sclerosis, which can include numbness, aching, or pain.
____ Angina or chest pain from heart disease.
____ Uterine fibroid tumors (growths in the womb that can be associated with bleeding).
____ Chronic obstructive pulmonary disease (COPD) or emphysema.
____ Peripheral vascular disease (inadequate blood circulation to arms and legs).
____ Ankylosing spondylitis (severe arthritis with restriction of spinal movement) .
____ Myofascial pain syndromes (heightened experience of pain coming from the brain, which impacts soft tissue and muscles). This includes fibromyalgia, which is characterized by tenderness in multiple trigger points, widespread muscle pain, fatigue, and stiffness.
____ Whiplash that doesn’t go away after an accident.
____ Broken bones that healed incompletely or in the wrong position.
____ Arthritis (rheumatoid, osteo-, or other forms), which can affect any joint, including hips, knees, neck, back, fingers, wrists, and feet.
____ Neuropathy from a variety of conditions, including HIV/AIDS, injury, and cancer.
____ Other: _____________________ ____________________________ ____________________________ ____________________________
ALL PAIN IS REAL
Since chronic pain frequently cannot be seen or measured, unlike a broken arm (acute pain), doctors, colleagues, friends, or family may question or doubt your pain. In effect, it doesn’t matter if anyone believes you, but it is extremely important for you to acknowledge that all pain is real. Your nervous system is made up of electrical circuits modified by chemical neurotransmitters, and the sum total of how these billions of cells interact is your essence—your joy, fear, sight, smell, and all sensations, and your experience of pain.
Pain Is a Subjective, Personal Experience
For some people chronic pain can be disabling, while for others it is merely annoying. Just as pain is entirely subjective, your responses to pain and the responses of your family may vary widely. Some of you stay in bed when you hurt; some of you go about your business. Your unique experience of pain is based on many personal factors, including:
There are countless examples of how these factors can influence your perception of pain. For instance, studies have identified a number of gender differences regarding pain perception. Women are likely to experience pain more often and with greater intensity, while men are less likely to seek help for and express their pain. Attitudes toward and expressions of pain also vary among different cultures. For example, Western cultures tend to have a much lower threshold for pain than some Asian cultures where pain is viewed as having spiritual meaning. If you have had a prior painful experience, you might expect this occurrence to go similarly, and that will affect your actions and, in turn, your pain.
{ exercise 1.2 }
Pain Is Subjective____________________________
Describe how your experience of pain has been affected by the personal factors previously listed or list other factors you believe affected your pain.
________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________
Secondary Gain: A Hidden Barrier to Recovery
Secondary gain refers to any perceived benefit you receive from having pain. If not identified, secondary gain gives you unconscious reasons for holding onto your pain. This does not mean you are pretending to hurt for the benefits you get, just that the perceived benefits make the pain rewarding in some ways and thus more complicated to treat.
Some examples of secondary gain that might result from having chronic pain include:
You
