A small interview study suggests that chronic pain can affect suffering through more than physical intensity. For six adults in Quebec, loneliness, judgment, reduced independence and changes in social identity were central parts of the experience.
The findings describe lived experiences in depth, but they do not show how common these experiences are or prove that social disconnection causes poorer health. The study also did not test a treatment or identify which forms of support work best.
When pain changes a person’s social world
All six participants connected their suffering to social experiences, including feeling judged, mistreated, lonely or less independent. They described missing shared activities, being seen differently by other people and losing parts of the personality they had previously expressed through work, relationships or everyday roles.
One participant identified loneliness as the greatest source of suffering. Several participants distinguished pain itself from the situations surrounding it, such as losing independence or being judged by others.
The researchers described pain-related suffering as what can happen when pain disrupts a person’s sense of self. In the interviews, participants spoke about changes to their relationships, activities, social roles and ability to present themselves to others.
The pressure to look well
Participants described a difficult tension: They wanted to appear normal while also needing their mostly invisible pain to be recognized. Trying to hide pain could help them avoid unwanted attention, but a lack of recognition could leave them feeling dismissed or misunderstood.
The study’s participants also described stress mainly in terms of suffering or a route toward suffering. The researchers suggested that stress and suffering may be closely connected in chronic pain, while emphasizing that this remains a hypothesis for future research.
What the study can—and cannot—tell us
The study included six adults with chronic non-cancer pain lasting more than three months. Their median age was 45, with ages ranging from 25 to 65. There were two women, three men and one non-binary participant. Pain histories ranged from three to 44 years, and pain interference scores ranged from 5.0 to 8.3 on a 0-to-10 scale.
Each person completed two interviews, producing 12 interviews in total. The conversations lasted from 44 minutes to nearly two hours and took place in French or English. Researchers used Interpretative Phenomenological Analysis, a qualitative approach focused on how people make sense of major life experiences.
The sample was small and had important limits. Five participants were white, four had a university education and four worked full time. Everyone was recruited through a support organization, so participants may have had more access to support or validation than people outside such groups. The researchers also noted that the study could not show how experiences differ by gender, ethnicity or income.
The interview prompts in the second round included questions about feeling threatened or challenged and about available resources. The researchers noted that these prompts may have directed participants toward negative experiences. People in an active mental health crisis were not included.
How the findings fit earlier research
The interview findings are consistent with earlier qualitative and questionnaire research, although the types of evidence answer different questions.
A 2013 review of 77 papers from 60 qualitative studies described chronic musculoskeletal pain as involving struggles to affirm the self, explain pain and prove that it is real. In a survey of 1,455 people with rheumatic diseases, invalidation and low social support were associated with worse mental health, while being discounted by others was also associated with worse physical health. Among 92 people with chronic low back pain, being discounted—particularly by a partner—was associated with greater pain-related disability.
Those questionnaire studies showed associations, not proof that invalidation causes worse health. Likewise, the Quebec interviews offer insight into how some people understand their suffering, rather than a measure of how frequently these experiences occur.
A practical implication
The accounts suggest that acknowledging chronic pain may involve more than asking about pain intensity. For some people, understanding missed activities, changes in relationships, loss of independence and the effort involved in appearing well may provide a fuller picture of what pain is doing to daily life.
That does not mean physical pain is unimportant. The researchers noted that overwhelming bodily pain may be the main source of suffering for some people. Instead, the study highlights that pain and its social consequences can coexist—and that the balance may differ from one person to another.
AI tools were used to assist with the preparation of this article.
Leave a Reply