Chronic pain is one of the loneliest, most isolating experiences ever. No-one else feels what it feels like to have pain. No-one can tell whether you have really bad pain today, or if it’s just a nuisance pain. Some people think they can tell whether you have “real” pain or not (in other words, they think they can tell if you’re faking) – well, in all the research I’ve looked at, this cannot be done. There is NO way for someone else to determine if you have pain or not. Some people can tell that you’re having a bad day – but they’re not feeling your pain, they’re interpreting how bad your pain is from the way you move, your facial expression, what you say and how you say it.
You have a choice about how, and whether, you show other people what your pain is like for you.
You can decide to be quite open about it – I am, not only about pain but about having depression. I decided that one way to accept my pain and depression was to let other people know that I have both, AND that I manage both.
You can also decide not to be open about it, and choose to use your body normally, being careful to hide your stiffness, your grimacing, and the care you take when you do things.
You can also decide to let it all hang out, let everyone know you’re sore, grumpy, tired and you’re sick of having pain.
Each option has various consequences.
If I decide to tell people quite openly that I have pain, some people roll their eyes and think I’m a drama queen or nuts or something. Others see it as an excuse for me not to do things. And some just accept it as part of who I am. The important thing is: that’s their stuff. The way they choose to interpret what I have to say tells me more about them than me.
If I decide not to tell people, try and act as “normal” as possible, keeping it close to my chest I can end up being treated just like anyone else – except I’m not. I’m not like everyone else, because when I do something out of the ordinary routine, I get a pain flare-up that lasts for days. I need to work up to doing physical things like tramping (hiking) with a heavy backpack, or moving soil around my back yard, or even painting my house. It’s not that I can’t do these things, it’s just that these things have consequences. If I don’t share this with other people I’M the only one who knows, and no-one can support me. No-one can judge me either, but they may see the way I present as less than authentic as well.
If I decide to let it all hang out, and complain and grump about my pain, I’m likely to wear out my welcome really quickly. No matter HOW wonderful my friends and family are, it’s not pleasant hearing about pain all day, every day. And it makes me feel even more horrible than I already am!
So, you can choose to be authentic, but at the same time not dwell on your pain. I think of it a bit like this:
If I am walking along a path, and I see a matagouri bush in the way (see the picture? that’s matagouri, found in the High Country in Canterbury, NZ), I can choose to stop, let it get in the way and get really cross with it. I don’t get torn to bits by it, but I don’t go anywhere either. Alternatively I can walk right on through it, getting caught on all those thorns, shredding my skin and clothes. I’ll get places, but I’m not going to enjoy the process! The final option is to stop for a moment, take a good look at how big it is, then make a decision about where I finally want to end up. I can then choose to step around it, or I can put something over it and keep going, or I can hack at it and remove it completely, or I can even take a photograph of it and appreciate it for what it is then go on around it.
There are no hard and fast rules about how to deal with pain, it all depends on your goal, what will work in YOUR life, and most importantly, what will work in the long term. And each option has long term consequences that we might not think about in the heat of the moment.
Whatever you decide to do, just know this – you are not alone with your pain.
The usual estimates of chronic pain in the general population suggest that around 1 in 5 people have a painful condition that lasts more than 6 months (Dominick, Blyth & Nicholas, 2011), maybe more. Pain can be arthritis, fibromyalgia, migraine, whiplash, dysmenorrhoea – lots of things. And you might not know just by looking that someone YOU know has it. Perhaps by talking about it, but not dwelling on it, chronic pain might be more accepted in our communities.
Dominick, C., Blyth, F., & Nicholas, M. (2011). Patterns of chronic pain in the New Zealand population. New Zealand Medical Journal, 124(1337), 63-76.