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What Does Pain Actually Look Like?

Here’s a scenario I’d like you to consider: two people are currently experiencing acute and intense pain. The first person is generally in perfect health and almost never experiences pain of any kind. The second person has been living with rheumatoid arthritis for ten years and has been forced to deal with pain on an everyday basis. Do these two people look or behave the same way when they experience intense pain?

Differences in pain tolerance

In my mind, the answer is almost certainly not. It seems logical to me that intense pain would have a much more visible impact on a person who doesn’t have much experience dealing with pain. In that person I’d expect to see more wincing, writhing, frowning, groaning, and maybe even crying.

But in a person who has dealt with pain every day for the last ten years? I’d expect pain to have much less of an impact on how they behave. Maybe you wouldn’t even be able to tell that they were in pain at all just by looking at them.

Finding a way to cope with RA pain

Personally, after years and years of living with rheumatoid arthritis and dealing with pain on an everyday basis, I’ve come to the realization that it isn’t really worth it to let pain get the best of me. I’ve worked hard to figure out how to maintain a positive attitude no matter how much pain I am in because wincing or groaning or crying generally only makes me feel worse on top of being in pain. And after so much experience with pain, it seems perfectly reasonable to me that I would have developed coping skills that might make my pain less obvious to the average observer.

Allowing RA pain to have less of an impact

In general, I think allowing intense pain to have less of an impact is a benefit to my life. I’ve certainly dealt with depression as a result of having a chronic illness, and refusing to allow pain to impact me as much is one of the ways I maintain my own emotional health. Changing the way I deal with pain allows me to count my blessings and enjoy whatever I can enjoy, regardless of how I feel. But there’s one situation in which my carefully honed coping skills seem to have a negative impact on my life, and that’s dealing with some healthcare professionals.

How do healthcare providers assess pain?

While you might expect healthcare professionals to understand better than most people the long-term impacts of living with chronic pain, I don’t always feel like this is the case. There have been quite a few scenarios where I felt like a healthcare professional wasn’t taking me seriously when I said I was in pain because I didn’t look like I was in pain.

When I’m not wincing or groaning or crying – but rather trying to smile and keep a positive outlook on a bad situation – I feel like I’m taken a lot less seriously. Which, of course, means that my pain is treated less seriously.

Delayed pain treatment due to a positive appearance

This happened to me most recently when I experienced a great deal of tooth pain a few weeks after having a filling. When I went back to see the dentist, I truthfully described the amount of pain I was in and how it was impacting my life, but I also maintained the best mood that I could manage and I didn’t wince or cry. Unfortunately, I feel like the result of trying to keep my spirits up was that the dentist took my pain a lot less seriously.

I had a similar experience after my second son was born via C-section and I got a terrible headache as a reaction to the anesthesia they used for surgery and a spike in my blood pressure. At the time I was trying to keep my spirits up for the sake of my newborn son and my own mental welfare, so I didn’t look like I was in that much pain. Consequently, the nurses delayed treatment for my pain, ultimately resulting in me having to withstand a great deal more pain than I should have.

What is the solution to this pain issue?

So what’s the solution to this conundrum? Do experienced pain patients need to “act” like they are in pain to be taken seriously? Or is there some way we can help healthcare professionals understand that pain isn’t necessarily visible?

Have you ever been faced with this issue? How did you handle it?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • 1957carolyn
    3 years ago

    I agree after several years of dealing with pain, I have found that I hide it, then sometimes people don’t take it seriously cause I don’t fuss and whine about it. I really don’t know if there is an answer, I wish there was an answer. But it is comforting to know I am not the only one that does, this.

  • Lawrence 'rick' Phillips moderator
    3 years ago

    I think our pain tolerance is so very differnet. Ony we can actually name it. I know when I had back surgery recently the doctor asked how I was making it with the spinal stenosis? He said many people with that level of build up would be unable to keep going. The thing is we who have RA just do what we do.

    I mean want to talk about pain? Well doctor, those of us with RA understand pain. Yeah that hurt, but if we are discussing pain lets talk about RA.

  • Richard Faust moderator
    3 years ago

    Hi Rick. Thought you might like this article on characterizing pain from one of our contributors in which she points out that the person with RA isn’t some sort of freakish hero and would much rather have a low pain threshold.

    No on wants to be that person with all of that experience with pain. Best, Richard ( Team)

  • Kelly Dabel moderator
    3 years ago

    So true! Thank you for sharing. Sorry that you have such an understanding of pain, you are not alone in this community. Keep on doing what you do. Kelly, Team Member

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