Chronic Pain Never Has A Gain – So How Should You Talk About It?

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Chronic pain. In some ways, it’s such a simple term. Chronic means the condition has been going on for more than three months and has no obvious end in sight. And pain – well, pain we all understand.


For something that should, on the surface, be obvious – why do so many people have trouble understanding it?


The truth is, if you’re non-disabled and free of pain, then you can’t understand what life is like for chronic pain sufferers. You can try to empathize, and sometimes, you may even succeed.


Perhaps you can recall a time when you were injured, and you can tap into that emotion – and sharing that experience may show you’re trying to understand. But the reality is: you can’t. You can’t measure a temporary inconvenience with the feeling, knowledge and misery that comes with a condition that is guaranteed to hurt every single day.


If you have a friend or family member who suffers from a condition that causes constant pain, it’s difficult to know what to do. There is no societal survival guide for doing or saying the right things – not until now, anyway!


It doesn’t matter if you have done any of the “don’ts” on this list. It’s a tricky situation that few people know how to navigate correctly. All you can do is switch your behaviour and ensure that, in future, you’re not going to be putting a foot out of place.


DO: Understand Pain Is Relative


If you have a high pain threshold, then understanding someone else’s suffering is more difficult. The same applies if you have given birth, which is widely recognised as one of the most painful experiences a human can go through. (The TV show Mythbusters actually proved that women who have experienced childbirth have a higher pain threshold, so keep this in mind.)


What you need to try to focus on is that:


  1. a) Pain is relative. We are all wired individually, and a 2 on the pain scale is an 8 for someone else. Neither is “correct”; it’s just subjective. The pain they feel is still very real and very distressing, so you shouldn’t be comparing your own experiences with what they’re going through.




  1. b) They go through this every day. It’s not a one-off inconvenience. It doesn’t have a beautiful ending like childbirth. It’s just their life; something they live with every single day, and there’s no end in sight.


Instead, treat their issue as their issue and nothing more. If they’re having a bad day or turn down social plans to their discomfort, then that’s all that matters. You have to let their perception of how they are experiencing the problem be your guide.


DON’T: Offer Suggestions For Pain Relief

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This is something most of us reach for when we are trying to empathise or comfort someone. It’s a natural impulse. We read an article or see a TV show suggesting some miracle cure, and we want to bring it up.


It’s not welcome. The only exception would be if your advice is deliberately solicited, along the lines of:


“Hey, friend, have you heard anything about ways of curing pain recently? My back has been so bad, and my ankle isn’t great either, I need some advice!”


And you reply:

“Yes I do, I heard of this amazing treatment that can help with your back and bring some relief!”


Chances are, this conversation isn’t ever going to happen. If it does then sure! Go for it! But in reality, it’s not going to.


Why? Because a chronic pain sufferer knows more about handling pain than you do.


If there’s some new inventive treatment or just an old wives’ tale you want to share, they’ve heard it. They’ve heard it from other people, from their doctor, from their own late-night Google sessions as the pain stops them from sleeping. It’s not new information to them.


All you do is force them to smile and thank you politely for something they had already known. The conversation, if you strip the politeness away, is actually more like:


“Hey,” you say, “I know your back is bad, have you tried a heat bag on it?”


To which the honest response is:


“Of course I have tried a heat bag. I’m not an idiot. Why are you making it sound like I don’t know the basics of caring for my own issues? Do you think I’m incapable of knowing what might help or running my own internet search?”


DO: Sympathise


Although often used interchangeably, there is a difference between sympathy and empathy.


Sympathy is feeling sorry for what another person is going through. You have no idea what it’s like to go through what they are suffering with, but you care and understand on an intellectual level why it’s difficult.


Empathy is when you have also experienced the same thing another person is going through and can relate to it.


A perfect example is period cramps. A man can sympathise with what it’s like to have period cramps, but they can’t empathise with it.


We often reach for our own experiences in an attempt to empathise. It’s such a natural thing, such as in the above example: “I’m sorry about your period cramps, I had a really bad stomach infection a few years ago, and it hurt all the time…”


You’re trying to say that you care; that you’re sorry they’re going through this. It’s an attempt at empathy. But what it sounds like to the sufferer is: “stop whining about this! Everyone goes through painful things – and also, can we please talk about me now?”


Be content with sympathising. You don’t know what it’s like to live with chronic pain, but that doesn’t mean you can’t intellectually understand how draining it must be.


DON’T: Be Offended If They Cancel Plans

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If someone you know has a pain condition that’s well-managed, it can be easy for you to forget. You make plans together, you look forward to it for weeks and then the morning of the meeting arrives… and they cancel, citing their pain levels being too severe.


It might feel disheartening, but try to think what it’s like for the sufferer. Not only are they having to let down someone they care about (causing emotional discomfort), they are also suffering on a physical level.


Be patient, be aware that plans are subject to change. If you feel frustrated – and it’s understandable if you do – then try to vent it away from the person themselves.


DO: Treat Every “Bad Day” Seriously


“How are you feeling?” You ask, knowing it’s a loaded question to a chronic pain sufferer, but you still want to ask. It’s only human to query after someone’s health, after all.


“Bad day today,” they respond with a forced smile.


“Oh, I’m sorry. How are the kids doing anyway?”


If the above sounds eerily familiar – don’t worry. Everyone does it. When you become used to the idea of someone being in pain frequently, it has less meaning on an emotional level.


The danger here is that it makes the person you care about feel unrecognised. If someone who didn’t have a chronic pain condition complained of being in a dreadful condition one day, would you immediately respond, change the subject or not linger on it? No, chances are, you’d ask for more information and if there is anything you can do to help. You’d see it as a big deal.


Try and frame all references to “bad days” on the same scale as if your friend/family member were otherwise well. They might be more prone to experiencing pain, but that doesn’t make it any easier to deal with. It doesn’t make it hurt less.


DON’T: Tell Them What They Can and Can’t Do

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Say you want to go on a hike. Your friend/family member expresses a desire to join you.


“Oh,” you shake your head, “I think it’d be too much for you.”


You think you’re being understanding; perhaps even advising them for their own good. What you’re actually doing is being patronising.


Chronic pain comes in waves. They will have good days where they feel almost normal, followed by days where they wish the earth would swallow them whole. It’s not up for you to judge what they can do on the good days. You don’t know their body – they do. They may be perfectly capable of hiking for 10 hours one day and then a week later be in agony for hours.


If someone is prone to overexerting themselves, then all you can do is show them the possible hazards. If you frame this in a general discussion, just you making them aware of potential issues, then it won’t come across poorly.


On the other side of the coin, don’t assume they can do something if you judge it to be acceptable. If they say they can’t walk a distance or sit through a three-hour theatre show, it’s not your place to contradict them.


Navigating all of the above may feel like a minefield, but it does become easier with time.

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