The Stigma of Chronic Pain | Arthritis Information

 

A church organist is asked to stay at her bench during the entire service, despite chronic arthritis pain. The same church provides an interpreter for the deaf, and wheelchair ramps for the disabled. It also allows a pregnant organist to move about the church freely to ease her back.

A woman with chronic back, hip, and leg pain is publicly upbraided by a stranger for parking in a handicapped spot, even though she has handicapped plates on her car.

A male moviegoer, standing in the back of the theatre to ease his aching back, is asked insistently to take his seat by the usher.

A pain patient's parents tell her to quit acting like a baby. "Where's the blood running out?" her mother asks her.

An anesthesiologist is suspected of angling for a disability when colleagues hear he is suffering from chronic neck pain due to a whiplash injury.

What do these scenarios have in common? They are all vivid, real life examples of the stigma of chronic pain.

Stigma: A Fact of Life for Those with Chronic Pain
"It's easy to be paranoid when you hurt like hell and you're at the mercy of the health care system," says Dr. Bernard Filner, a Rockville, Md., pain management physician and chronic pain sufferer. He sustained a whiplash injury in a car accident 10 years ago, and still experiences neck pain and headaches.

Stigma, as defined by The Random House Dictionary as "a blemish on one's record or reputation is a pervasive fact of life for people with chronic pain.

The most wide-spread misconception about chronic pain is that it results from a psychological disturbance. Other common misconceptions are that those with chronic pain should be able to tolerate pain better as time goes on, that they are using pain to obtain narcotics, and that they exaggerate their pain for secondary gains, that is, for sympathy or financial gain.

The impact of stigma on chronic pain sufferers is devastating. "Stigma is a magnifier of pain," says Roberto Anson, 41, of Silver Spring, Md. "It boils down to one word ? discrimination."

Chronic pain often presents sufferers with a real "catch 22" dilemma. If they talk about their pain, they risk being perceived and labeled as hypochondriacs, or even worse?fakers or malingerers. On the other hand, if they hide their pain, others don't believe the pain is significant. It is enough to tax the patience of the most stoic person.

Health care professionals who see pain patients every day agree emphatically that stigma makes an already bad situation worse. Dr. Paul Buongiorno, a Fairfax, Va., psychiatrist who serves as medical director for Northern Virginia's Fair Oaks Hospital's Pain Management Program, sees patients daily who suffer from guilt, demoralization, and depression due to the negative perceptions of others. "Others feel you should pull yourself up by your bootstraps," Buongiomo says. "I don't believe that, though. You can't just talk yourself out of it."

Dr. Richard Baither, a Fairfax, Va., psychologist who treats chronic pain patients, refers to the "Job" syndrome. "People remember Job's patience," Baither says. "They feel they must have sinned. They ask themselves, 'What did I do wrong for these bad things to happen?"'

Noreen Freedman, a nurse and the coordinator of the Pain Resource Center at Washington Adventist Hospital, in Takoma Park, Md., says that her patients report a real sense of frustration about the public's perception of chronic pain. "You look fine, you must feel wonderful," others say, according to Freedman. "Pain is something you wear on the inside, not on the outside, " she notes. Freedman observes that men tend to emphasize the way chronic pain affects their work, while women tend to focus on the way it affects their relationships.

Stigma can be manifested in various ways?by raised eyebrows at work, by friends asking "Shouldn't you be feeling better by now?", and even by family members looking the other way or minimizing the problem.

Societal biases are also apparent ?theatres, restaurants, and the workplace are all designed for pain?free people, despite the staggering statistics that as many as one in three Americans suffers from chronic pain.

In addition, even very recent articles in the pain management literature demonstrate that negative stereotypes are alive and well even among professionals. Consider the following: Lynn492009-04-02 04:48:47I agree.  When I wear my huge splint iron braces tho, people seem to understand better. I hope everyone reads this and puts it somewhere it can be found easily.  Just reading it validates what I have felt from others around me and even from my own family.

This;  If they talk about their pain, they risk being perceived and labeled as hypochondriacs, or even worse?fakers or malingerers.
I was never so hurt as when my sister (an RN) said in anger "Yes, we all know you have arthritis, we hear about it enough!"  The words still bring tears to my eyes and pain to my heart even though I know she was just stressed at the time. 

I never complain to my family or my friends about the pain I am in now.  Poor dh!  I still unload on him occasionally... and of course (thank goodness) I have you all here.


Copyright ArthritisInsight.com