On The Foot of Doom, and recovery

Two months ago I injured my left foot. Well, not even injured. Stressed, really. For a couple of weeks I did a huge amount of walking across London and up and down hills, culminating in wearing strappy (flat) shoes very tightly all day for a day trip to Colchester on a hot day. The next morning  I noticed a snagging pain in my left foot when walking. I assumed it would go away and carried on as normal. It didn’t. A day later it had got worse. I went to minor injuries. The doctor prescribed me with anti-inflammatories and said it would get better within a week. A week later it was no better, and bruised. X-Rays showed nothing, the pills did nothing. “Just a few more days resting it,” I kept thinking. And still it was no better. If anything, it was worse. I still couldn’t walk. I was told it was tendonitis but all the advice forums were for serious runners – as I hadn’t run for months, it seemed unlikely. Strapping it in a bandage briefly seemed to help but then make it worse. Soon after I was in so much pain I could hardly cover my foot with a duvet and had to slather it with Ibuprofen gel to move. Getting dressed and ready took half a day; walking up and down stairs was an epic journey. And still, no-one seemed able to help me. The closest I got to a diagnosis was my Pilates teacher saying it was a “trigger point injury”. He very kindly came and did a few exercises with me at home but the relief was temporary. The next morning I tried to stretch my foot in bed and was in agony. I was housebound, dependent and completely infantilised – my dad even had to bring me breakfast or else I wouldn’t feel up to eating until lunchtime.

By the third week, underusing the foot had led to painful cramp every morning and night. At the worst point I sat in the bath with my leg hanging out wailing in despair. Although rationally I knew nothing with a trigger as minor as a tight sandal could last forever, as time dragged on and nothing seemed to get better I started to panic. What would Christmas be like? Would my dad have to drive me into London to do presentations for work? What if people didn’t believe me? People had been sympathetic (offering me wheelchairs, saying “Oh you poor thing” and such, but that was in hospitals and doctors surgeries. What about everywhere else?) Eventually, just as it looked like it might be starting to improve, my GP referred me to a physio who diagnosed me with Complex Regional Pain Syndrome (or Muscular Sympathetic Dystrophy), a condition normally associated with athletes, soldiers and arthritis, where an injury heals but the brain keeps sending pain signals to the area. The foot was still very swollen and intermittently painful, although the pain was getting less frequent. We did some exercises, including the classic mirror exercise where you touch your good foot in front of a mirror to trick your brain into thinking it’s your bad foot. She said she was optimistic but warned me a full recovery could take weeks or months. Two weeks later, the pain was gone and apart from some inevitable stiffness in the underused areas I was back to normal. It was as though once the pain had started to ease and I knew there was no physical injury which would get worse by moving I could train my brain to override the signals. I’ve been walking to the small Tesco at the end of the street regularly, and done a couple of brief local outings. I’ve just been back to physio and been given the all-clear, apart from some shoe recommendations for the future and a couple of calf-stretches and balancing exercises to get my left foot leg properly used to exercise again. The physio said I was very lucky: she has seen awful cases and some people get saddled with this for years.

It has been, as they, say, an Eye Opener. It’s not that I ever disputed chronic pain exists (people do – some of them are in public office) but I didn’t think something so minor could cause something so disruptive, or that the health service could do almost nothing to help – FYI, being unable to walk is regarded as “non-urgent”. Sadly, people with chronic pain (of whom I know several) are resigned to it. (Just as I’m resigned to the fact that there’s little or no free help available for adults with dyspraxia unless it’s funded by an employer, even though if there were my quality of life would improve immeasurably and I’d stop being referred for treatment for depression/anxiety every eighteen months, but I digress…).  For those who are not resigned to it, the sudden thought of it is terrifying. I’m assured there is no evidence that having CRPS once makes you more predisposed to it in future but I doubt shoe-shopping (never quite the pleasure it’s supposed to be with my clumsiness and wide, size-8 hooves) will be much fun again for a long time, and I’m going to switch to swimming for exercise as I’m too afraid of injury to run. I feel bewildered at how I got so badly ill, and profoundly lucky not to have been worse. Taking the anti-inflammatories (while being a vegetarian and of the lady persuasion) has also made me anaemic, which means that after six weeks’ virtual immobility I’m now on pregnant doses of iron tablets which make me nauseous – not the greatest fun. But I have my freedom, and am trying to remember to cherish it as I get back to the normal despair over work: being skint, edits, rejections and not getting enough done. Those of you who have your health, be glad. When you’re ill, little else matters.


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