Chronic Pain – what not to say!

Chronic Pain – what not to say!

People with a history of injury and pain can often be overly sensitised to warning signals in the brain. A normal movement pattern reminiscent of a movement that may have caused pain in the past can trigger pain pathways in the brain, even though it is merely an ‘alarm’ for potential pain. It certainly doesn’t mean that it’s just in their head!

When someone you care about is living with pain, the most important thing you can do is to support them with understanding, but that’s not always easy. Sydney pain medicine specialist Dr Charlotte Johnstone says, “People tend to talk down to others in chronic pain and try to ‘manage them’ or tell them what they should do – and that closes the conversation.” Instead, aim to keep the conversation going, she advises. Allow the person in pain to say what’s wrong and respond in a way that shows you’ve listened. Here’s what not to say – and what they might like to hear instead.

1. “Snap out of it.”
In an ideal world we would all have the ability to shake off a black mood or “focus on the positive”. However, pain can feel very isolating. Do you really want to make someone you care about feel even worse because they can’t “brighten up” or “forget about it”?

Johnstone suggests you avoid asking questions with ‘yes’ or ‘no’ answers as they don’t encourage conversation. Instead you could say, “It sounds to me like you’ve had a difficult day and you managed it (this way). How do you think you’re going to handle the rest of the day?”

2. “There’s always someone worse off.”
Or just as bad is: “We all have bad days” or, “At least it isn’t cancer.” While you may be trying to give a bit of perspective, you’ll only undercut the emotional and physical pain of the other person. It’s better to concentrate on the positives of your friendship.

“Highlight the things you appreciate or you can see they’re doing really well,” suggests Johnstone. Try: “It sounds like you’ve had a tough day today but it’s really nice we can spend some time together now.”

3. “Have you tried …”
The reality is they probably are already investigating every possible option. It’s possible nothing will ever erase, or even manage, their pain and they know it. If you really have to go there, then instead try something like, “You must be driven mad by all these hare-brained cures that people come up with, but every now and then they do seem to work for some people.”

4. “Just don’t think about it and you’ll feel better.”
So snapping the elastic band on your wrist distracted you when you were trying to cut back on sugar? That’s great. However, when your loved one’s best day is the equivalent of your worst day, you‘re not exactly on a level playing field.

Clinical psychologist and pain specialist Toby Newton-John adds, “Be careful not to suggest their pain is psychological, or suggest they see a psychologist without being given ‘permission’ to talk about the emotional effect of their pain. People with chronic pain are often sensitive about either being not seen as genuine – or being ‘weak minded’. A good strategy is to mention your own positive experiences with a psychologist or ask if they’re feeling ‘stressed’, as this is a more neutral word.”

5. “Let me know if I can do anything to help.”
I like this point, it’s really common and basically feels like you are out for coffee with a friend who is on their phone.
The thought is a good one, however try offering something specific such as, “I’d honestly love to help. How about I do your laundry and take your dog for a walk once a week?” Or get into the habit of calling or texting when you’re going to the shops to see if they need anything.

6. “At least you don’t have to go to work/school.”
Telling someone with chronic pain that they’re lucky they don’t have to go to work is as insensitive as saying to someone with no legs, “You’re lucky you don’t have to walk up the stairs.” They’re probably dreaming of the time they’re well enough to have something else to fill their day.

7. “Things will get better soon.”
Even if things do eventually turn around, your loved one isn’t in the head space to think about some magical time in the future. Your hopes are likely to be taken as annoying. “Do give positive feedback,” advises Newton-John, “but make it about them. Say something like, ‘I really admire the way you do X.’ Or ‘I think you’re remarkable for coping how you do X’.”

8. “Are you in pain because you…”
Even if your loved one’s back may hurt them a little more because they’re carrying a few extra kilos. Newton-John adds, “As much as you might be genuinely concerned, enquiring about the cause of someone’s pain is not always helpful or respectful. If they want to tell you about it they will. A lot of people don’t want their pain to define them.”

9. “I feel so sorry for you.”
There’s a massive difference between pity and empathy. Instead, saying, “I’m here for you,” is always a good option. Newton-John adds, “If you want to convey your empathy then say ‘I admire how well you cope.’” When in doubt? Smile, hug your friend or family member, say “I love you” or “I’m here for you”, hold their hand, sit and truly listen.

Look after yourselves,


Thanks to Reader’s Digest