People with chronic pain will often mask their discomfort and dodge social situations to avoid being shamed, according to new research from Auckland University of Technology.

Sufferers say they face many social stigmas throughout everyday life, including from family, friends, educators, employers, and colleagues. 

To avoid being labelled as drug-seeking, lazy or mentally unwell, the study found they often isolate themselves.

The study’s lead author, Dr Debbie Bean, says that pain is “invisible”, meaning it is often ignored by others and put down to mental illness or imagination.

“People with chronic pain will anticipate stigma, often concealing their pain and avoiding potentially stigmatising experiences across all areas of life. Consequently, stigma is associated with higher levels of isolation, depression, and disability.”

One in six adults suffer from chronic pain globally, including 770,000 New Zealanders.

However, it is often poorly understood by the general public and many health experts.

Researchers say chronic pain is not adequately taught in medical training, so many professionals go against guidelines by giving opioids to patients.

“Inconsistent prescribing can create misunderstandings. If a clinician declines to prescribe opioids, this could be misinterpreted as disbelief of pain and patients may feel accused of drug-seeking, even when the clinician understands that the pain is real,” says Bean.

This kind of response is called “self-stigma”, which happens when an unwell person feels ashamed of their condition.

Bean added that self-stigma was seen among study participants who expressed high rates of stress and low self-esteem.

“Clinical interventions may be beneficial [for self-stigma] if they challenge beliefs that pain must be either biomedical or psychological. One intervention that holds promise is acceptance and commitment therapy, which has shown to reduce self-stigma in substance use disorders.”

Bean argues that chronic pain needs to be more broadly understood and societal norms challenged to make life less painful for sufferers. 

“Improving public knowledge, altering prescribing behaviour, and equipping clinicians with the necessary communication skills to discuss opioids with patients would be helpful,” she says.

“Other interventions may need to target societal views more broadly and the socio-political structures that enable the stigma in order to be more effective. These strategies include education, mass media campaigns, personal contact with people in pain, and protest.”

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