As a source of human suffering, chronic musculoskeletal pain ranks pretty high. Low back pain - just one kind of pain! - is one of the biggest heath problems in the world in terms of medical expense, days missed from work, and economic burden.
So it’s strange that we actually don’t talk that much about chronic pain. (At least outside of blogs like this.)
I thought about this recently when watching an episode of the Morning Show where Jennifer Aniston’s character experiences some severe back pain and has to miss work. It occurred to me that I have almost never seen a movie or TV show with a plot centered on back pain! I’ve seen countless depictions of other forms of suffering: depression, death, drug use, relationship problems, financial stress, cancer, loneliness, illness, and poverty. All these subjects make for gripping drama and create empathy for real world people. But for some reason chronic pain doesn’t get the same kind of attention. This isn’t because we don't care about other people. Otherwise, why would there be so many dramas about other kinds of suffering? It's just that for some reason, chronic pain isn't the kind of suffering that we want to hear about.
I'm not sure why this is, but perhaps one reason is that chronic pain is in many ways invisible. Doctors literally can't see a reason for back pain in most cases, even when they use x-rays and MRI to look. In everyday life, we can see pain in others if it is accompanied by injury or obvious signs of physical distress. But many kinds of chronic pain don't involve these outward signs. You might be sitting at dinner next to someone in a lot of pain and not know it unless they mention it. And if they do, it might be hard to know exactly how they are feeling, unless they are especially descriptive. What does it mean when someone says “my back is killing me?”
Maybe another reason we don't talk about chronic pain is that we feel powerless to help. And in this respect, we can see a difference with acute pain caused by injury. If someone gets into a car accident and tells friends they are now in so much pain they can’t walk, the friends will probably listen patiently and empathetically. And for the next few weeks they will check in with their injured friend to see how he or she is doing and offer help.
But if for some reason the pain continues for years with little improvement, people will at some point want to stop talking about it. The person with pain will be expected to mostly keep the problem to themselves. At the very least, they’re not supposed to answer: “my back hurts like hell” every time someone asks “how are you doing?”
Perhaps this is to protect the listener from empathy fatigue, or the uncomfortable feeling of just not knowing how to help. Either way, it means that the person with the pain not only needs to bear a huge burden, but needs to do so alone.
My ideas about this subject are informed in part by my own experience with chronic pain in my twenties. I don't blame the people around me who didn't quite understand it. Because how could they? My pain was mostly invisible to them. They had no idea how it felt, what caused it, and how they could help. Luckily, I don't have any pain now, but I retain some understanding for what it must be like for the people who do. This post is to simply say that I respect their bravery and wish them the best. And to remind others that people you know may be suffering a lot, even if they never talk about it.*
*I realize this all applies to more than just physical pain.
Picture by Tim Bartel courtesy of Wikimedia commons
I just wrote a (very long) piece about this. We don't talk about chronic pain, and we certainly don't tell the story of living with severe, daily pain, of intractable pain. Of progresive, painful, incurable disease.
And IF a person with chronic pain is represented in the media, they are invariably presented as an opioid addict, which only adds to the stigma in a patient population who are already extremely vulnerable and extremely stigmatised. OR they are a bludger, trying to game the system.
There is no empathy for severe, daily pain, because the story is never told. No compassion. Just 'You're exagerating, shut up and try harder!'. Without representation, of course healthy people can't understand what it is to live with intractable pain. And you make great points about compassion fatigue, that's definately a thing. (Aren't you better YET???). We live in a world full of toxic positivity traveling at too fast a pace to notice the person who is sick, and struggling with a painful, progressive, incurable disease.
Thanks for writing this.
Deadwood had an episode on chronic back pain. It even featured an old west traction board and the usual 'helpful remedies' to cure what ales ya. Great show!
Seinfeld was another one... Actually it's got 2 episodes... The one where Elaine hurts her back and Cramer snaps her neck in exchange for a classic Schwinn (she eventually swims in the east river) and the one where Mr Nagelbaum ends up hospitalized from picking things up wrong.
Oh wait.. 3rd Seinfeld episode! George's mom goes to hospital for a bad back after catching George 'in the act' in The Contest episode...
I'm guessing Larry David has back issues now...