Have you been to a medical practice recently to deal with an injury or sickness? If so, I’m guessing you were asked to rate your current pain level on a scale of 1 to 10. Pain assessment and management is a growing part of today’s health care services. This is helpful since many have pain as their primary presenting problem. There are a number of syndromes and disorders that cluster around pain as the presenting problem: Chronic Fatigue, Fibromyalgia, Irritable Bowel Syndrome, Rheumatoid Arthritis, Osteoarthritis, back pain, etc. Depending on which research study you read, some 9-17% of the population struggles with some form of chronic pain.

Common Pain Presentation?

While these various forms of pain are quite different, there are some commonalities. Chronic and diffuse pain sufferers frequently experience some form of inflammation, fatigue, sleep disruption, negative mood, and poor memory (it is hard to pay attention to new information when you are weighed down by pain). These symptoms develop into vicious cycles. If you don’t get restorative sleep, you experience more fatigue, you are more prone to negative thought patterns, your pain levels go up, memory goes down…and thus you don’t sleep well the next night, and so on. Researchers describe this vicious cycle in terms of “allostatic load”–the deleterious effects of chronic stress hormones without restorative sleep.

Is It Just In My Head?

When pain is diffuse AND there is a lack of visible evidence for the pain (a big red spot, a swollen limb, etc.), chronic pain sufferers and their families struggle to understand whether or not the pain is real. In addition, family and sufferers wonder just how much can be expected of the person in pain. Thus, it encourages more “I should be able to…” thinking in all parties. As a result, pain sufferers tend either to do too much (creating more pain) or withdraw even further (creating more emotional distress).

As with all physiological problems, mood, perceptions, focus, and stress levels impact severity of the problem. While chronic pain is not just a mental state, how we respond to chronic pain may help alleviate or elevate the pain sensation we experience. Ironically, many pain sufferers resist counseling because they fear that others will believe that their symptoms are all in their head. Those who refuse to acknowledge the psychological factors in pain sensation and management miss out on important means to cope with the pain and to lower pain perceptions.

Chronic pain sufferers must accept the need to adjust their lifestyle to accommodate more rest. They must fight to get the best restorative sleep possible. Sleep may even be more important than pharmaceutical interventions (and I am not knocking medical treatments nor saying that just getting sleep will solve the problem).

Faith and Pain?

One of the biggest challenges for believing pain sufferers is the matter of hope and faith. When we suffer problems, we often expect and hope they will go away. When they do not get better it is easy to slide into despair. Despair usually is the result of things not going the way we hoped or expected. Part of living with chronic pain requires grieving what is lost. Without good grief, it is hard to accept–even enjoy–what strength and health we do have. Without hope, we may lose what self-efficacy we once had. We may stop doing the basic care-taking activities within our grasp. Interestingly, one of the clearest signs of this struggle is the massive dropouts in pain management research. Frequently, dropouts number about 50% in these studies. This means that before a study gets too far along many are dropping out because they assume the new treatment won’t work.

Faith is not that things will go my way right now but that God is in control, cares/protects me, and is working for my ultimate redemption–even when the opposite seems to be true. Faith is acting in a manner consistent with said assumptions even while grieving over real losses. Such faith enables us to be mindful of our thoughts so that we do not practice into beliefs counter to what we have come to know as true.

A Realistic Picture of Suffering Well

The chronic pain sufferer who grieves well

  • asks God for relief
  • stays in community with others
  • seeks relief through human means yet has an attitude of waiting on the Lord, and
  • explores and confront hidden sin in self that the pain may reveal

Grieving well does not mean coming to a place where the pain were nothing. That would be living in a false world. Rather, the faithful Christian notes God’s presence in distress and rejoices when they find 5% improvement—even as they cry out for greater relief and healing.

Phil Monroe is Professor of Counseling & Psychologyand Director of the Masters of Arts in Counseling Program at Biblical. He also directs Biblical’s new trauma recovery project. You can find his personal blog at www.wisecounsel.wordpress.com.


