Chronic pain isn’t just constant pain, though that would be more than enough for anyone to handle, the truth is chronic pain always brings friends. These added challenges are obvious, but rarely taken into consideration by “healthy” people. Remembering that like all bullies chronic pain travels with a gang can help to better understand the life of someone in chronic pain.

Pain is exhausting. We have all had a bad headache, a twisted knee, or a pulled muscle, and by the end of the day it is a monumental effort just to read the mail. You may not have consciously realized it, but the pain that has relentlessly nagged you through out the day has drained you as bad as any flu. Even when you try to ignore pain it will stay in the back of your mind, screaming for attention, draining away all of your energy. With chronic pain this is amplified because it isn’t just one day, it is months or even years of struggling to live with this very demanding monkey on your back. I’m tired just thinking about it.

Pain causes poor sleep. You would think that after a long day of fighting with constant pain sleep would be a great reprieve. Unfortunately, this is just a dream (pun intended). First chronic pain can make it hard to get to sleep and stay asleep. The pain will pull you right out of deep sleep. Many pain patients take medications to sleep, because sleep is vital to your health, chronic pain, or no. Even when you do sleep, the pain signals continue to your brain and can cause sleep to be broken, restless, and oddly enough, exhausting.

Pain makes you cranky. Chronic pain sufferers aren’t (all) just cranky buggers by nature. Pain drains you physically and mentally. When you are in pain even the simplest things feel overwhelming and people tend to react accordingly. You may have only asked your chronic pain spouse if they would like to go to a movie, but in their head they have considered if they can sit still that long, how much medication it would require, if they have the energy, if they will stay awake through the movie, how high their pain is now and how it might increase, if they go will it make getting through tomorrow harder, and most importantly, given all this, will it be any fun. They didn’t grouch at you for the fun of it, pain just makes it very hard to remember that everyone else is coming from a totally different perspective, where a movie is just, well, a movie.

Pain kills your concentration. Most chronic pain patients fight like crazy to live a normal life. They try to ignore the pain and go about their days, but it’s just not that easy. Even when you ignore pain, push it to the back of your brain and focus on, say, work, pain doesn’t give up. You can sit at your desk, working on your computer, trying to concentrate, while your pain plays the part of a toddler desperate for your attention. Pain will poke you, tug at your clothes, spill juice on your keyboard, scream your name and try to use your arm and leg as practice for the uneven bars. No matter how hard you try to tune it out, part of your brain is always processing the pain and it often pulls your concentration to terrifyingly low levels.

Pain damages your self esteem. The pain has made you tired, cranky, and killed your concentration. Being exhausted all the time makes everything more of a challenge than it should be, your quick temper has strained or destroyed once strong interpersonal relationships, and your inability to concentrate has hurt your job performance. You can’t do what you want to do with your time even when you try and it seems like everyone is mad or unhappy with you no matter your efforts. Life as you know it is crumbling and all because of …you? Most pain sufferers blame themselves for these failings, remembering that they used to be able to do everything. They see chronic pain as a sign of weakness or a personal defect that they should be able to overcome. The end result is that on top of everything else chronic pain damages your self esteem.

Pain causes isolation. When you’re in constant pain the last thing you want to do is attend the company party, the neighbor’s backyard barbecue, or even small gatherings with your closest friends and family. Your friends and family are still the light of your life, but the physical and mental energy it requires to go out and be social can be just too much to handle. You start to bow out of parties and cancel plans, not because you don’t want to go, but because you just can’t. Eventually people stop inviting you, calls to make plans decline, and the scary thing is you don’t mind. The pain has slowly, but surely, isolated you.

What about you? What are some effects of pain that seem obvious, but aren’t?