It’s easy to spot someone with chronic pain. It’s a normal part of ageing. Bed rest is better than exercise. Pain medication is addictive and lines the pockets of big pharma, but it’s the only thing that will help.
These are just some of the things believed to be true about chronic pain. Statements such as these can be more damaging than supportive and are often embedded in misconceptions and falsehoods.
“Chronic or persistent pain is quite common, with approximately 13 per cent of the Irish population experiencing it,” says Dr Maria Galve, a pain management physiotherapist with the Evidence-Based Therapy Centre in Galway. “Myths about chronic pain are also common and can be unhelpful to a person with chronic pain, causing unnecessary distress, and even preventing or delaying them from seeking adequate treatment and management.” Helpfully, Dr Galve is on hand to debunk some of the most confused myths surrounding chronic pain.
As she says, “Chronic pain is an individual experience that is frequently misunderstood. Pain is influenced by many factors, including biological [age, gender, genetics, disease severity, health, sleep], psychological [fear avoidance, catastrophising, mood, stress, previous experience, coping skills] and social [work, environment, relationships, economic stressors, disability, culture] factors.”
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Pain is an important human experience. Without it, we may not recognise danger, threat or injury. It builds on our instincts, strength and growth. While pain is necessary, it is a constant for some people. Considering many of us have grown up with a belief that we should walk off pain or suffer it until our body naturally heals, the understanding of pain and how to treat it has become skewed with an abundance of myths badly narrating the story.
1) Myth: Chronic pain means living with it or continuously taking pain medication
“One of the most common myths is that chronic pain is permanent,” says Dr Galve. “Even the word ‘chronic’ has negative connotations suggesting that it will last for the rest of your life. To change this misconception, many pain specialists and advocates are moving away from using the word ‘chronic’ and using the word ‘persistent’ instead.”
If you experience chronic pain, it can feel as though it is never-ending with little relief, but it’s important to know that persistent pain can and does ease with the potential to stop. Also, as we get older, we may be more perceptible to injury and pain, but that does not mean that pain is a necessary part of ageing or that it has to be endured or medicated. The route to managing and treating pain is individual and focused on improving quality of life.
“According to the International Association for the Study of Pain, chronic pain is pain that persists or recurs for longer than three months,” says Dr Galve. “However, having chronic [or persistent] pain does not imply that you will experience it permanently. Evidence shows that chronic pain can be greatly improved and that patients can return to a regular life without the need of continuous pain medication. Pain management programmes have shown to improve the quality of life of people with chronic pain. These pain services can provide tools and teach skills to self-manage pain and return a patient to reach their full potential.”
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2) Myth: The pain is all in my head, I’m imagining it
“Pain is a subjective experience with the brain and the nervous system playing an essential role,” says Dr Galve. “It is true that pain cannot be seen in blood tests, X-rays or MRIs. However, pain is very real.”
This myth perpetuates a belief that a person focuses on pain because of anxiety, depression, an inability to tolerate pain, that they are weak or are exaggerating their pain. It’s a damaging myth as it invalidates the person’s experience with the potential for them not to seek help for their pain.
“Research has shown how the brain can act and react differently in people with chronic pain when compared with people without pain,” says Dr Galve. “When experiencing chronic pain, the nervous system is in a hyper-protection mode which means that stimulus, which in other circumstances would not be painful [like resting your back against a chair or gentle movements], suddenly become painful or uncomfortable. While this can be frustrating for people with chronic pain and even those around them, it is important to understand that chronic pain doesn’t equal injury or harm.”
All pain is individual but because it cannot physically be seen it does not mean that it is in your head. Allowing pain to continue and delaying getting help can make the condition worse before a treatment plan is sufficiently in place.
“Evidence shows that the changes that have occurred in the brain and the nervous system can be reversible,” says Dr Galve, “and that chronic pain can be greatly improved without the need of taking regular pain medication for the rest of their lives. A proactive approach to chronic pain has shown to improve the quality of life of people with chronic pain.”
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3) Myth: Chronic pain can kill you
It may feel as though pain is draining the life out of you, as it focuses not just on the physical side of your health but also on your mental wellbeing. Persistent pain can be a significant source of stress. So, while it cannot kill you, it can have a profound effect on your life.
“Experiencing chronic pain can affect many aspects of your life,” says Dr Galve. “It is a source of constant stress that can have significant repercussions personally and professionally. However, experiencing pain will not kill you.”
One of the reasons this myth is widespread is because pain can contribute to mood changes, depression, fear and anxiety, which can fuel the cycle of increasing levels of pain. However, the cycle can be broken.
“It is true that chronic pain and certain mental health conditions are correlated,” says Dr Galve. “Depression and anxiety do not cause chronic pain but the symptoms of both can be worsened by pain. Similarly, having pain for a prolonged period of time can increase the risk of developing anxiety and depression. If you feel hopelessness, despair and loneliness from having to constantly struggle with chronic pain contact a health professional and reach out for help. Your GP and a psychologist may be able to support you and refer you further to specialists for appropriate treatment.”
