The Nuances of Pain


Pain. It comes in varying degrees and the severity is very much a subjective thing. It always makes me laugh when doctors ask for you to quantify pain levels on a 1 to 10 level as the results will differ for each person and can depend on a huge number of variables (and yes, I appreciate that they are trying to guage how the pain is affecting *you* at the time rather than comparing it to other people)

As I’ve written here just once or twice, I have fairly major issues with my spine. So much so that in 2010 I underwent major surgery on my cervical spine (the neck) and now have a neck that is made from titanium and polymer. As the surgery took place several years too late I live with daily pain, a high dosage medication regime, and a constant mental excercise to “manage the pain”

It’s that last phrase that people often can’t wrap their heads around. You can manage people, situations, finances (well some people can anyway!), physical objects – but how can you manage pain? The hardest part is that you can’t explain it easily – managing pain is a mental process for keeping pain compartmentalised and locking it away in a part of the brain. Doing something mental with something physical is a strange concept. But it works.

Well, to a degree.

Over a period of time it is possible to manage regular pain levels, the day to day pain, to an extent that you are in constant pain but you aren’t as aware of it. By that I mean that it’s not that I don’t feel it it’s just that I put my focus on everything apart from that.

This is constant. It’s something that I do subconciously, but all the time. And it’s tiring. It takes effort, energy and focus that drains you.

Day to day it’s manageable. Where it has a bigger effect is in those times when the pain is greater than normal, or when there is more pain through a different injury. More pain requires more mental effort, which increases the levels of tiredness. This then leads to the other “side-effect” of putting in more mental effort in that I am more irritable, I can snap at people without meaning to and my interactions with folks are more tense.

I try not to snap at people, but I can’t switch off the pain management – if I did, I’d be crying on the floor. So the alternative is trying to keep the pain isolated whilst being normal. And all the while this is making me more and more tired.

As I get more tired, the pain management becomes harder to do because I’m mentally shattered.

Can you see the vicious loop?

It’s only once the pain has levelled off again that I can start to become more rested and can begin to become human again – but, depending how long the peak of pain lasts, that can take a good week or two to fully get back to normal levels.

I’m not writing this to get sympathy or to ilicit any sort of response really – to be honest this is mostly my way of documenting for myself what I go through. For the past 6 days my lower back has been playing up, nearly crippling me with the pain at times and, although the pain is easing off a bit, I’m now getting to that latter part. I know that some people won’t fully understand that, even though the pain is lessened, there is still a long process that is likely to kick me for at least a week now.

Chronic pain isn’t just about the physical, there’s much more to it. And sometimes it can really stink.

2 Replies to “The Nuances of Pain”

  1. Hi – I’m pointing out that pain goes beyond simply a physical state, and that the 1-10 scale is not a good indicator based upon whether or not someone (like me) has managed to develop mechanisms for managing pain.

    People can often look at chronic pain sufferers as say “well you look alright to me” but don’t realise that actually that person is fighting a mental battle just to make it through the day without collapsing in a heap and screaming.

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