an ambitious pain in the neck. They want more. They want your entire head. Known fondly as cervicogenic headaches, or the headache that never ends, these yearn to crawl up your neck, wrap around your skull and pluck out your eyeballs.

There is a disc-pain industry built up to profit from your misery, as there is to profit from all your miseries. There are chiropractors, who, in their overzealousness to readjust your spinal column, can stroke you out. Chiros were recently reprimanded for telling patients that manipulation would bolster their immune system and reduce their chances of Covid-19 infection.

There are physiotherapists who manipulate you, heat you, ice you, give you exercises and can make you feel like a million bucks. For about 24 hours. If you follow their exercises, you might feel a more limber. Or not. You can, as I have, spend thousands of dollars of your own or your insurance company’s money and roll the dice. I have found them to be well meaning and congenial, but as one admitted when I told him I had DDD, he said, “I can’t do anything. There is no material there to work with. You don’t have to pay.”

There are machines and belts and bindings and support systems. Heating pads and hot water bottles. Books and online lectures.

Or, you can then hit the pharmacy and/or the script writers. There is Tylenol, which studies show to be as effective or less effective than a placebo. And if a placebo works, more power to it. Taken excessively, which is not difficult since they throw the stuff into countless cold and brand name meds, it can kill you. Swallowed with quantities of alcohol, and who in pain doesn’t enjoy a gargle or two, it’ll kill you. Like Hannibal Lector, It has an appetite for your liver. With or without fava beans.

There is ibuprofen, an NSAID aka non-steroidal anti-inflammatory drug. It works well, relieves pain, causes stomach bleeding, severe, roll-around-the-bed heartburn and, if taken excessively, can cause kidney and liver damage. It may or may not kill you. The FDA has issued two warnings about long-term use of all NSAIDs. It says they can kill you without warning. And no one should be taking them long-term. Period.

There is aspirin, the only NSAID that won’t kill you, supposedly. It does thin blood, can burn holes in your stomach or esophagus, cause tinnitus if taken excessively but probably won’t turn you into a stone-cold killer like the character in Truman Capote’s novel, In Cold Blood.

And then there are the supplements that people swear by that have no clinical value but work splendidly on some for whatever reason. And creams and unguents galore, most of which are a variation on the theme of what is called counter irritants. The burning sensation of the "cooling" or "warming" cream or gel takes your mind off the joint pain. As will banging your head against the wall. Some have aspirin variants or NSAIDs and bring real relief. Anything that works, works.

There are opiates, the drug behind today’s opiatephobia, that, if taken properly, will kill pain. You will develop a tolerance for it and so have to take more. It might make you feel good, what they call euphoric, where you embrace unparalleled love for your partner and your fellow man. You will want to talk a lot to a lot of people, until you don’t and become grumpy and moody.

The drug’s been around for 500 years and some people get addicted to it. But, as one wag told Michael Pollen in his new work, Caffeine, there’s nothing wrong with addiction if you have an unlimited supply and it’s not hurting you. Holding up drug stores does not mean having an unlimited supply and yes, you are hurting yourself by chewing a handful of opiates and staring at the wall for ten hours. Taken as directed, they work, which is why so many people take them.

And there are a ton of muscle relaxers. Some work. Some don’t. Some relax you so much you basically pass out. Some doctors prescribe, some don’t. Some cause nightmares. Many are addictive, which makes doctors reticent.

Some doctors preach the glories of CBD oil and will send you to a CBD expert. The expert will tell you the glories of CBD oils and tell you where to buy them. The experiment costs about $350 and I found it as useful as Tylenol, only 20 times more expensive.

DDD is not too different than osteoarthritis, which is a shortage of rubbery material in your knee, for example. This is called cartilage and often retires before you do and heads down to South America, drinking wines from the Mendoza region, eating grilled cow and mondongo, and taking tango lessons.

This causes the bones in the knee to inflame and hurt like hell. Other than the above retinue of medication, there are cortisone shots designed to reduce inflammation, the body’s natural defence against intrusion and overuse. As the orthopaedic surgeon I have come to know told me, inflammation is the body’s way of telling you to stop doing what you’re doing.

For this joint, that means stopping just about everything, other than lying in the fetal position with a hot water bottle between your knees and sucking your thumb. Which may lead you to an orthodontist. Or, as the doctor admitted, he can tear you part and try to put you back together with a new titanium knee and several months of rehab. “When your knee is ready,” which means when you walk like the old fart you are and tend to take the Lord’s name in vain every waking moment.

As with DDD, health practitioners tell you to exercise despite the pain. It’s good for you. Like your coach told you in high school. No pain, no gain. And is how we ended up this way in the first place, by thinking there was virtue in suffering and we could play forever.