Say It Better: How to Talk About Pain

Relationships can become strained because of pain, emotional distance, and misunderstandings.

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Chronic pain is a deeply personal experience that is often misunderstood by others. Because pain is invisible to others, it can be hard to explain the ups and downs, or why some days are good days and others are not. It is often difficult to share about one’s pain, yet so important for others, such as loved ones and doctors, to have a better understanding.

Those with pain may feel that they have made attempts to talk about the experience, but become frustrated by not feeling heard. Sometimes people with pain are reluctant to share the truth out of a desire to protect family and friends from worry. The misunderstandings can lead to emotional distance. But if you live with chronic pain then your experience needs to be shared and you’re the best person to do it.

How to Talk About Your Pain and Changes

Despite the challenges, the following can help:

• Be specific. It “hurts all over” may not tell them enough; consider adding details where possible. Here are some examples:

  With health care providers, try: “It started with my low back, but now my left hip and upper back also hurt.”

  With loved ones, tell them exactly what would be helpful for you: “Focusing on the pain makes it feel more intense, but it’s more manageable when I do some regular activities that take my mind to more pleasant feelings."

• Translate impacts. While the quality of pain or your history can be hard for others to grasp, describing functional impacts on various areas of life creates a better picture and fosters empathy.

  With health care providers, provide day-to-day impacts: “Just before my pain started, I was going to the gym a couple times a week, I would go for walks, and I pitched in around the house; lately, it is hard to stand or sit in one place for more than 15-20 minutes and I stopped exercising because I couldn’t keep it up.”

  With loved ones, describe preferences: “I’d love to go to the park and will need to take a break from walking every 20 minutes for just a few minutes, since that is what I can handle right now; would that work with your plans?”

• Use resources. Organizations like the American Chronic Pain Association offer valuable communication tools for visits with your health care team and practical “conversation guides” to feel better prepared for positive interactions.

How to Communicate With a Person in Pain More Effectively

Those who care about people with chronic pain are also faced with challenges around how to communicate most effectively. Loved ones often want to help but do not know what to do or have offered assistance previously and been unsuccessful. To add another layer to it, those in pain may be struggling with irritability or low mood, which can feel like a personal rejection to those who are close.

Break out of the rut by walking and talking, even try pacing and taking breaks.

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Social support has been shown to be especially important for those with pain. People with pain who have supportive relationships are more likely to engage in activities and even reduce pain-related fears. So how can we improve our communication to ensure that relationships remain intact and beneficial?

Loved ones, consider these strategies:

• Offer practical assistance. Instead of asking what you can do to help, offer something specific such as “I’m going to the store tomorrow, what can I pick up for you?” or “I’m taking my kids to get dinner and would love for your kids to join.”

• Be persistent. It is not uncommon for those with chronic pain to cancel plans or simply decline invitations due to the way they are feeling, but don't give up as it is not personal and being asked is meaningful.

• Minimize advice. Since you do not know exactly what the person is going through, making suggestions or offering platitudes is often more divisive. Instead of “you should get out” or “we are never given more than we can handle,” try asking what they think by saying “What do you think would be helpful right now?” or “What recommendations have you learned from your doctors?”

• Just be. Being there without offering solutions can be the hardest part since you want to fix it; however, maintaining a good connection and simply having times of quiet or “normal” moments of watching a movie together offer more benefits than you might be aware of.

Living with chronic pain can be a challenging and isolating experience, particularly for those with pain as well as for the people who care about them. Although the challenges may be different, the mutual feelings may be fuel for trying a new way. Trying these strategies may feel uncomfortable at first, but if both people are willing to experiment, then you will hopefully be rewarded with more positive interactions.