ALL PAIN IS REAL
Since chronic pain frequently cannot be seen or measured, unlike a broken arm (acute pain), doctors, colleagues, friends, or family members sometimes question or doubt the sufferer’s pain. Chris is a good example of this, doubting the validity of Amy’s fibromyalgia pain. In order to be helpful, it is extremely important to acknowledge that all pain is real. The nervous system is made up of electrical circuits modified by chemical neurotransmitters, and the sum total of how these billions of cells interact is our essence—our joy, fear, sight, smell, and all sensations, as well as the experience of pain.
The Subjective Nature of Pain
For some people, like Amy and Jim, chronic pain can be disabling, while for others it is merely annoying. Jim stays in bed when he hurts; Amy pushes through the pain some days and goes about her business. Each person’s unique experience of pain is based on many factors, including:
There are countless examples of how these factors can influence a person’s 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 (suffering in silence with a “stiff upper lip”). 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.
Prior painful experiences can also influence pain perception. Jim expected to have so much pain at a family picnic, because he had previously, that he just refused to get up and go with Mary and the kids—another serious disappointment for this damaged family. In fact, Jim would come to learn that believing that his pain would be worse based on the last time he was up and around for four hours actually created more pain for him and more suffering for his family.
And just as the experience of pain is entirely subjective for Jim, the responses of Mary and the kids (and other family, friends, coworkers) to his pain vary widely.
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Pain Is Subjective _____________________________________________
Describe how the personal factors listed on the previous page may have affected _______________’s experience of pain. Include any factors not listed that you believe affected his or her pain.
Describe your personal issues and assumptions about pain. How do these things affect your feelings about _______________’s pain?
Manifestations of Chronic Pain
Chronic pain can be a troublesome annoyance or a devastating curse that interrupts life functions, relationships, employment, and most things in life that bring people satisfaction. In Jim’s case, it took over his life and the lives of his family, it consumed them, and it threatened Jim’s well-being and the well-being of Mary, Mandi, and Ross. For Amy, traditional pain management (medication and physical interventions) did not help sufficiently. She developed a constellation of troubling symptoms.
Pain Manifestations ___________________________________________
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Here is a list of some of the manifestations of chronic pain. Please check off those you believe _______________ has experienced.
____ Pain that has lasted for more than six months.
____ Feelings of depression, anger, worry, discouragement, and irritability.
____ Sleep difficulties.
____ Financial problems.
____ Problems relating to others, causing significant disturbance in relationships.
____ Inability to tolerate physical activities.
____ Withdrawal from social activities.
____ Inability to concentrate.
____ Poor memory.
____ Isolation from support systems, including family, friends, and coworkers.
____ A decrease in sexual activity or performance.
____ A decrease in self-esteem.
____ Secondary physical problems.
____ Problematic use of pain medications and/or alcohol or addiction.
____ Avoiding work and leisure activities.
____ Negative attitudes concerning everyday life.
____ Other: __________________________________________________________
_________________________________________________________________
Write about the feelings that come up as you review this list.
The Pitfalls of Pain Management
Traditional pain management uses a multitude of interventions, including medications. Opioid medications are the primary drugs used to treat chronic pain and are often the cornerstone of pain management. Unfortunately, they carry with
