Chronic pain is something that most people living with arthritis are all too familiar with. This article is the first of a three-part series on communicating about arthritis pain – one of the most common symptoms that impacts daily living and quality of life.
Pain is a tough subject for many people. Pain is personal and private – only you really know what it’s like for you. How you share your experience with others is up to you, but it can be challenging to explain it to friends, family, and others.
Here are some aspects to keep in mind.
What is pain?
Pain is your body’s alarm system, alerting you that something is wrong. No matter where pain is happening in your body, it’s first recognized and processed by your brain, after a pain signal travels through your nerves. Acute pain, or short-term pain, tells you that damage is happening and you need to attend to it, so that your body can heal. Chronic pain, which lasts three months or longer, does not always mean that damage is occurring at that moment. Instead, chronic pain is sometimes caused by an issue with the nerves and the way they send pain messages to your brain. People who live with arthritis often live with chronic pain. You can learn more about the types of pain and where arthritis pain comes from in our resource, Understanding Pain.
Communicating with family and friends
“Talking about pain can make people feel vulnerable,” says Margaret Smit-Vandezande, an Arthritis Society Canada social worker. You may be concerned about pity, judgement or not being taken seriously. She notes that people living with arthritis are often worried they’ll be seen as complaining if they talk about joint pain with friends and family. Still, your loved ones aren’t likely to understand your pain and how it affects you if you never talk about it. Instead, she advises, reframe it to yourself and to them as venting. “Try saying to somebody, ‘you know, I just need to vent for a little bit, thank you so much for listening.’ Think of it like letting off steam from a pressure cooker, to prevent anger and depression from building up,” she says. “The thoughts that roll around in our head are pretty disjointed. And they might even go unnoticed; they happen really fast. But when you’re speaking, then you might start to gain some insights.”
Since arthritis pain is often invisible to others and can come and go, it can be hard for others to understand. Try using relatable metaphors, suggests Smit-Vandezande. If you’re acknowledging that it can be hard to make plans based on your pain and energy levels, you can say something like: “I would love to do this, but I know that my gas tank has been a little smaller since living with arthritis pain; it takes up some energy. And I really want to spend some time with you, so let’s think about how we can get the most mileage out of today.” It can help to be specific and describe the impact—rather than saying “I can’t go,” you can say “I have a lot of sharp knee pain for days afterward if I have been walking on rough ground, so what if we do a paved trail instead?”
Communicating with spouses and partners
In intimate relationships, “communication is two ways, so is there is listening and there is talking,” says Smit-Vandezande. She adds that using “I” statements, such as “I’m worried about the impact that this has on you,” or “I miss not being able to do the same things together” is a well-established technique for communicating without blaming or sounding threatening.
For both emotional and sexual intimacy, value what works well, such as cuddling on the couch if you’re feeling sore or modifying a position to make it more comfortable. Finding neutral ground to talk about what's difficult is essential. Feedback alo helps. Make a point of saying, “That feels good” or “Let’s try something else.” For more ideas, be sure to check out our Intimacy Guide.
Managing household responsibilities during a flare-up or with longer-term joint pain and fatigue can be challenging—maybe you don’t like to ask for help or feel guilty you can’t do things the way you want, or maybe your partner feels resentful about the division of labour. “It’s important to be clear on what you would like help with, and what you can do on your own. Also factor in other people’s needs, and consider what’s realistic to do,” says Smit-Vandezande.
As Smit-Vandezande points out, when talking about arthritis pain, it is always important to remind yourself that the purpose of sharing information about your pain experience is to support relationship building and providing information that might help others better understand. Sharing information is not about having to prove the legitimacy of your distress, she says. “Talking about pain does not always end with open receptivity or resolutions. When that happens, it is normal to take that personally, possibly feeling dismissed or undermined. It is helpful to remember that the responses of others may not be about you. It may be about issues or impacts they’ve experienced.”
It makes sense, then, that a neutral ear like a counsellor can be useful, says Smit-Vandezande. “Counseling support is not just for when problems hit us hard. It can be a great support to help build communication skills or manage feelings of depression or anxiety or guilt, just to include a professional objective perspective as well.”
Why support helps
It’s important to remember that talking about pain with others doesn’t mean relentlessly focussing on your pain levels and talking about how you feel all the time—that might make you feel worse and have a negative impact on your relationships. You are a whole person, not just your pain. Still, your pain is a part of your life, and it shouldn’t be ignored, glossed over or belittled. Talking about it with the ones you love and being clear about what you all need helps you feel empowered and connected. And there are several support groups and mental wellness resources available across the country.
After all, emotional and physical support is a big deal. Studies show that people living with chronic pain who feel support in their lives have an overall better quality of life, with less depression and anxiety, less intense pain and lower pain-related disability. Helping others in your life understand your daily experiences with pain can help you build the support network you need to thrive.
In the next article in this series, discover ideas and techniques about communicating with health professionals about arthritis pain. You can also learn more about living with arthritis pain in our comprehensive Arthritis Pain Management Guide.