Mixed Findings on Effectiveness of Medical Cannabis

By Pat Anson

Some new studies are muddying the water even more on whether medical cannabis is an effective treatment for pain, anxiety, insomnia and other health conditions. 

The first study, a review of over 120 clinical trials, medical guidelines and meta-analyses (a study of studies) published in JAMA, found that there is not enough scientific evidence to support most of the conditions that cannabis is commonly used to treat.

Over one in four (27%) adults in the United State and Canada have used cannabis for medical purposes. And over 10% of people in the U.S. have used products containing cannabidiol (CBD) for therapeutic purposes.

But researchers say that widespread use is driven more by perceptions, anecdotes and promotion than it is by scientific evidence.

"While many people turn to cannabis seeking relief, our review highlights significant gaps between public perception and scientific evidence regarding its effectiveness for most medical conditions," says lead author Michael Hsu, MD, a psychiatrist and health researcher at UCLA Health. 

“Patients deserve honest conversations about what the science does and doesn't tell us about medical cannabis.”

Hsu and his colleagues found that FDA-approved cannabis-based medications, such as dronabinol and nabilone, are effective for conditions such as HIV/AIDS-related appetite loss, chemotherapy-induced nausea, and pediatric seizure disorders such as Dravet syndrome and Lennox-Gastaut syndrome.

But for most other conditions, the evidence remains either inconclusive or lacking. Over half of medical cannabis users take it for chronic pain, but current medical guidelines recommend against cannabis as a first-line treatment for either chronic or short-term acute pain.

The researchers also highlighted the potential health risks of cannabis. High-potency cannabis containing over 10% THC has been linked to higher rates of psychotic symptoms and anxiety disorder.

Daily use of cannabis, particularly of inhaled or high-potency products, is also associated with higher rates of coronary heart disease, heart attack and stroke compared to non-daily use.

About 29% of people who use medical cannabis also met the criteria for cannabis use disorder.

The review emphasizes that doctors should screen patients for cardiovascular disease and psychotic disorders, and evaluate for potential drug interactions, before recommending THC-containing products for medical purposes.

Medical Cannabis Reduces Opioid Use

But another study, published in JAMA Internal Medicine, suggests that medical cannabis is an effective treatment for chronic pain because it reduces the use of prescription opioids.

Researchers at Albert Einstein College of Medicine and Montefiore Health System evaluated 204 adults in New York State’s Medical Cannabis Program who were prescribed opioids for chronic pain between 2018 and 2023.  

At the start of the 18-month study, most participants reported high levels of pain and were taking an average daily dose of 73.3 morphine milligram equivalents (MME). By the end of the study, the average daily dose fell to 57 MME, a 22% reduction.

“Our findings indicate that medical cannabis, when dispensed through a pharmacist-supervised system, can relieve chronic pain while also meaningfully reducing patients’ reliance on prescription opioids,” said lead author Deepika Slawek, MD, an associate professor of medicine at Einstein, and an internal medicine and addiction medicine specialist at Montefiore. 

The reduced use of opioids suggests that chronic pain sufferers can be slowly weaned off opioids by using medical cannabis. For example, participants who received a 30-day supply of medical cannabis reduced their opioid use by an average of 3.5  MME per day compared to non-users.

“Those changes may seem small, but gradual reductions in opioid use are safer and more sustainable for people managing chronic pain than stopping suddenly,” said Slawek.

Since the study occurred during a time period when opioid prescribing overall fell by nearly 50% in the United States, we asked Dr. Slawek if that could have influenced the findings. She said researchers adjusted their modeling data to account for that as best they could.

“The only way that we will be able to get definitive answers on whether medical cannabis reduces opioid use is to conduct randomized trials, which are very difficult to do in the U.S. specific to cannabis,” Slawek told PNN in an email.

“We believe that by using causal inference modeling in this study, we were able to add the highest quality evidence possible (without conducting a randomized trial) that cannabis may reduce opioid use in patients with chronic pain.” 