0 # michel emond 2013-03-11 16:11
Thank you so much for this encouraging article. It helped me refocus on my Lord.
God bless.
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0 # joyce b siegel 2013-03-13 16:01
I am so grateful for your wisdom writings.Despite living in a remote rural part of PA the Lord blesses me with the likes of you. I work in a secular community mental health agency in the 'large' town of williamport. In God's kindness he sends me fellow believers hungry to learn how to live in a God honoring way.One of my clients has the most unrelenting high level of pain. I trust this article will speak volumes to him.Blessings to you dear Phil. Carol keeps me posted on the rwanda efforts.
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0 # Philip Monroe 2013-03-16 12:51
Dear Joyce,

Blessings on YOU! Miss seeing you but glad you are bringing quality care to the hinterlands.
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0 # michel emond 2013-03-18 16:57
Does anyone know of a book, a testimony of some sort, of a person who lived with great physical pain all his/her life, but yet had learned to walk with God? I would certainly benefit from such a book. Yes, I've read the book of Job. Anyone who was on opiods?
Thanks. God bless.
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+5 # Tammy 2013-03-18 23:52
Thank you for your article. I printed it to share with my husband. He wants me to talk to him about my chronic pain (I have Multiple Sclerosis), but I find it difficult to articulate. Your article provided a great way to tell him what I'm dealing with in a way he can understand. I will have to say, though, if I am reading your views on "Faith and Pain" and "...Suffering Well" correctly, I'm not in full agreement. I am not a professional like you, so my basis for disagreement is in no way academic; it is simply where God has brought me thus far in this journey...
Psalm 119:75-"I know, O Lord, that Your judgments are right,and that in faithfulness You have afflicted me." God knows I need a leash. My MS keeps me chained to Him.
Romans 8:29-"For whom He foreknew, He also predestined to be conformed to the image of His Son..." My MS has purpose.
2 Corinthians 12:8-10 "Concerning this thing I pleaded with the Lord three times that it might depart from me. And He said to me, "My grace is sufficient for you, for My strength is made perfect in weakness." Therefore most gladly I will rather boast in my infirmities, that the power of Christ may rest upon me. Therefore I take pleasure in infirmities, in reproaches, in needs, in persecutions, in distresses, for Christ’s sake. For when I am weak, then I am strong." I get a strength that bears witness to Christ's power and grace!
I don't believe part of living with chronic pain requires grieving what was lost. I don't believe suffering well involves continually asking God for relief, but for His grace and mercy. And, I believe a faithful Christian has a profound understanding of God's presence in distress (not just "notes" it), and rejoices in the Lord always, not making it contingent on a preferred outcome, i.e. improvement. God is sovereign. He determined that chronic pain and fatigue would be one of the means He would use to sanctify me and prepare me for eternity. My body may be in constant turmoil and pain, but, it is well with my soul...
On really bad days I think about how much sweeter it is going to be when I get my glorified body because I have known the bitterness of this one.
God brought me to life through the sacrifice of His Son, Jesus Christ; my life is His. If this is how my life brings Him glory, Praise God!!
(I sincerely hope I in no way sounded disrespectful, but if I did, I ask your forgiveness.)
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+1 # eunice g 2013-03-25 13:24
To michel emond - I highly recommend checking out ALL the resources at www.joniandfriends.org Joni Tada, who has lived 40+ yrs as a quadriplegic, the past 10 with chronic pain and the last 2 battling breast cancer. The TV episodes are excellent, as well as the 35+ books she's written and daily email & radio encouragement.
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0 # michel emond 2013-03-26 12:50
Quoting eunice g:
To michel emond - I highly recommend checking out ALL the resources at www.joniandfriends.org Joni Tada, who has lived 40+ yrs as a quadriplegic, the past 10 with chronic pain and the last 2 battling breast cancer. The TV episodes are excellent, as well as the 35+ books she's written and daily email & radio encouragement.

Thank you Eunice. I will surely check out her site. I knew about her, heard her on radio when I was living in Qc, but I didn't know of her website and the fact she was now living in chronic pain. I will read and listen to her materail. I need it. God bless you dear.
Michel ;-)
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+2 # Jenna Smith 2013-08-07 06:38
The blog is very interesting and informative.Thanks.
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