The Stigma of Living with Chronic Pain
It would seem that physical discomfort and emotional duress should be enough of a burden for you if you are living with chronic pain, but there is also a component of social isolation that may stem from stigmatization. For most people who encounter pain only rarely and usually garner compassion when it strikes, it can be difficult to understand all of the social implications of a chronic pain condition.
While much of the stigma associated with chronic pain is rooted in misunderstanding the health condition, there are also elements of personal uncomfortableness with illness, mistrust, and fear of a psychological imbalance. For many chronic pain sufferers, there is a continuing struggle with their bodies as well as with the people they encounter in their daily lives.
How Big of a Problem is Chronic Pain in America?
According to the Centers for Disease Control and Prevention, 20.4 percent of the U.S. adult population suffers from chronic pain, and 8.0 percent experience high-impact chronic pain that interferes with daily life. Of these almost 50 million Americans, pain conditions are more likely to appear with advancing age, among women, and among the impoverished. The report goes on to state that chronic pain costs the nation almost $560 billion every year in lost work productivity, medical expenses and disability programs.
It appears that chronic pain cases are on the rise, but there may be some contributing factors. First of all, the U.S. population is getting older and that raises the likelihood of pain conditions. Secondly, this generation of Americans is more likely to seek out medical assistance for their pain than previous generations. Finally, many pain conditions may be a result of a more active lifestyle; more baby boomers have adopted a physical fitness routine that can lead to slips, falls and fractures.
What Causes Chronic Pain Stigma?
For the 50 million Americans who struggle with chronic pain, one of the first challenges is convincing a physician that the pain condition is real and not an attempt to obtain pain medications. For many pain patients this is one of the first instances of social isolation and probably one of the most painful. Health care professionals are supposed to treat pain, but the ongoing opioid epidemic has made almost every physician into a criminal investigator that must first be convinced that the pain is genuine.
Unfortunately, some people may have to go on for some time before a physician believes their pain is real. It may be even more difficult to convince a doctor of ongoing pain if you are a minority, a substance abuser, impoverished, homeless, very young or HIV positive.
If you are able to find a physician who believes you are in pain, they may not be able to help you as much as you would hope. Many doctors are cutting back on prescribing power pain killers due to changing guidelines. However, most doctors have minimal training in pain treatment, so they may not be able to offer any reliable alternatives. Your best bet is probably to get a referral to a pain specialist.
For many chronic pain sufferers, there are ways to manage pain, but there is no way to completely eliminate it. This means that they must accommodate their condition at work, at home and out in society. This can mean drawing attention to oneself that often invites social stigma.
Most people are willing to show compassion to others who are injured or ill for an initial period, but if the condition persists, it can become increasingly uncomfortable. There is an innate psychological desire among people to want to avoid uncomfortable situations and people in pain is a common trigger.
In many circumstances, this rejection may manifest as skepticism about the pain symptoms or criticism of the sufferer. This is often exacerbated by behavior on the part of the patient; most people in pain avoid social situations due to fear of an episode or depression about their state.
What Needs to Change
There is little doubt that something must change, either within the medical community or society in general. With almost one in five Americans in severe, ongoing pain, the social aspects of this condition must be addressed by the health care community. Here are some of the key changes that medical authorities have suggested:
- Inspire compassion—more medical professionals are urging their colleagues to maintain an attitude of compassion and empathy in spite of an increasingly challenging work environment. Instead of merely assuming that a person in pain is masking drug-seeking behavior, consider how they might feel if they were in as much pain and being interrogated. Even if the patient is a substance abuser, that may not disqualify them from reasonable pain treatment.
- Learn about pain care—treating pain can no longer be just about opioid medications. Too many physicians learn about prescribing pain killers and ignore many other pain treatments like cognitive retraining, NSAIDs, yoga or physical therapy. The risk of opioid addiction is real, but it shouldn’t outweigh a patient’s access to effective pain treatment.
- Broaden access to counseling—social stigma for pain patients is an unnecessary burden that may be alleviated by psychotherapy or group counseling. The medical community can help pain sufferers by more strongly encouraging pain patients to utilize counseling to deal with emotional issues like social stigma before they lead to depression, substance abuse or suicide.
- Acknowledge bias in medicine—although physicians are supposed to treat all patients with equal care and attention, it is human nature to favor some people over others. In the case of pain, however, this bias—which might be based on race, age, health or cognitive ability—may disqualify some people from getting the pain relief they need.
- Consider alternatives to opioids—if you are one of the millions who are on opioids legitimately for pain therapy, you may want to minimize the conflict with health professionals by using non-opioid pain relievers. Some patients can transition to OTC pain relievers like Tylenol, but others may want to try medicinal marijuana.
Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care
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