In the movie “The Princess Bride,” Princess Buttercup shouts at the Man in Black, her captor, “You mock my pain.”

 
He replies with the cynical perception, “Life is pain, Highness.  Anyone who says differently is selling something.”

While we needn’t adopt the pessimistic view presented by the Man in Black, for many people in our population, chronic, persistent pain is an agonizing reality.  Chronic pain is often defined as pain that lasts at least three to six months or beyond the time of expected healing.   A common misperception is that the pain is continually present but it usually refers to chronic intermittent pain.  Its roots may include fibromyalgia, arthritis, migraine, or lower back problems among other things.

Chronic pain sufferers often deal with negative perceptions associated with their poorly understood condition.  Since the sources of the pain are often difficult to identify and diagnose, it is misinterpreted by the uninformed.   To many, a person with chronic pain is viewed as lazy, neurotic, and unable to cope with the day-to-day stresses of life.  Often the motives of chronic pain sufferers are questioned by health care providers who confuse them for hypochondriacs or even drug seekers shopping for prescriptions.   Unfortunately these misperceptions make life even more difficult and confusing for someone coping with the realities of a chronic, unrelenting condition.

In truth, chronic pain sufferers not only deal with the primary symptoms associated with their condition, but they must also deal with the psychological distress created by persistent pain coupled with dramatic changes to lifestyle.   Certainly depression and confusion play a contributing role in this debilitating circumstance.  If health care providers, employers, friends, or family question or doubt the condition, it may further exacerbate the sufferer’s feelings of worth or even  sanity.  It is not unusual to find someone dealing with real and substantial chronic pain to question whether they are sane or if their condition is indeed real.  The uncertainty associated with chronic pain is in fact a poorly understood side effect that increases the suffering of the person.

A recent survey by Statistics Canada found that people with chronic pain were more likely to use the services of health care professionals such as nurses, physical therapists, and psychologists than people who were usually pain free.  They are less likely to respond positively to measures of well-being, including self-perceived health, satisfaction with life, and sense of community belonging.  Finally, individuals with chronic pain were more likely to report mood and anxiety disorders.

Generally there are not simple solutions or cures for chronic pain.  While most sufferers long for a silver bullet to restore them to full health, the reality is more complex.  In most cases, a multi-disciplinary approach is necessary involving doctors, physical therapists, dieticians, physiatrists, and psychologists.  Education is a necessary component teaching a person to manage their symptoms and condition.    A person suffering from chronic pain is encouraged to seek out a knowledgeable health care provider to help them develop a management plan. 

The approach taken in physical therapy is to conduct an evaluation of the individual by the physical therapist to identify how the disease is impacting movement and function. An individualized rehabilitation and wellness program is then designed by the physical therapist who takes into consideration all body systems that are impacted. The physical therapist may work collaboratively with other health care providers in a multi-disciplinary way to address the broader range of symptoms experienced by the person.

While the symptoms of a person suffering from chronic pain may never completely go away, these symptoms can be managed and substantially improved.  Chronic pain sufferers can still lead a rich and fulfilling life.   The first step is to find knowledgeable support and reliable information regarding the condition.  The second step is to maintain hope and know that with help and effort there can be improvement in the condition.