For some, these changes have been positive and for others, detrimental. But how does this related to an individual’s experience of pain? It all has to do with what these changes have done to each person’s nervous system. I think the best way to illustrate this is to introduce two very different people who both have chronic pain, let’s call one Jane and the other John.
Jane thrives off social connection outside of her home. She also loves her job, specifically because of those she works with. She doesn’t have a great relationship with her husband and her two teenager children want nothing to do with her at this point so she has found her happiness elsewhere. The happiest times with her family are always when they travel, especially outside of the country so she makes sure they go on a few trips a year. Jane has had neck pain for years. She believes it is likely because of a few horseback riding accidents in her childhood as well as a car accident in her late 20s. She manages it through massage and group exercise classes. She does yoga 3x a week and strength training 2x a week. She is extremely consistent with her exercise and looks forward to connecting with her instructors and her community, plus it helps her pain so that’s an added bonus.
John is as introverted as it gets. He loves quiet, he loves to be alone. His happy place is reading in his favorite chair with a good cup of coffee. He also has a very stressful job as an engineer. The amount of work he is required to do for his job is ridiculous. He often puts in 60-70 hour work weeks but if that were the only stressful part, he could manage. What makes him miserable with his job is the toxic work environment he is in. Everyone is out for themselves and there are some very wealthy and equally needy clients that are just impossible to please. Every weekend he tries to escape to the outdoors to breathe fresh air, move and be immersed in nature but often he is forced to work through the weekend just to get the required projects done. John has low back pain and it’s just gotten worse over the years. He thinks it started when he got this job with the commute increased time at his computer. He knows that movement helps and feels better when he can go on walks but he just doesn’t find the time to do it all that often. He has resorted to pain medication to help him get through his day and he feels it’s becoming less and less effective. He is afraid to go get an MRI because he doesn’t want back surgery. He just can’t deal with that right now.
Everything that brought Jane joy has been eliminated. She got laid off from her work because of COVID and is now spending all day, every day inside with her family where her husband works from home and her two teenagers are doing distant learning. In many respects, she feels like she has become the full time house nanny and professional nagger to people who never want to listen or do as they’re told. She feels stuck and with the travel restrictions, she literally is. For awhile Jane tried to do her exercise classes virtually but it made her realize that she didn’t do them for the exercise, it was all about the community that was there. It was her social time and without that piece, she has no motivation to do them. Here massage therapist has also been shut down and she needs the bodywork more than ever. Her neck is killing her. She is carrying the weight of the household and is extremely worried about getting COVID. She has asthma and an autoimmune condition that puts her at risk. Everyday she watches the news and it just keeps getting worse and worse. Jane is struggling and she doesn’t see any way out of it.
Meanwhile, John is living the dream. He no longer has to commute to work and there is less work for him. He doesn’t have to be surrounded by any of the toxic co-workers and he finds he can accomplish what he needs to far more efficiently. He is also able to go out for a walk or go read by the ocean at his leisure. He has even started to make home cooked meals with his extra time and is finding a lot of joy in experimenting with recipes. He’s lost 20 pounds without trying and is finally feeling what it is like to live exactly as he wants to. John’s pain is basically gone. He notices it comes back a bit after a long zoom meeting with his boss and co-workers but he found that if he goes for a quick walk after, it’s goes away. He is amazed!
There are many reasons that Jane’s pain increased while John’s decreased, the most obvious being that they each has a change in their physical movement/position/activity level but there are also some not so obvious reasons that their pain was effected by the way life changed with a pandemic.
For instance, Jane lost all of her social connections and her work which made her feel like she wasn’t contributing or participating as much in the world. She feels solely responsible for the household and the success of her teenagers with distant learning. She is also incredibly worried all the time. Worried about getting COVID, worried about her family and friends getting COVID and mourning everything that is being lost every day and every minute. This stress, worry, grief, anxiety and lack of joy are all contributing to the increase in her neck pain.
In John’s case, most of his stressors have been removed. He feels like he can enjoy each and every day now and do exactly what makes him happy. He is sleeping and eating better in addition to getting outside every single day. This absence of stress, freedom to find joy, ability to sleep more and exposure to the sun are all contributing to his decrease in low back pain.
These not so obvious factors for each individual all have to do with the nervous system. Chronic pain is a nervous system problem. It is the point at which pain does not correlate with tissue damage and it becomes more about the faulty alarm system of the brain. So anything that turns this alarm system up, or heightens the nervous system, will increase pain while anything that calms the nervous system and quiets the alarm will decrease pain. And this is how the pandemic can have extremely different effects on individuals with chronic pain.
If you are more like Jane, think about all of the things that you have lost. Think about what you are missing and brainstorm how you can achieve a similar outcome but with a different means. Social connection was really big for Jane so perhaps she can find that same joy by doing a socially distant walk with her friends or a zoom happy hour. Then think about the things that stress you out even further. Can you eliminate any of them? Sure, Jane can’t remove her teenage children but maybe she can stop watching the news or at least limit it so she isn’t adding to her stress.
If you resonate more with John, good for you 🙂 but also, this pandemic isn’t going to last forever. Think about how your life has changed for the better because of COVID. How can you keep what you have gained once the world starts to return to a more normal state. You have felt what it feels like to live, don’t give that up.
Do you want to learn more about pain science? Check out my pain science blog series part 1 here.
Do you want to be out of pain? It’s time to address your nervous system. Check out my Conquering Chronic Pain program here.