The Invisible Revolution: Living With Chronic Pain
Chronic pain changes every part of your life, and most people can’t see it. They aren’t ignoring your pain, they just can’t witness it. There’s no cast. No bruise. No clear sign that says, “I’m hurting.” So the world expects you to keep showing up like you always have, even when your life has shifted under your feet.
You do quiet math all day. You weigh every choice. You do it in your head, in silence, while trying to look fine.
You’re doing mental gymnastics just to make small talk at a family gathering. You’re deciding if brushing your teeth will spark shoulder pain. You smile, you nod, you listen, and inside you’re counting the cost.
I worked as a maxillofacial trauma surgeon for 30 years. I treated pain. I wrote prescriptions. I thought I understood it. Then I became the patient. I learned one of the hardest lessons of my career: chronic pain isn’t just acute pain that lasts longer. It plays by different rules. It responds to different care. It doesn’t care about your plans for tomorrow.
The New Math You Have to Do
Before chronic pain entered my life, I understood pain in clinical terms: nerve pathways, brain chemicals, pain scales from one to 10. I knew what the books said. I watched patients wince. I listened to their stories. I tried to help.
What I didn’t understand was the daily math, the kind you never asked to learn.
Almost every choice turns into a problem to solve. Should I go to that event? What will it cost me tomorrow? Can I cook dinner, or will standing too long ruin my sleep? Is this talk worth the brainpower it will take? This isn’t weakness. It isn’t drama. It’s survival.
I call it “pain math,” and it wears you down in ways that have little to do with pain levels alone. You are always guessing, planning, and weighing outcomes. You learn patterns. You spot triggers. You track your limits. You become the world’s leading expert on your own body because you have to.
Here’s the hard part. You build those predictions with a brain that is already tired. Chronic pain doesn’t only hurt, it takes up space. It pulls your focus. It can fog memory and slow thinking. Decisions feel heavier because your mind is already working overtime, just to process the constant signal of pain.
People around you don’t see that work. They see you skip a dinner. They see you cancel plans. They may think you didn’t try hard enough. They don’t see the fast list you ran through in seconds before you said, “I can’t.” They don’t see that you already spent your day doing extra work, and now you’re running on almost nothing.
One of the hardest parts of chronic pain is the invisible labor. You can’t show your work. You can’t hand someone proof. You decide, and then you hope the people who love you will trust that you’re trying to prevent more harm.
That trust matters. It can feel like oxygen.
What Helps (and What Doesn’t)
Most advice people offer doesn’t help. “Have you tried yoga?” Yes. “What about meditation?” I’m trying. “My cousin changed her diet and she’s fine now.” I hope that worked for her.
People usually mean well. They want a fix. But chronic pain often isn’t a problem you solve once. It’s a condition you manage. You adapt. You live with it. You grieve what it takes. You keep going anyway. That is its own kind of courage.
So what helps?
First, the right specialist. Not just any doctor, the right one. Someone who understands that chronic pain often involves the nervous system, not only joints or muscles. Someone who listens to your lived experience, not just test results. I saw several specialists before I found my current pain doctor. That relationship has mattered more than any single treatment.
Second, self-compassion. It sounds soft, but it’s hard. Chronic pain can make you furious at your body. It can make you feel like you failed. You have to practice talking to yourself the way you would talk to a friend you love. Shame makes pain worse. Your nervous system reacts to threat, whether that threat is physical or emotional. Harsh self-talk keeps your body on high alert.
Third, connection. This isn’t optional. Chronic pain can push you into hiding. You cancel. You withdraw. You stop reaching out because you’re tired of being the person who hurts. But isolation can make pain louder. Many bodies settle when they feel safe. You need people who can sit with you without trying to fix you. You need witnesses who don’t look away.
A few strategies that have helped me: pacing (doing tasks in smaller chunks), heat or ice (simple, boring, and often effective), gentle movement when I can, distraction that fits my brain (audiobooks work better for me than meditation apps), and clear words about limits. I’ve learned to say, “I can do 30 minutes, not 2 hours,” instead of forcing a yes and paying for it later.
What the People Who Love Us Can Give
If you love someone who lives with chronic pain, start with belief.
Believe them when they say they hurt.
Believe them when they say they can’t.
Believe they’re doing their best with the body they have today.
Unless they ask, don’t offer solutions. Don’t compare their pain to someone else’s. Don’t suggest that more faith, more discipline, or more willpower would fix it. They’re already using enormous effort just to get through the day, even if they look calm while doing it.
Offer practical help. “Can I bring dinner on Tuesday?” helps more than “Let me know if you need anything.” Stay in touch even when they cancel. Remember them on good days, not only on hard ones. Treat them like a whole person, not a problem to solve.
And keep this in mind. When they say they can’t do something, they aren’t being dramatic. They’re telling you the truth about what their body can handle in that moment. Trust that they wish they could be there. Trust that they’re trying. With chronic pain, that trying often looks like resting, saying no, and choosing what matters most.
What kind of courage is that? Quiet. Constant. Unseen.