The scientific data for medical cannabis is improving. According to an analysis by the National Organization for the Reform of Marijuana Laws (NORML), cannabis research studies grew for the fifth consecutive year, with over 4,000 scientific papers involving cannabis published so far in 2025.

“Despite the perception that marijuana has yet to be subject to adequate scientific scrutiny, scientists’ interest in studying cannabis has increased exponentially in the past decade, as has our understanding of the plant, its active constituents, their mechanisms of action, and their effects on both the user and upon society,” said NORML Deputy Director Paul Armentano. 

“It is time for politicians and others to stop assessing cannabis through the lens of ‘what we don’t know’ and instead start engaging in evidence-based discussions about marijuana and marijuana reform policies that are indicative of all that we do know.”

According to NORML’s analysis, over 37,000 scientific papers about cannabis have been published since 2015. That means over 70% percent of all peer-reviewed scientific papers about cannabis have been published in the past ten years alone.    

The studies are growing and so is the anecdotal evidence. A recent survey of 1,669 medical cannabis users in the UK found that nearly 89% of those with chronic pain reported somewhat improved or significantly improved quality of life.

Feline Good: A Sense of Purpose Helps Me Manage Chronic Illness

By Crystal Lindell

Every morning, at around 5 a.m., my very fat orange cat Goose starts his daily routine: Screaming at the top of his lungs in an effort to wake up me and my partner.

He’s hungry and he doesn’t care if we’re asleep – it’s time for cat breakfast.

Trust me when I tell you that we have tried a number of workarounds to help avoid this daily cat alarm clock.

We have attempted to ignore his screams. We have tried feeding him a bigger meal later at night before bed. And we have left dry food out overnight.

We even gave him a late-night catnip snack in hopes that it would help him sleep later into the morning.

Goose doesn’t give a shit about any of that. He still gets up at 5 a.m. every single morning so that we can feed him.

Turns out, though, this daily ordeal may actually be helping me manage my chronic pain from Ehler-Danlos syndrome.

GOOSE AND CRYSTAL

New research from Cigna shows that having a strong sense of purpose can help offset the effects of chronic disease. And every single morning, Goose makes sure that I know that my purpose is to take care of him.

Cigna researchers found that while adults with chronic conditions usually have much lower vitality scores than those who are not sick, the same does not hold true when they also have a strong sense of purpose. 

Adults with chronic conditions and a strong sense of purpose actually have a significantly higher vitality score — nearly matching the scores of people without health issues. Cigna defines vitality as the ability to pursue life with health, strength and energy. 

People with a strong sense of purpose are significantly more likely to have vitality than those who do not (89% vs. 61%). They are also five times more likely to say they feel energized (63% vs. 13%) and nearly three times as likely to look forward to each new day (86% vs. 31%).

Notably, having a strong sense of purpose is linked to greater ownership of physical health — 84% of adults with strong purpose say they feel in control of their health vs. 55% of those without strong purpose. People with a strong purpose are also more likely to get regular exercise, sleep better, and to see their doctors for regular checkups. They also have less anxiety and depression.

“Having a sense of purpose gives people energy and helps them feel happier and healthier,” says Stuart Lustig, MD, National Medical Executive for Behavioral Health at Cigna. “When you know what matters to you, you’re more likely to bounce back from tough times, build strong friendships, and take care of yourself, which impacts your overall physical health.”

It can be easy to shrink into yourself when you’re dealing with chronic health problems, especially when it comes to chronic pain. And truth be told, one of the reasons I resisted my fiancé’s pleas to get a cat in the first place is that I was worried I wouldn’t be able to take care of the cat on bad pain days. 

But as fate would have it, having Goose actually helps me get through the bad pain days —  especially when he is waking me from a deep sleep by screaming for breakfast. In fact, Goose and his cat sisters give my life meaning and make me feel needed every morning, even on the days when I don’t feel like I have much to give.

Of course, you don’t have to get a cat to have a sense of purpose. You don’t even need to have a constant level of activity. Small, gentle acts of generosity can go a long way. 

