How a Conversation With My Physical Therapist Changed How I Talk About Pain


Once upon a time, I dizzily walked into my physical therapist’s office, migraine and joint flare close to a level 10 on the pain scale, vision blurred, and checked myself in.

The receptionist frowned, “Bad day?”

“Yes, very.” I mumbled as I signed my name and paid my copay.

I had almost called them to cancel that day, but my physical therapist (PT) is great at relieving my migraines and flares during sessions, at least bringing me down a few points on the pain scale. I had hope that today she’d be able to bring my pain down a few notches.

Heading back to the treatment room, my PT despairingly looked at me and said, “Honey, you’re not looking so great today.”

“I’m not feeling it. But I’ll be OK,” I muttered back through aphasic words.

We settled in the room and went over the preliminary process of reviewing my past week, my migraine diary, all the activities I’d done, rating my abilities, and then, of course, my pain level on that particular day.

“What’s your pain level right now?” she asked.

“Oh…I don’t know.” I stumbled over forming a sentence. My eyes watered and the light burned, even though she had made the room as dark as possible for me, a small favor I was always thankful for. It has always been difficult for me to rate my pain level with a number, but that day I knew it had to be a nine, pushing a 10. I was barely functioning. I wasn’t even sure how I’d made it there. I’d have gone to the ER if I thought there’d be a prayer’s chance in hell they would help me more than I could help myself. “I guess it’s around a four.”

She gave me a look that told me she knew I was lying. “There’s no way you’re a four right now. Come on, what is it, really?”

“OK…a six.”

“No it’s not. I know you. I can look at you and tell you are very high on the chart today.”

“Fine. I’m a 9 – a 9.5 more likely,” I replied, defeated. “I hate saying that though. I hate admitting to being that high on the pain scale. It could always be worse.”

At that moment she put down her pen and all her paperwork and turned away from her desk to face me, one on one. She was clearly troubled.

“Your pain matters, my dear,” she said. “Please, please, please don’t compare your pain to someone else’s pain. Their pain isn’t yours. Your pain matters so much – to me as your physical therapist, and definitely to you as the one experiencing it. Don’t downplay it. Be honest. That’s the only way I can help you, is if you are honest with me about your pain.”

She went on to explain how comparing ourselves to others doesn’t help us in any way, it only makes us feel downtrodden about our condition. No, I may not be a terminal cancer patient. I may not have had a bad accident and broken several bones in my body. But I do live with chronic pain. And that pain is still pain, no matter what someone else is experiencing. Whether “worse” than someone else or not, I still have pain, and I still deserve to have it treated.

That day, I realized that my pain is valid.

That conversation happened over a year ago, yet it has stuck with me almost daily since it happened. Her words awoke a concept within me that I never knew I needed to consider. I desperately needed to start acknowledging, accepting, and embracing my pain in all its realness in order to heal and cope properly.

I think much of the time I spent denying the level of my pain was due to not only my own judgement of myself (”I’m not as bad off as others,” or “I could always feel worse”), but also due to the judgement of doctors, family, friends, coworkers, and society as a whole. That’s not to say that any of those people have ill intentions for me, it’s just the subconscious standard of society. It’s up to us, to me, to work to change that dynamic.

We are conditioned to give sympathy to those who have it worse than us; it’s human nature. And of course I do have sympathy for those cancer patients or those people who have endured horrible accidents. I know they are in pain; that’s a given fact.

But do I actually know their pain? No, I don’t.

We cannot ever claim to know another person’s pain. We can sympathize, even empathize by imagining ourselves in their shoes, but we can’t experience it for them. We can only experience pain for ourselves, in our own bodies and minds.

That’s why it’s important to be honest about pain. The only way we are going to be able to cope, I mean really mentally accept our condition, is to just be honest with ourselves and stop playing the game of comparison.

As Theodore Roosevelt once said, “comparison is the thief of joy.” He was totally right in this respect.

Figuring out how to voice pain properly, though, came as a challenge to me. The “suck it up, buttercup” idea was and often still is a phrase that was repeated to me often, and thus I became accustomed to telling myself the same thing.

That, my friends, isn’t doing any of us any favors.

Feeling pain for what it inherently is can be a frightening concept, at least it was for me at first – pain isn’t just a physical sensation. It’s mental, as well.

For so long I had just shoved it away to a dark corner, refusing to acknowledge it, just tossing it away like a piece of annoying junk mail. I wanted to appear strong, and I thought that’s what I was doing – I thought my stone-faced facade was benefitting me and others. To me, this ensured that I wasn’t a burden; I was the one who could get through anything. But after that conversation with my PT, I decided to dust it off and meet it face-to-face.

Pain isn’t a friend, but it can be an incredible teacher. And once I acknowledged pain as something that could be of use to me, rather than something useless to ignore, my life actually changed for the better. Living in chronic pain has truly shifted my perception of how I live my life.

My coping mechanisms are stronger now that I’m open and honest about my pain. I started finally assigning the real pain scale number to my pain every time I saw a doctor, regardless of how much I absolutely despise the pain scale (but that’s another topic), and I found that when I did so, I received better treatment. I received the right treatment most of the time. I was trusted more. And more importantly, I trusted myself.

I also stopped hoarding my medications and instead I now weigh the situation realistically: do I need my pain medication? If the answer is yes, then I simply take the pain medication. In the past, I would disregard my pain until it was so overbearing that I couldn’t handle it anymore, in which case taking pain medication was useless at that point. Being honest about pain in the situation of taking medication is equally important to being honest mentally, physically, and with others.

Speaking of being truthful about pain with others, it’s essential to be open about your pain when you’re asked or when you’re in a situation where it might be exacerbated. I used to clam up and deal with it, again bringing to light the “suck it up, buttercup” concept. But that’s not a healthy way of dealing with our struggles.

Instead, I now tell others when I’m in too much pain to do something. If I have to miss a day of work, I miss work or accommodate appropriately. If I have to skip a date with a friend, I tell them. If I have to excuse myself at a family function, that’s what I do.

These actions have led me to feeling better about myself and treating my pain better as well. Self-care now comes first in my book, every day. And, I’ve found, people are a lot more understanding of your pain when you’re honest about it.

Ultimately, the key factor to remember is that pain is subjective, which means it’s absolutely not in our favor to compare it to others. Your level eight might be my five. My five might be another person’s two. Pain should never be forced into objectivity, and as such, we should never feel guilty about our struggles.

Without my struggle, I would never have stumbled upon my strength.

Getty Image by catinsyrup

This story originally appeared on Migraine Mantras.


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