“Pain is weakness leaving the body”. This expression is derived from the military in which crisis scenarios necessitate a soldier’s heroic ability to cope for survival. Transitioning from crisis scenarios to the routine of daily life, however, this expression loses its inspirational tone. Whereas pain indeed yields resiliency after adversity has been overcome, for the chronic pain patient this expression may be an unfair judgment conveying failure.
Pain carries a stigma. Unlike many other ailments with concrete signs and symptoms, a chronic pain condition is, to some degree, subjective and therefore subject to greater scrutiny. The patient’s pain can be criticized as a failure of will, an atonement for past actions, or a futile fact of life. This stigma serves to alienate the sufferer. In all illnesses, there is some loss of independence, but with chronic pain the dependence on others can be prolonged. The patient’s concern that friends and family may fatigue in their support can suppress the outward expression of pain and result in silent suffering.
Needless to say, due to its subjective nature, the potential for abuse exists in both patients and pain management practices. Particularly in an era of astronomical rates of prescription drug abuse and greater scrutiny of pain clinics, the stigma of pain needs close examination. The community attention on this matter is warranted, but care must be taken to avoid a vacuum in which two poles exist: stigmatized patients for having pain and a stigmatized field for misconduct of outlier practitioners.
With an aging population, degenerative changes will inherently yield painful conditions. Early assessment of a painful problem can often make the difference between an acute injury and an incapacitating chronic pain. While pain may not reflect weakness, it will leave the body under the proper guidance.