3 Tips for Explaining Your Pain

Chronic Pain

Jul 22

Pretty Caucasian woman at the beach smiling at camera.

Communicating about Pain with Others is HARD.

People ask me all the time: “Why is it so hard for other people to understand my pain?”. One of the reasons it is so challenging for others to “get” pain is because pain is an incredibly complex and personal experience. No two people experience pain exactly the same way, and you may have even noticed that your own pain is different within your body from day to day. Pain is even more complicated by the fact that we can’t see someone else’s pain; we might be able to see a wince on someone’s face or notice if they use an assistive device like a walker, cane, or wheelchair, but we can’t see the actual pain with our own two eyes. Finally, pain is subjective; unfortunately, medical science has not yet come up with a reliable way to measure pain intensity. All of this makes it very hard to explain our pain to someone else, and it also makes it hard for others to understand. When we feel misunderstood or as if other people in our life don’t believe our pain, it’s easy to get angry and feel emotionally hurt (on top of the physical pain you are already in). You may end up accidentally lashing out or being short or nasty to your friends and family, or you might just shut down and keep to yourself. Both of these reactions are completely understandable and extremely common for people who experience pain everyday, but they don’t always lead to the best outcomes in relationships.

Here are some ways to try communicating about pain with family or friends.

1. Spoon Theory

You may have heard of this one. It is an idea created by Christine Miserandino, who according to healthline.com (see below) lives with Lupus. The idea is simple: everyone has a set number of “spoons” the have in their personal spoon arsenal. As you got through your day and are faced with various challenges, you give your spoons away. For example, maybe you help your friend out with a project- there goes one spoon. Later in the day you have to sit in traffic- there go two spoons, one for the annoyance of traffic and another for the pain that comes from sitting in the car. This keep happening all day long, and by the end of the day, you may have no spoons left; that means you have nothing left to give when the pain becomes unbearable or when a family member needs your help with something. This sets you up for arguments. Its not your fault, but it’s also not working.

I like spoon theory because it’s an easy way to explain the idea that we all have only so much we can take on any given day. Spoon theory is also easy for other people to understand and remember, which makes it a perfect tool to help you communicate about your pain. Once you and your loved one both understand spoon theory, I encourage you both to adopt it as a way for you to cue them in to how you are doing on any given day. You may try saying something like “I’m down to only 2 spoons”, or “I’ve got no spoons left today”. This is a quick and easy way to signal to your loved one that you really can’t take on much more on that day, and they can then act accordingly (i.e. they may choose to give you some space, or to wait to have a stressful conversation, or they may simply be more understanding if you inadvertently are a bit more grouchy than usual). The goal is to help prevent the arguments that often happen when pain or other stressors have left you completely tapped out.

*If the idea of spoons doesn’t work for you, that’s ok, it can really be any unit of measurement that feels good to you. I had a patient who preferred to think of it as pieces of their self. I personally like the metaphor of a gas tank, and cueing my loved ones when I’m “full”, “half- empty”, or “almost on e”. The point is that you can make it your own, whatever is quick and gets the message across will work.

2. Number System

The number system is another strategy that provides a way to talk about your pain without having to actually talk about your pain. Instead of thinking about spoons, or gas tanks, or your total internal resources left to give, the number system is based only on your pain. This is similar to the pain rating system used by your medical providers. In this system you first rate your pain from 0-10. What makes this different is that you get to determine what each number needs to indicate to your partner/loved one. For example,

Pain

0 = “I’m good! No pain today!”

3 = “I’ve got some pain, but it’s manageable right now. I may need to take it easy later”

7 = “I’m in a lot of pain, I may be irritable today. Please get me my heating pad and let me be”

10 = “The pain is unbearable.”

I encourage you to sit down and make this system with your partner so that you can be sure that they truly understand and are also on board with using this system. You may also choose to add a request to the numbers so that your loved one know what they can do to help at each pain number. Just like spoon theory, this strategy provides a short-hand way for being able to communicate a lot of information without actually having to say very much, because lets face it, sometimes it can be hard to come up with the right words when you’re in a lot of pain.

3. Create your own language

This is another take on the strategies above. If spoons or numbers just aren’t doing the trick for you and your loved ones, try making up your own personalized way of cueing others in to your experience. You may choose to use code words or phrases, or maybe it’s a hand gesture- whatever it is make sure that a) it’s quick and easy, and b) that both you and your loved one understand what it means.

It is my sincerest hope that one or all of these strategies help you to better communicate about your pain with the people who are closest to you, and that by using these cues you have fewer arguments, misunderstandings, and loneliness at the hand of your pain.