Pain Partners – Working For Lasting Relief

Pain Partners brings together people living with chronic pain, patient advocates, researchers and clinicians. We aim to increase global pain awareness, understanding, treatment and management through research studies, treatments, treatments and management initiatives.

Both patients and partners reported several motivations for pain behavior, with patients viewing some partner responses positively as providing help and encouraging pain talk.

What is pain?

Pain is a physical sensation that alerts us when something hurts, a vital aspect of being human – we feel it when our bodies or those around us suffer, as well as when other people do so too. Pain serves an important purpose; we experience it when something physical damages our body or someone else’s does, acting as a warning signal against potential injury and sickness. Unfortunately, however, pain may persist beyond expected or become chronic and become an ongoing source of distress – however when prolonged or chronic, its intensity becomes an issue that cannot be controlled effectively by treatment alone.

Chronic pain can disrupt every aspect of life and leave you deprived of activities that define who you are – be they work, hobbies, social lives or avoidance behaviors that further fuel its cycle. Chronic pain may steal away everything precious from you while leaving you depressed, anxious and exhausted.

People living with chronic pain often report difficulty communicating their experience to loved ones and health care professionals, leading to miscommunication and misinterpretations which exacerbates its negative impact. This may increase its burdensome effect.

In our study, we asked dozens of patients and their partners to describe how their partners responded to their pain behaviors. We identified various responses such as invalidating, attempts at relieving pain relief, validation, encouragement, caregiving exhaustion or just simply not paying attention – patients and partners often perceived different responses differently: some considered only watching and not participating as invalidating while other found it supportive.

General consensus indicated that both patients and their partners tended to view helping as being validating, seeing it as evidence of care and empathy towards their pain condition from their partner. They similarly perceived encouraging pain talk and problem-solving sessions as validated behaviors; they may even view hostile-solicitous interactions positively since these reflect frustration with one partner versus having any malicious intent; ultimately though this type of interaction makes it harder for both partners to communicate effectively about pain issues in relation to each other and any impact it is having on their relationships.

Understanding pain triggers

Pain is a multifaceted experience that differs depending on its cause and context, from physical injury to emotional turmoil and decreased socialization. These symptoms may manifest themselves through behaviors related to symptoms: such as symptom-focused behaviours, hypervigilance, activity avoidance and decreased socialization – commonly referred to as “pain flare-ups.” To manage pain effectively and limit flare-ups effectively, identify its triggers and learn how to avoid them – typically related to emotions or activities like bending down or crossing legs physically, or emotional events like sadness or frustration – remember that each person’s unique pain triggers typically involve activation of certain parts of their nervous systems.

When touching a hot stove, your skin’s sensory receptors (nociceptors) send nerve fiber messages via your spinal cord and brain that interpret these signals and generate the sensation of pain. Repetitive stimulation of these nociceptors oversensitizes them and lowers your normal pain threshold; this phenomenon is known as neuropathic pain.

Although external causes for pain are well understood, less is understood regarding how partners’ responses to pain behaviors contribute to how patients interpret them. Our research has demonstrated that patients’ perceptions of partners’ responses vary significantly and even when instrumental support and validation were rated as preferred partner responses for pain behaviors, they frequently reported receiving invalidating reactions from their partners.

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Happily, this doesn’t imply that all responses to pain behaviors are negative; participants in the study interpreted several responses positively including providing help, encouraging pain talk, problem solving and showing empathy. They were also able to distinguish between solicitous and hostile-soliciting responses. One participant reported that their partner’s hostile-solicitous response to their pain behaviour was actually an indicator of her efforts to help alleviate it; their hostility did not signify lack of compassion on her part. Our findings demonstrate the need for further study on relationships among support preferences, interpretations of partners’ responses and pain-related outcomes.

Managing pain

Pain is a complex problem, yet manageable with the right strategies. First off, finding an experienced doctor to treat your specific condition and avoid activities which exacerbate symptoms like yoga. Also make sure that you get enough restful sleep and nutritious meals, reduce your stress levels as much as possible and consider joining support groups that may offer some respite from life’s trials.

Our study provided some very insightful observations about patient and partner interpretations of various partner responses to pain behaviors. Both patients and partners typically perceived instrumental responses (e.g., providing help) as being pain-relieving while other forms of partner responses such as expressing resentment and exhaustion as invalidating. This finding suggests that while partners’ intentions may be positive, how these actions are delivered might influence the effectiveness of support they provide.

Most patients perceived encouraging pain talk and problem solving to be validating, with one patient commenting ‘When she says that he can’t do the task herself, it shows she understands his limitations; by acknowledging he can’t do it himself and showing empathy’ [Patient 23 male 44 years].

Both patients and their partners interpreted most responses in the vignettes as either invalidating or trying to relieve pain, consistent with previous research showing that in some dyadic relationships patients engage in pain behaviors for validation while partners often fail to do so.

GAPPA strives to build partnerships between people living with pain and researchers so that the lived experience perspective can be brought into all aspects of study, understanding, education, management and advocacy of pain worldwide. To this end, the GAPPA board has devised The Amsterdam Principles which set overarching, governance, leadership and membership principles which guide their work.

Managing stress

Stress can be a real problem for people living with chronic illnesses like arthritis. Discomfort, fatigue and unpredictable symptoms such as flare-ups can all amplify levels of anxiety to unhealthy and dangerous heights, according to Joan Westreich LCSW-R, Social Work Coordinator for HSS’s Early Arthritis Initiative. Joan recommends learning effective stress management techniques as part of treating arthritis effectively.

Stressful situations can quickly engage the nervous system and release adrenaline and cortisol into our systems, increasing heart rate and blood pressure while activating our “fight or flight” responses (the kind our ancestors used to evade saber-toothed tigers), raising heart rate, blood pressure, inducing the “fight or flight” response and leaving us on edge. Prolonged exposure to prolonged stress puts your health at greater risk – such as high blood pressure and digestive disorders as well as unhelpful behaviors such as excessive alcohol consumption – leaving us on edge all of the time!

Emotional stressors include relationship difficulties, financial worries, discrimination or major life changes; while physical strain such as muscle pain, Kidney Stones Pain or headaches may also play a part. Self-compassion — treating yourself with kindness and care as you would any friend — is one effective way of handling stressful situations.

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