Images of pain

One thing I starting noticing once I had chronic pain was the images used to depict pain. I noticed what images were commonly used to show pain, and what images weren’t.

Open a new tab now and Google “pain”, look at the images tab. What do you see? Do the same for “chronic pain“.

You’ll see images of the nervous system and of people (both cartoons and real) curled up, tensed up, screaming, crying.

I’m not saying these images don’t depict pain. They do and the photographers capture this pain, physical and emotional, in a beautifully raw way.

However, most of the images are of people alone. Some of the images have few clothes on.

Photo by Larm Rmah on Unsplash

Yes, pain is a personal experience. Yes, pain is an unpleasant experience. Yes, pain is a vulnerable experience.

You don’t often see images of people in pain with other people though. And if you do it is usually an unidentified hand, or in a healthcare setting.

You don’t often see images of people in pain doing activities or out and about.

I believe this depiction is one factor that contributes to the invisibility of chronic pain. Real people with chronic pain don’t look like the people in images of “pain” so they must not have real pain. I don’t look like the people in images of “pain” so I must not have real pain.

I have real pain here:

I’m out and about here. Before this photo was taken I’d been on a walk with my husband and his parents while we were on holiday. I was sore and tired and needed a rest. That’s what we’re doing here. Resting (my husband calls it Hazel-management) before continuing on with the rest of our day. I’m living my life.

I have pain here:

I’m doing my job here. This is me introducing a speaker.

Sometimes I get a bit stubborn and still try to do the things I love when the pain is worse than usual. Then it’s a bit more noticeable that something’s not right.

Stubbornly going to Death Cab for Cutie during a flare-up of my pain.

One in six people in New Zealand have chronic pain. That’s around 800,000 people. Most of the time we’re not living as depicted in images of “pain”.

People can live a full life with chronic pain. I live a full life with chronic pain. My life is different than it would be if I didn’t have chronic pain but not lesser. I don’t think about my pain every hour of the day.

I do often need help. My husband helps me, my parents support me, my friends are there for me. I have flexibility at work. I have had lots of professional healthcare support to develop pain management strategies that work for me. I take medication.

With this support I am able to be me. To do the things that bring me joy – spending time with my people, learning, reading, attending music and science events. With this support I am able to be a good wife, family member, and friend, and to contribute to my fullest ability at my job.

If chronic pain was a little less invisible, then my journey to get to where I am now might have been easier.

Thoughts

One of the key changes in the way that I think about my pain that resulted in great improvements in how I manage my pain is:

Chronic pain is my brain and body being really, really, really good at protecting me.

I was first introduced to this way of thinking about pain at the Pain Management Programme I attended in 2013.

I was never interested in knowing more about pain, or about my pain, before this programme.

I was certainly not interested in studying or researching pain! Why on earth would I want to learn more about something that was such a negative being in my life!?

Turns out understanding pain is a powerful tool in your pain management toolkit and that there are a lot of unanswered questions about pain. For my PhD, I tested if an impairment in attention might be one reason that pain makes it so difficult to think. That’s another story for another pinch or more another time.

Pain is produced when your brain detects threat to body tissue. One of the best explanations of pain I’ve seen is this talk by Lorimer Moseley.

In chronic pain, there is either ongoing damage to body tissue, or your threat protection system has become overactive and detects threat when there is none (1, 2, 3).

Many factors go in to the assessment of threat: including your previous experience (as with Lorimer and the pain he experienced from a scratch from a branch in the video), the context of the current situation, even your knowledge of pain (1, 2, 4).

Detection of threat is not under your conscious control, but one thing that is possible to change is how you think about and respond to the pain. I’m not saying this is easy. I’ve been practicing thinking that of my pain as my “overactive threat protection system” for years. It doesn’t always help me, and sometimes I still hate my pain.

The more I practice thinking about my pain this way though, the more I don’t feel overwhelmed by the pain.


  1. Moseley, G. L. (2007). Reconceptualising pain according to modern pain science. Physical Therapy Reviews, 12, 169–178. https://doi.org/10.1179/7108331907X223010
  2. Moseley, G. L. & Jones, L. (2009). Pain. In S. Kumar (Ed.), Ergonomics for Rehabilitation Professionals (pp. 71–102). Boca Raton: CRC Press.
  3. Tabor, A., Keogh, E., & Eccleston, C. (2017). Embodied pain – negotiating the boundaries of possible action. Pain, 158, 1007–1011. https://doi.org/10.1097/j.pain.0000000000000875
  4. Peters, M. L. (2015). Emotional and cognitive influences on pain experience. In D. P. Finn & Leonard, B. E. (Eds.). Pain in Psychiatric Disorders. Modern Trends in Pharmacopsychiatry (Vol. 30, pp. 138–152). Basel: Kager. https://doi.org/10.1159/000435938

The first pinch

I am Hazel. I experience chronic pain. I have conducted research to extend our understanding of chronic pain. I live a full life. Most hours I am in pain. Sometimes I suffer, most of the time I don’t. I am a wife, a daughter, a friend.

Pinches of pain is starting out as a place for me to share my thoughts about my chronic pain, about our scientific understanding of chronic pain, and about how I and other people with chronic pain live in this world.

Some of the pinches will be short, some long. Sometimes they will be released weekly, sometimes irregularly.

I’m also going to share resources I have both found helpful in my pain management and that are consistent with our current understanding of what pain is.

For a long time I found it easier to never talk about my pain, to not share that part of my life. I ended up completely unable to manage my pain. A lot of things happened, that I’ll share in some of my pinches. I learnt that sharing my pain experience didn’t make me weak, it made my relationships richer and managing my pain a hell of a lot easier.

Pinches of pain is the next step in me sharing my pain. I am now comfortable sharing my pain with my family, old friends, new friends, and colleagues. I hope sharing my pain and linking my experiences to the science of pain could be useful to other people experiencing pain and the people supporting them. I hope sharing my life and science will make chronic pain a little less invisible.