Chronic pain is an odd phenomenon. I had no idea just how odd until it became a part of my life. This is the first of a series of blogs exploring the weird and sometimes counterintuitive world of chronic pain and pain science...
While no one wants to be in pain, acute pain serves a useful purpose. Nociception, our body’s perception of pain, tells us that our fragile human tissues are in danger and to stop doing whatever it is we are doing that is causing the pain. For example, prompting us to remove our hand from a scalding hob, change our posture when stationary for too long or take painkillers for a headache.
When we experience pain beyond the time of usual tissue-healing (3 to 6 months), the body’s perception of that original pain can become stuck in a loop, imprinted on that person. You still feel the pain from that injury or illness even if the original cause of the pain has been removed. And that residual pain is very real.
Chronic pain can result from an injury, following surgery, or due to a health condition. Some illnesses that bring chronic pain to the party as a co-morbid companion include endometriosis, sickle cell disease, multiple sclerosis, arthritis, lupus, diabetes, migraine, irritable bowel syndrome, Ehlers Danlos syndrome, fibromyalgia, complex regional pain syndrome, sciatica, shingles, and many more. So, it is not surprising that chronic pain conditions are cited as one of the main causes of disability globally. The World Health Organisation cite lower back pain as the single leading cause of disability in 160 countries!
Chronic pain has no singular look. It can affect people of any age, any ethnicity and any socioeconomic group (although there are some groups of people who experience higher rates of chronic pain, which we'll discuss in a later blog). Some people living with chronic pain show visible signs, such as mobility aids, dark sunglasses, scarring or slow, bracing movements. Some people may wince, furrow their brow or verbalise their discomfort, while others may appear no different from their pain-free counterparts. It is important to know that even those who appear okay to others may be still be living with life-altering pain that would send those without chronic pain to A&E in desperate search of relief. Pain levels can also fluctuate throughout the day, week, month and year.
Few people with chronic pain can achieve a state of no pain, even with analgesic medication. To have chronic pain, is to know medical science has serious limitations. Being in pain all or most of the time can make those experiencing it less mobile, fatigued, unable to sleep and mentally unwell in many ways. It can stop them earning an income and participating in society. It can make day-to-day tasks challenging and sometimes impossible.
Chronic pain can be very alienating because pain is an entirely subjective experience! It is because of this subjectivity; other people tend to underestimate its impact on the person saying ‘I’m in pain’.
This can show up on a systemic level when a person disabled by chronic pain is trying to access housing or benefits. For example, in the UK benefit system, an assessor, who holds power over the claimant’s future security and well-being underestimating or disbelieving a claimant’s experience of pain is a dangerous and cruel reality baked into the assessment criteria and methods.
While chronic pain is a lot to live with, there are tools and techniques out there that may (when combined with others), help us manage the pain and live more fulfilling lives. Some of these, I will cover in more detail in this series. Until the next one, from this eternally pained author to you; if you live with chronic pain and it dominates your life, try to cut yourself some slack. You’re living life on hard mode. If you can, do something that feels good to you today.
We would love to hear your thoughts and experiences on chronic pain send us an email at firstname.lastname@example.org
'Pain is really strange' by Steve Haines