Chronic Pain: The Invisible Illness

Chronic pain is an insidious health condition for many reasons. In many ways, most kinds of chronic pain remain a mystery which is why they are so difficult to treat.  They may originate as a fairly obvious and diagnosable injury or illness and transform into a long-term condition without clearly delineated causes.  These kinds of conditions include fibromyalgia, neuropathy and Chronic Regional Pain Syndrome.

Another reason chronic pain is such a burden is that it is often invisible to others. Unlike conditions like chicken pox or a broken limb, which are readily apparent to others, chronic pain is often not apparent to the naked eye. Because others can only infer that is afflicting you, it is all too easy to dismiss it as less severe than it is or treat it as a psychological condition.

Even if others recognize your pain as real and debilitating, without visible markers, it is often easy to overlook the many challenges that accompany chronic pain. In many cases, it is difficult to even convince physicians that a pain condition is chronic and severe.

What Is Chronic Pain?

Almost everyone has encountered pain at some point in their lives, most commonly in its acute form. Acute pain from injury or illness is a warning sign that there is something wrong physiologically. As the underlying health condition is resolved, the pain symptoms diminish until they disappear.

Unlike acute pain, chronic pain may continue for months or years, and there may be no identifiable physiological cause. If this pain persists for 3 to 6 months or longer, it is considered chronic.  In many cases, chronic pain is an illness in itself with roots in both the physical as well as mental.

Chronic pain also has serious effects on the brain that acute pain does not.  A constant barrage of pain signals re-wires the brain making it more prone to emotions like anxiety, stress and depression.  If untreated, these emotional states can compound pain symptoms making them more intense. That is why chronic pain management is a multi-tiered strategy that should include both physical and mental modalities.

Chronic Pain in the United States

Chronic pain is pervasive in the U.S. According to a 2016 report from the Centers for Disease Control and Prevention, 20.4 percent of the adult population in the U.S. suffers from chronic pain, and 8.0 percent of U.S. adults struggle with high-impact chronic pain that interferes with work or personal activities. Of the 50 million Americans in chronic pain, the most common groups are women, older people, unemployed, poor, rural and uninsured.

The age group with the highest number of chronic pain sufferers was 45-64 with 23.3 million, of which 10.0 million had high-impact chronic pain. More than 28 million U.S. females suffer from chronic pain while only about 22 million American men have this condition. By far, this condition most often affects white, non-Hispanics with 36 million cases.

Ongoing pain afflicts more Americans than heart disease, diabetes and cancer combined. It is the most common cause of long-term disability. The American Pain Society reports that chronic pain costs the U.S. more than $635 billion annually with up to $300 billion spent on health care treatment and $335 billion due to lost productivity.

Challenges for Chronic Pain Patients

Most people who struggle with chronic pain agree that the biggest issue is the pain itself, but these symptoms are often complicated by the invisibility of the symptoms.  There are many challenges associated with chronic pain including the following:

  • It is all psychological—many people, possibly including work supervisors, family and physicians, may assume that your condition is in your head rather than physical. Without proof, most people will assume that you are trying to avoid responsibilities or seek sympathy.  It may take some time and quite a lot of patience to convince others of the seriousness of your chronic pain.
  • Empathy—even if those around you believe that your chronic pain is real, they may lack the ability to truly understand the scope of the problem.  Human beings are naturally programmed to forget how much pain hurts, so convincing others that you dealing with a crippling condition is an uphill battle.
  • Qualifying for disability—despite the widespread nature of chronic pain, it can still be difficult to convince insurers, health care organizations and government agencies that your condition is real. Most groups start with the assumption that you are faking in order to obtain benefits and place the burden of proof on the patient.
  • Getting diagnosed accurately—not all physicians are as familiar with chronic pain disorders as a pain specialist which is why certain conditions are not easily diagnosed. It also takes some sophisticated tests to confirm some conditions so it may take multiple visits to convince your primary care doctor that your pain is worth testing for.

Making Your Pain Visible

If you are looking for ways to make your chronic pain condition more apparent to others, you may want to consider some of the following strategies.

  • See a pain specialist—a physician with expertise in pain conditions is much more likely to recognize the symptoms and provide a more accurate diagnosis. It may also be helpful to keep a pain diary that tracks your symptoms.
  • Educate people—it may not be easy, but you may want to educate the people around you about your condition.  Provide links to webinars or online materials that explain the nature and specifics of living with your chronic pain syndrome.
  • Find others like you—you may not need to convince everyone about the authenticity of your pain. In many cases, you only need to build up a small group of people who have similar experiences. Of course, you should start with family and friends, but you may find more resources at support groups.
  • Obtain disability status—once you are accurately diagnosed, see if you qualify for disability status.  This may help you overcome any insurance hurdles and may make it easier to convince your employer.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information. 

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