A pain by any other name

Being a good doctor means going further than a diagnosis. I remember talking to an acquaintance of mine at a backyard party. He was describing his recent development of neck pain and associated arm and hand pain. He had gone to his primary care physician for this very reason. He was relieved to have had a diagnosis after a very thorough exam and x-ray. He was told that he had "cervical radiculopathy". He was certain that he was on the right path to recovery, since he left the MD with a prescription for opiods.
I remember not being able to hold back a chuckle. My acquaintance asked why I thought it was funny. I replied "I knew you had cervical radiculopathy the very second you described it to me." He seemed astonished. I informed him that the phrase "cervical radiculopathy" only meant that you have neck pain and associated arm and/or hand symptoms. It is a way to classify a condition, and does not specify how one develops it. Nor what to do if you have it.
But I do understand where he was coming from. Sometimes doctors tend to minimize a pain or a problem when they feel that they don't have a good solution for it. They may suggest that the pain will go away on it's own, therefore any treatment beyond medication is unnecessary. The diagnosis of "cervical radiculopathy" meant that there was definitely something wrong, and that there was a good standard operating procedure for dealing with it.
What is even more important, however, is the reason that the person has the "cervical radiculopathy". Why this patient? Why now? Why on just this arm and not the other?

This where having a good doctor is helpful. Asking questions like the person's sleeping position, computer workstation setup, and exercise history are crucial. Looking at the entire body posture is also important. Assessing range of motion and core strength are essential.
After a few weeks of only slight improvement with the opiods, this acquaintance came to my office for the same reason. I was able to determine that his computer workstation did not have a pullout tray. This means that he had to lift his arm too much to mouse with the arm with the pain. Considering he spent 10 hours per day at the computer, this was significant. He also slept on this same side with his arm underneath his head. After a month of treatment, and improvement in his workstation and sleeping position, he was 75% better. His arm pain was completely gone.
I still see this patient periodically, as his 10 hr/day computer usage is still too much for his body to handle, even with improved ergonomics.

Just try it.

I am chronicling my experience as a newbie triathlete in an effort to motivate people to just get out there and do it. What is "it"? It is something. It is anything more than what you are doing now. It is a step in the right direction.

Ten years ago I had consistenetly hit 212 lbs and my blood pressure was climbing. I believed heart disease was just around the corner. I was weight training, but doing little to no cardiovascular exercise. I was stuck in the bodybuilding types of exercise that I always had done. I had been doing them for 20 years. So that's when I started running. And it felt good. It felt like a meditation. Like I could think more clearly. I decided to see if I could run a marathon. I trained way longer than anyone else I talked to. I trained for a year. And I did it. And I was satisfied with that.

Then I got bored again. I needed a change. I knew that I always stunk at swimming. So I challenged myself to do a triathlon. It probably sounded more absurd to me than to anyone else. In the eyes of some people, it seemed a natural progression. I was already considered "athletic" by some. But it certainly did not come natural to me. The first year I did not train long enough. I only gave myself 5 months. I did not come close to being able to do the swim. So I did not even register. The second year I trained for 10 months. But this still did not prepare me for shock that my lungs would go through. The 43 degrees air temperature was too much and I swam to a lifeboat. I decided it was not a good day to die.

This time I trained - well I don't know how long. If you count the previous attempts, you could say I trained 2 or 3 years. And I did it! I stunk at the swimmimg. NOBODY passed me on the bike! Three people passed me in the run, but I passed a dozen others easily.

But you do not have to do triathlons. You do not have to do marathons. Maybe you will one day. Never say never. You can start by walking around the block. Join a gym. They are alot cheaper than they used to be. And there are alot more options. Yoga. Pilates. Orange Theory. Fit Body Boot Camp. Spinning. Barre (ballet?). Maybe Jazzercise? Instead of just do it, I would suggest just try it. If you don't like it, try something else. What is the best exercise you ask? It's the exercise you LIKE THE MOST. Then again, maybe it's the one you hate the least.