I have recently been pondering the differences between the concepts of “Pain”, “Chronic Pain”, and “Disability”. What defines each, when does one cross over into the next, and what can we do to help our pains and even chronic pains from becoming disabling?
PAIN is generally defined as A localized, physical suffering associated with a bodily disorder (as in disease or injury) or a basic bodily sensation induced by a noxious stimulus, received by a naked nerve ending, characterized by physical discomfort and typically leading to evasive action.
CHRONIC PAIN is generally defined as Any pain lasting more than 12 weeks, which may be from an injury or illness. Often CP is accompanied by other health issues – fatigue, sleep disturbances, decreased appetite, mood changes – and may limit a person’s movements, flexibility, and strength.
DISABILITY is generally defined as A physical condition that limits a persons movements, senses, or activities…a condition of being unable to do things in the normal way.
Some distinguishing factors between the three are duration of time endured, degree of limitation caused, and, I would add, a sense of having control (or not) over the situation. Pain can and does move into chronic pain, and chronic pain can obviously be disabling to a varying capacity. This discussion is in no way intended to diminish anyone’s experience of any of these three elements, as the lines between the three can be and often are incredibly blurry, can shift from moment to moment and day to day, and one person’s experience of any of these three states will differ greatly from another’s. Much of what we experience in these areas is subjective, variable, and influenced by factors we sometimes can but can’t always control.
For example, suppose someone accidentally cuts off the end of his finger and it cannot be reattached. It will be painful in the immediate action and for a period of time afterwards (pain). In time the acute pain will likely diminish, but perhaps conditions like repetitive hand action or cold will cause a sensation of pain in that missing digit for an indefinite period of time (chronic pain). And if the victim is a professional violinist, his pain and circumstances may be disabling to such a degree such that he may have to take up a new profession altogether (disability). What will matter here is what the fiddler tells himself about his current circumstances, his willingness to entertain other future possible endeavors, and his ability and resources to launch a new career and move forward.
Pain, chronic pain, and disability can and do exist to a degree at times in many of us. Like the fiddler, what matters is how we view our circumstances. Sometimes our pains are chronic and seem disabling. Sometimes it’s important or helpful to put them into categories and give them definitions, and sometimes it’s helpful to view all our conditions as laid out on a spectrum of life’s circumstances. We can focus in intently at times on what our issues and problems are, and at times we can just let them exist as part of the baseline of our lives. It’s helpful to adopt a sense of fluidity to this spectrum, and to allow each day or week or moment to unfold as it will and not feel too stuck in any one place or situation if it makes us feel helpless.
Some factors that are known to influence or aggravate one’s perception of pain are negative emotions, sadness, anxiety, and relentless dwelling on the pain. Chronic pain can cause depression and depression can cause one’s perception of pain to worsen as well. So how can we help to prevent this from becoming a downward spiral?
Several remedies and known methods of pain control are mentioned here. It seems easiest and most pertinent to discuss these more thoroughly in my next blog on my own experience with chronic pain.
Known beneficial ways to help deal with pain and chronic pain:
Alternative remedies: Acupuncture, MASSAGE, meditation, spinal manipulation, biofeedback
Exercise, especially low impact
Physical or Occupational Therapy
Nerve Stimulation Or TENS therapy, the use of low-voltage electrical current for the purpose of pain relief.
Cognitive Behavioral Therapy, or finding ways to cope with discomfort and limit the extend to which pain interferes with life.
I have tried all of these tactics with varying degrees of success during my own 15 year relationship with chronic pain, and will share some of that next.