Chronic pain is ongoing pain that can last for months or years. According to NHS, ‘Chronic or persistent pain is pain that carries on for longer than 12 weeks despite medication or treatment. Most people get back to normal after pain following an injury or operation. But sometimes the pain carries on for longer or comes on without any history of an injury or operation.’
It is not only the physical, sometimes debilitating, pain the patient endures but also all that the pain takes away or impacts, including personal relationships.
Human beings are social creatures. We seek out others in order to feel connected. Relationships are a cornerstone of happiness and contribute to leading a full life. They can take the form of family, friends, colleagues and intimate partners. They give us people to share our lives with - the ups and the downs. Relationships have been around since time began and are often the foundation for many things such as family, community and even future goals.
Chronic pain can affect relationships as, often, the life the patient has built and become accustomed to can change, either gradually or suddenly. They must manage the physical, emotional and mental impact of life with chronic pain. For the person or people watching, they may be left grappling to understand how to help and support the other person and often feel helpless.
There are many ways living with chronic pain can affect relationships including:
Chronic pain can mean the patient is unable to do something or attend something. They may feel reluctant to explain their condition at this point; perhaps they don't have the words because they're still coming to terms with a life with chronic pain themselves. This can lead to feelings of isolation which can affect relationships.
Chronic pain is not curable. Treatment may be available to manage and alleviate the pain, but these methods don't provide a cure. For the person suffering from the pain and their family, friends or partner, each time a treatment is presented and tried, this can raise hope of managing the pain to lead a more comfortable lifestyle. Sometimes they may even harbour hope that the treatment will provide a cure. Often, these treatments can end in disappointment on both sides if they don't work out as hoped. This rollercoaster of emotions is hard on everyone involved. Acceptance that chronic pain is a permanent part of life is extremely difficult but something that must be faced by all involved. See our article on acceptance for helpful advice.
Sometimes, the compassion from a loved one can seem to wane as a result of the ongoing nature of chronic pain. There may even be suspicion that the condition is being exaggerated, or that the patient is a hypochondriac. Some people might even believe ‘it’s all in your head' if they are really struggling to come to terms with the situation.
Research suggests that problems in a relationship can significantly impact the severity of pain experienced by the patient. The study also suggested relationship issues can affect the levels of physical disability and levels of depression experienced.
Someone living with chronic pain may find that their condition affects all their relationships or that it affects some more than others.
Living with chronic pain can be an isolating experience, particularly for people who are single or live alone. The ever-present burden of pain can lead to an ever-reducing circle of friends, and even family, for support. This can come from either side of the relationship: withdrawal on the part of the patient or lack of understanding on the part of the friend or family member.
Friends and family may struggle with changes in the relationship they have become accustomed to having with the patient. That lack of understanding about the condition can lead to compassion and tolerance dwindling. Plans being regularly cancelled by the patient as a result of the unpredictability of the pain may lead to friends no longer including the person with chronic pain. They may even feel uncomfortable, watching their friend in pain, which can lead to them withdrawing from the relationship.
The other side of the coin is that the person living with pain may withdraw from a relationship as a result of changes to themselves. An inability to participate, or participate fully, in activities such as sport, work or evenings out can lead to avoiding these activities altogether. Changes to the body, both seen and unseen, can have an impact on self-esteem and identity which can also result in social avoidance due to fear of rejection. As the person in pain pulls away more and more, this too can contribute to a decline in invitations to socialise.
For someone living with chronic pain, the cycle of withdrawal - isolation - pain can lead to a downward spiral, removing intentions or possibilities of meeting new friends or potential partners.
Being single when living with chronic pain can be a daunting experience. It can mean relying heavily on the support of family and friends (which is easier for some than others). It may even mean moving back in with parents for a time. Another worry faced by many single people is how they will build a potential relationship while living under the shadow of chronic pain; they may feel concerned about burdening someone with this early in the relationship.
