When it Comes to Pain, How Much is Too Much?

As a health coach who specializes in axial spondyloarthritis I often find myself talking with people about their experience of pain.

Unsurprisingly, it’s the most common topic that comes up when people with AS describe what they’d like to change about their lives.

Chronic pain infiltrates our sleep, affects our mood and alters our enjoyment of daily life. When it’s bad it can ruin careers, end relationships and shrink life down to an isolated cycle of just surviving day by day.

How can we measure pain?

During a particularly dreadful flare some years back I was asked by a doctor to rate my pain on a scale of 1-10.

It seemed so pointless at the time. What was a 10? Getting your leg chewed off by a shark? Being burned alive? And would he refuse to give me the good pain relief if I went in too low?

Pain is an invisible force that’s nearly impossible to describe because it happens inside of us. Given that it’s entirely subjective, it seems to make more sense to rate it on a scale of individual loss;

“It’s too much pain for me to sleep.”
“I can’t care for my children.”
“It’s affecting my ability to think clearly or feel happy.”

Quality-of-life measures can provide an honest indication of how pain is impacting you. It removes ideas of stoicism or "trying to be tough" and takes a big-picture look at the fallout.

To assess this for yourself, try dividing a page into two columns and writing down what life is like now compared to your life before AS. It can be a confronting process but it’s also an opportunity to seek help and make changes.

What’s wrong with remaining in a state of pain?

Along with eroding our ability to cope and enjoy everyday life, ongoing high levels of pain put every system of our bodies under stress.

Allowing serious pain to continue over time can create changes in the brain. Pain receptors become more sensitive and easily stimulated, and we can continue to experience the sensation of pain even when its source no longer exists.

In the case of axial spondyloarthritis, severe pain is an indication that inflammation is out of control. Over time this can contribute to progression and bone change, the most serious manifestation of AS.

In a form of self-protection, pain often goes hand in hand with fear. Many people living with AS who experience ongoing pain become so afraid of further pain or injury they stop activities like gentle exercise which could otherwise help reduce inflammation.

Getting out of pain

Sometimes the first step in getting out of pain is getting unstuck. Taking a step back to re-assess can bring new perspective and open up opportunities to try new strategies. Whether it’s finding a new doctor, trying different medication, starting gentle movement, or trying a natural health protocol, the change is up to us.