If you doubt, first consult your doctor.

The cause of pain:

Pain is a signal of the body that there is something wrong. But what is wrong?

It means that what you do to your body is more than your body can sustain.

What you do can be much, like walking home with a heavy bag full of groceries. It might also be very little, like just sitting on a chair.

Your physical fitness is what your body can do. What your muscles can do, what your joints can do and what your ligaments can have.

1. If you have arthritic joints, your joints can't support very much and you will have frequent pains.

2. If your muscles are weak, then normal daily activities will already cause pain and fatigue.

3. The ligaments will stop movements if the muscles can't do it anymore. So if the muscles are weak the ligaments will be continually under stress. So the ligaments will cause pain.

What does pain do to you?

Pain is an unpleasant feeling you want to avoid.

If a movement hurts, you stop that movement.

Because you are going to move differently you are going to use other muscles, these are going to hurt too.

Because you are going to move less your muscles are going to be weaker. This causes an overload of your muscles and more pain.

What do you do with the pain?

Because of the unpleasant feeling and the anxiety you are going to use medicines. Medicines against pain usually don't do anything against the cause of the pain so in the end they don't help.

Kind of medicines:

1 Paracetamol: suppresses pain and is innocent

2 Morphine like drugs ( oxycontin): suppresses pain as much as paracetamol and makes you less afraid of the pain. Disadvantage is that you need after some time more to use the same effect and you grow dull.

3 NSAID’s (ibuprofen, diclofenac, naproxen): suppresses the pain like paracetamol and suppresses the reaction of the body on inflammation. Disadvantage: they cause stomach pain and bleeding. They have to be combined with medicines against stomach irritation. Further disadvantage: they give a higher risk of heart problems.

4 Hypnotics (in case of insomnia caused by pain): They are not effective for longer than one or two weeks and are addictive. A big disadvantage is that they cause muscle weakness This can increase the pain.

How to tackle the problems?

What will not be the solution?

Surgery is not eligible, so visiting a surgeon is useless.

Also from medication you should not expect much. If you want to use medication, preferably use paracetamol or , in consultation with your doctor, a NSAID.This will not finish the pain too, but the advantage is that if it is going better you might be able to lessen the dose yourself or you can use it only in times you really need it.

What is the solution?

You'll have to do most yourself. That is very difficult and will cost you yourself a lot of effort.

1. It is important that you know you might have always pain.

Maybe the pain will stop if you are able to build up a better condition. But if you have severe artritis of the spinal joints than you probably will have pain for years.

That is anoying, but people can tolerate much. Think for instance at the horrible stories about torture in the war. If people are motivated they can keep silence in spite of horrible pains. Of course, not everybody is a hero, but everybody can learn to tolerate more pain.

As said before: fear and anxiety are important reasons why pain is not tolerated. If you know that the pain is not a sign that there is going to be further damage and that you need the pain to build a good condition again and to live normally again, than you probably are better able to endure the pain.

It is better to have pain and to be able to do things yourself, than to have pain and be dependent of other people.

2. You have to do exercises to get a better condition.

It might be better to do this together with a physiotherapist. It is not only strengthening the muscles but also having the right position and do the right movements.

After the exercises you will have more pain, this is a good sign. But be aware of moving in the right way, in spite of the pain!

If you use crutches: try to get rid of them as soon as possible.

If you are sitting in a wheelchair: try as often as possible to come out of it.

As soon as the pain after the exercises diminish you have to do more intensive (or other) exercises.

Try to make your exercise program so that afterwards the pain is just as much as you can stand and think it over occasionally if you can sustain more pain.

3. Siësta

By the exercises you get pain and you will be tired. This is normal. But because you are impaired you can't maintain this the whole day. It is wise to do a siesta. It is not necessary that you sleep, but lie down for about half an hour. A good time for this is around two o'clock in the afternoon.

But be aware, if you do sleep, take care that this is no longer than about half an hour. And into bed in the evening go a little bit later (or wake up earlier).

4. Meditation?

Some people and some cultures appreciate meditation. What is this?

Meditation exist of two parts:

1. relax consciously, for instance by sitting relaxed in a chair.

2. repeat a certain sense continuously. By this you bring all other thoughts to the background.

Implementation:

three times a day:

- switch off radio and tv

- sit down and close your eyes

- say three times in yourself: 'I am not afraid of pain, pain is normal, pain is a sign that my muscles are working.'

If you never did meditation, you will feel strange with this. In the beginning you might even feel ridiculous. But try it for a week. Many people feel well by this.

If after a week, you still feel ridiculous, then quit.

Consult your doctor or physiotherapist for the above program.

As soon as it is going better you might start swimming or bicycling or running, whatever you like.