Spending some time learning about chronic pain, about yourself and about your body can be a worthwhile first step. This time to learn and reflect can help singles really think about what they want and need from a partner through learning about themselves and the effect their pain has on their life. This time of learning and reflection can also give you an opportunity to learn how to deal with your own feelings and thoughts on your pain: self-compassion, self-care strategies and understanding the changes in identity when living with chronic pain are all worthwhile strategies to help manage chronic pain. Have a look at our self-care packs for ideas, activities and tips to look after your well-being.
When you're ready, reach out for support and connect with people in a similar position. This can be a good way to re-engage with the world if you have disengaged from it for a while. Support groups offer a safe space to do this. In these groups you will find empathy, understanding and acknowledgement of your condition. These groups also offer other services and useful information which you may find useful in addition to the social aspect. Burning Nights CRPS Support offers care and support through a community forum and live chat.
Another way to connect with people is to join a group of like-minded people. This could be an exercise group, a religious group, a voluntary organisation or some other hobby group. Why not check out some of the activities we have on offer at Burning Nights CRPS Support including our Wellbeing Wednesday sessions which involves chair yoga and dance? Or perhaps Zentangle Thursdays are more up your street? This involves simple tools and basic strokes to encourage flow, generate positive energy and help calm the mind.
Studies of chronic pain have shown that building these social connections can help reduce pain, increase function and improve the quality of life by improving self-esteem and the sense of ownership over life.
Chronic pain can have a profound effect on both partners in the relationship. When chronic pain becomes the ‘third person’ in a relationship, this can dramatically alter the focus and trajectory of a relationship.
There may be changes to roles and responsibilities which can be challenging for some couples. The partner not in pain may have to take on more of the household duties or caretaking tasks. In some cases, they may become the sole earner, adding pressure to an already stressful situation. They may even become the caregiver for their pain-ridden partner.
The pain-affected partner may feel guilt or shame because of their changing role in the partnership. They may feel responsible for the burden they have handed their partner; this can outwardly show as anger. Unpredictable moods and behaviours as a result of the chronic pain can compound a downward spiral. A reduction in physical intimacy as a result of diminished self-esteem can also negatively impact the relationship.
Whatever way the dynamics of a partnership change as a result of chronic pain, the journey is one both partners are on, where the highs and lows are shared. At times, the partner may feel helpless as they struggle to help and comfort their suffering loved one. As they take on this additional emotional and physical load, their own health and well-being may be affected. Burning Nights CRPS Support offers a counselling service which is an opportunity to unburden yourself in a confidential, supportive environment.
Research has shown that mood and adjustment to life with chronic pain is linked to the empathy, intimacy and coping behaviours shown by a patient's significant other. For this reason, repairing and rebuilding relationships and learning coping strategies is important to deal with and manage a life with chronic pain.
In order to take the best care of your pain affected partner, the supporting partner must prioritise their own self-care. Ensuring a balanced diet, regular exercise and seeking support when required can help with this. By looking after yourself you can ensure you have the physical, mental and emotional energy to take care of your loved one.
In person or online support groups can provide a valuable outlet to connect with others in a similar situation. It allows for a safe space to vent if necessary and also somewhere to gain practical advice. For more information on Burning Nights CRPS support groups click here.
Research carried out suggests that promoting independence is one of the best ways to support your partner through the pain. Encouraging strategies that allow your partner to feel that they still have some sort of control over their life; strategies such as encouraging activity, pacing, self-advocacy, self-confidence and well-being. Also, supporting your partner with things like a well-balanced diet, good quality sleep, stress management, relaxation techniques can all help your partner on their journey. This is where support groups can come in, with a wealth of knowledge and advice.
Open and honest communication is key when living with chronic pain. Talk about and try to deal with challenges as they arise. Plan and set goals together that can include division of household chores and responsibilities in a way that meets the needs of both partners. Work on showing one another compassion and empathy as you navigate this difficult journey together.
