September is Pain Awareness Month, a time dedicated to recognizing the millions of people who live with the daily reality of chronic pain. While pain is something everyone experiences at some point, chronic pain is different. It lingers long after an injury has healed, affecting every part of a person’s life. To spotlight the challenges of living with chronic pain, we spoke to Tyler Dillman, Halifax Physiotherapist and owner of One to One Wellness, to get his perspective on the challenges, strategies, and common misconceptions faced by chronic pain patients and their families.
What is the most common misconception about chronic pain?
One of the biggest misconceptions is that chronic pain is “all in someone’s head.” After an injury, whether from a motor vehicle accident, workplace incident, or other trauma, the pain is very real. Even when tissues heal, the nervous system can stay “on high alert,” contributing to persistent pain. Because there may be no obvious X-ray or MRI finding, patients often feel dismissed. But chronic pain is real, valid, and deserves proper treatment.
How do you define chronic pain and how is it different from acute pain?
Acute pain is like the body’s alarm system; it signals that something is wrong and usually settles as the injury heals. According to the International Association for the Study of Pain (IASP), chronic pain is defined as pain that persists or recurs for longer than three months. Chronic pain is different as it lasts beyond the normal healing time and often involves changes in the nervous system and the development of coping strategies like boom-and-bust activity cycles or avoiding movement altogether. A simplified way to think about chronic pain is that the body is not responding to actual tissue damage but to the threat of tissue damage.
How does chronic pain impact mental health and emotional well-being?
Chronic pain doesn’t just hurt physically. It takes a toll on mood, sleep, and confidence. People often feel anxious, depressed, or cut off from others, especially after an accident when they’re grieving what they used to do and worrying about the future.
Emotions also change how pain is processed. Stress and low mood can amplify pain signals, while support and encouragement help “turn down the volume” through a process called descending modulation. For example, someone under heavy stress may notice more frequent pain flares, while the same person, when supported and reassured, often experiences calmer, more manageable pain.
What are some everyday challenges people with chronic pain face that others might not realize?
After an injury, even small tasks like getting dressed, sitting through a meeting, driving, or carrying groceries can become major hurdles. Many of our patients describe how unpredictable their pain is day to day, which makes it difficult to plan or return to work. Those of us without pain take for granted how much we move automatically, without extra thought or planning. People with chronic pain often need to carefully pace and coordinate activities and movement just to make it through the day, which can be exhausting.
What is the role of stigma in how patients with chronic pain are treated?
Stigma is a huge barrier. Patients recovering from accidents often feel judged by many people they come in contact with because their pain does not “show up” on a scan. Chronic pain is sometimes called an “invisible condition” because there are no obvious external signs. This invisibility is often misinterpreted as exaggeration or being pain-free.
In many contexts, it is important to understand that healthcare providers often encourage patients to return to enjoyable activities as part of their treatment. Seeing someone participate in something they love, while still being in treatment, does not mean they are pain-free. It usually means they are learning how to live with pain.
Beyond medications, what other treatments or approaches can help manage chronic pain?
Medication can help reduce the intensity of pain, but it is rarely enough on its own. Research strongly supports a patient-centered, interdisciplinary approach (Canadian Pain Task Force, 2021). For example, at One to One Wellness we coordinate care across physiotherapy, occupational therapy, manual therapy, psychology, and nurse practitioner services. Working together with the patient, we can develop individualized strategies for movement, pacing, stress management, and better sleep. For people recovering from accidents, this approach restores function and quality of life, not just symptom control.
How can friends, family, and employers better support someone living with chronic pain?
This is often one of the main stressors for patients. The first step is simple: believe, hear, and acknowledge them. As mentioned previously, people living with pain frequently feel invisible because others cannot see it.
Practical support makes all the difference. At home, this could mean pacing and prioritizing activities together. At work, employers can provide modified duties, flexible schedules, or gradual return-to-work programs. Friends and family can listen without judgment, offer patience, and recognize the effort it takes to manage daily life with pain. Compassion and flexibility are just as important as any treatment plan.
Tyler and his colleagues at One to One Wellness work with people recovering from accidents and injuries to help them manage pain, rebuild function, and return to meaningful activities. Their interdisciplinary approach ensures patients are supported physically, emotionally, and socially throughout their recovery.
References
- International Association for the Study of Pain (IASP). (2020). IASP Terminology: Chronic Pain. Retrieved from https://www.iasp-pain.org/resources/terminology/
- Canadian Pain Task Force. (2021). An Action Plan for Pain in Canada. Retrieved from