There’s a common misconception that ‘pain is just pain’ and there’s just one variety to contend with. Oh, if only that were true.
Pain actually presents itself in a wide variety of guises and disguises, each with a different cause, varying levels of intensity, and differing longevities. All of these different types of pain do have one thing in common of course: everyone is horrible and they all hurt like hell.
Let’s start off with the everyday, run-of-the-mill type of pain that we’ve all come to know and love: acute pain. This one starts suddenly and is short-term; its job is to let us know we’ve hurt ourselves. Think stubbed toes, broken limbs, hideous headaches or squeezing a rather large baby’s head out of a rather small birth canal.
I still shudder at the very memory of the third and would argue the pain certainly didn’t feel ‘short-term’ at the time.
Other members of the pain family include neuropathic (nerve) pain, that can come and go; visceral pain, felt when organs or tissues are damaged; breakthrough pain, that occurs in between regular, scheduled painkillers; and total pain, that includes the emotional, social and spiritual factors that also affect a person’s pain experience.
That, you’d have to agree, is a whole lot of pain.
Finally, we come to the point of this page and that mother of a pain that just doesn’t know when to quit: chronic pain. By definition, the word ‘chronic’ (when relating to an illness) means something that continues for a very long time or keeps constantly recurring. A ‘long time’ meaning when it drags on for more than 3 months.
Add the ‘pain’ element back into the equation and what you have is a persistent bitch of a problem that lingers around your body for months or even years on end. This is the sort of pain that can become an incapacitating constant in your life; it doesn’t ever give up, shut up or go away.
From the moment you open your eyes, it kicks off. It dominates every waking moment, limits what you can achieve and often drives you into a deep, dark pit of depression and total despair.
The type, location and level of pain experienced can, of course, vary greatly from person to person and illness to illness. On the ‘Ouch to the Off The Chart’ pain spectrum, it can range anywhere from a ‘mildly inconvenient and occasional nagging feeling’, all the way up to a ‘continuous, excruciating and eye-watering agony’.
Many people with Lupus (and a whole host of other autoimmune diseases) have to learn to put up (and shut up) with some type of chronic pain. It’s part and parcel of the illness and one of those ‘Top 5’ symptoms that can often be found whiling away the time in the company of other undesirable characters, such as Chronic Fatigue, Swollen Joints, Inflammation and Brain Fog. What a motley crew they do make.
If you’ve lived a relatively pain-free life thus far, understandably it would be very hard to understand how bad something like this can be. So to help you relate, let’s go back to that acute pain we first talked about. Now imagine a stubbed toe that never stops throbbing, an arm that always feeling broken, a migraine that never shifts or going through the agony of 7 cm dilated labour every single day, month after bleeding month. A bit of a nightmare, isn’t it?
So that covers what chronic pain is (and isn’t), but what about the why? If nothing is technically broken, hanging off or gaping open and bleeding, what on earth causes these high levels of pain?
That’s an excellent question and one I’ve often asked my own doctors (always receiving very vague and decidedly unhelpful answers in return). Apparently, there could be any number of possible reasons, including inflammation and Lupus arthritis, Lupus myositis, drug-induced muscle weakness, tendonitis and bursitis, carpal tunnel syndrome, osteoporosis and avascular necrosis of the bone. Read more about these here and take your pick.
The real issue (mine at least) with chronic pain is that when it’s just a symptom of a disease and not the cause of the problem (i.e. Lupus pain versus a broken arm), it can feel like there’s really no end in sight. If there’s nothing physical or visible to mend or heal, logic dictates it’s fiendishly difficult to treat. Unless that is, you wish to live your life popping ever stronger, mind-dulling pills like a Rolling Stone.
In the past, doctors used to believe that pain could only be caused by something: a manifestation of an underlying injury or disease. With this in mind, they only focused on treating the underlying cause of the pain, believing the chronic pain would then disappear. If they couldn’t find an underlying cause the patient was out of luck; they were often told they were ‘imagining’ the pain.
Even though there is still no medical test to measure pain levels, it is now accepted that chronic pain often needs to the treated as a stand alone condition – Fibromyalgia being the perfect example.
Of course, this lack of any objective evidence or physical findings to explain the pain means that some doctors are still just as reluctant to acknowledge or accept what can’t be seen. This ‘ostrich’ approach can result in a long-winded search for answers and often unnecessary evaluations and treatments for the poor patient who’s already suffered no end of pain every single day.
Hopefully all of the above explains the ins and outs of Chronic Pain. If you want to know what it actually feels like, I’ve tried to describe that (in my usual, no holds barred way) HERE.