Family provides a network that spans generations, providing security and love. When a family member becomes affected or changed by pain, it can have an impact on the whole family unit.
Often the person living with the pain can start to withdraw from the life they previously lead. They may become isolated, the only outings revolving around healthcare appointments. Treatments they are undergoing may alter mood and behaviour which impacts their relationships.
This can then be compounded by well-meaning family members trying to help and protect their pain afflicted loved one. They reinforce unhelpful coping strategies and behaviours, which can lead to increased levels of pain for the person with chronic pain and decreased levels of autonomy and self-confidence.
The strategies below may help families as they adapt to the changes in their loved one and support them effectively.
Spend some time learning about your family member's condition. With more knowledge and understanding, you can be a better support to them and have more empathy. Attend appointments with them and talk openly about the pain they are experiencing (if they are comfortable to do so).
While your loved one may always or often say no, continue to invite them to events. This can help remind them that there is a life outside the pain.
Don't assume you know what your loved one needs. Ask how you can help, what they need and how they're feeling. If we don't ask, we don't fully understand and we can't help effectively.
Try to be encouraging and supportive of your loved one’s independence as much as possible. This allows them to maintain a sense of ownership over their life and maintain their self-confidence.
Whether chronic pain has come on after your children were born or is something you had before they came along, parenting with chronic pain is challenging. Guilt can often go hand in hand with parenting, as you struggle to feel good enough amid never ending pressures and expectations. For those parents living with chronic pain, that sense of guilt can be elevated due to your limitations. Spouses may have to take on more of the caregiving, as well as grandparents or even older children.
Try to remember that children do not need a perfect parent. Children just need love, care and time- gifts that pain cannot take away.
This is often what children crave most of all, above all else. They will be affected by their parent’s pain so it is especially important to be intentional and present with them when you can.
There's no avoiding it, chronic pain will often get in the way or affect activities or events. As much as possible, plan ahead. If your child has a football match, bring a chair so you can sit and watch. If you're having a family day out, plan it so that there is plenty of time (and the facility) for you to sit for a while if required. This is important so you can feel well today as well as the next, which means you can be more present for your children.
Explain your pain condition in terms that are appropriate for your child and their age or stage. How much detail you go into is up to you, but also dependent on the child's age. The main objective is that your child understands your limitations, but also to avoid burdening them with excess worry.
Many family members and friends really do want to help but will need clear communication on what they can help with. Work out what time of day you struggle most with and this could be the time your spouse takes the lead with the children, or it could be a grandparent or sibling who helps at this time on a given day of the week.
There is no denying that a life with chronic pain will affect your relationships. But hopefully, with the help of some of the tips in our article, you can find a way through the pain with those you love.
Eugene Therapy (2021) ‘Why Are Personal Relationships Important?’ Eugene Therapy website. 2021, December 12. Available from https://eugenetherapy.com/article/why-are-personal-relationships-important3/#:~:text=Relationships%20are%20a%20cornerstone%20of,a%20result%20lots%20of%20joy.
Pain, J. (2007) ‘Chronic Pain in a Couples Context: A Review and Integration of Theoretical Models and Empirical Evidence’. National Library of Medicine. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1890016/
Northern Pain Centre ‘Chronic Pain, Changing Roles and Identity’. Available from https://www.northernpaincentre.com.au/wellness/chronic-pain-relationships/chronic-pain-changing-roles-and-identity/
Newton-John,T. (2013) ‘How Significant is the Significant Other in patient coping in chronic pain?’ Academia website.2013. Available from https://www.academia.edu/34373934/How_significant_is_the_Significant_Other_in_patient_coping_in_chronic_pain
Newton-John,T. (2008) ‘Solicitousness and chronic pain: a criticial review’. Academia website, 2002. Available from https://www.academia.edu/34373933/Solicitousness_and_chronic_pain_a_critical_review
If you, someone you care for, is struggling with Complex Regional Pain Syndrome, Burning Nights CRPS Support is here for you.
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