There are many things in my own life beyond my cats that help me see the world outside of myself and my chronic pain. I also care for my elderly grandma, babysit my niece, volunteer at a local animal shelter, and cook for my family on a regular basis. I also write these columns, which gives me a very direct connection between my pain and my purpose. 

Finding purpose can happen in a million small ways, throughout the days and years. As the old saying goes, it’s better to give than to receive.  And ultimately, when you give, you do, in fact, receive.  

Study Shows Anger Makes Chronic Pain Worse

By Crystal Lindell

A new study claims that the angrier someone is about their chronic pain, the worse their pain will be. But to be honest, the whole thing kind of pisses me off.

All kidding aside, the research published in The Journal of Pain, looked at four distinct “multidimensional anger profiles” in pain sufferers.

Researchers followed 735 adult patients with different types of chronic pain, assessing how they experience, express and control anger, and how strongly they feel about being wronged by their situation. About a third of the participants completed follow-up assessments 5 months later.

They found that people with medium to high levels of anger and feelings of “perceived injustice” had some of the most severe pain. They reported greater pain intensity, more widespread pain, and higher levels of disability and emotional distress. 

In contrast, people who seemed to manage their anger more effectively and viewed their condition with less resentment tended to have less pain..

However, the researchers did not clarify which treatments the patients had access to or how being denied treatment impacted their pain. Instead, they encouraged doctors to make an “early assessment” of patients that emphasizes “the need for tailored, anger-focused, patient-specific interventions.”

One of the biggest issues I have with this study is that it sets up doctors to blame the patient’s demeanor and mood for their physical pain – something they are often already prone to do. 

I can hear the in-office conversations now.

“Have you tried being less angry?” the doctor asks, as though he’s offering an actual treatment option to the patient sitting on a cold exam table.

The question would rightly be infuriating, which would then just lead the doctor to type in their notes that the patient’s pain is partly caused by their inherent anger and sense of injustice.

Leaving the insulted patient in a state of untreated limbo. 

Yes, people whose pain is left untreated or poorly treated are more likely to be justifiably angry overall. And they are especially more likely to feel like their pain is unjust.

In fact, anger is a very appropriate response to such suffering. It inspires you to push those around you to help you find relief. And unfortunately, it’s often required to get real help from medical doctors. 

In the study's conclusion, the authors admit as much.

"Anger is not inherently harmful - when adaptive, it can be a strong motivator, helping individuals set boundaries and navigate challenges," wrote lead author Gadi Gilam, PhD, a psychologist and neuroscientist at the Hebrew University of Jerusalem. "Rather than eliminating anger, interventions should harness this adaptive potential while mitigating its harmfulness."

Perhaps they could also focus on interventions that actually treat physical pain? Especially since the most effective treatment for many types of pain – opioids – has been severely restricted over the last decade.

Anyone who tells you they’d be calm and accepting while dealing with chronic pain, while at the same time knowing there was an effective treatment they weren’t allowed to have, is lying to you.

It’s actually very normal to be angry in that situation and to feel a strong sense of injustice. The situation itself is not just. 

I have long said that lack of sleep will make you crazy so much faster than you expect, and a version of that applies to pain as well. Unrelenting pain will make you angry so much faster than you expect.

Rather than trying to treat the anger, doctors should focus on the source, and treat the pain itself. 

7 Gift Ideas for People with Chronic Illness

By Crystal Lindell

Black Friday marks the unofficial start of the holiday shopping season, and that means hunting for the perfect gifts for those we love.

Below are some gift ideas for loved ones with chronic pain and illness. It’s a gift list you can trust because it’s all based on my own experiences of living with daily pain myself for over a decade.

All of these items also make a great addition to your own holiday wish lists, if you have chronic condition yourself. 

1. Comfy Clothes

The #1 must-have fashion item for people with chronic pain is any clothes that are super comfortable. 

When you have chronic pain, clothing comfort just takes precedent over the latest trends. 

I personally have re-purchased these comfy pants more than 7 times over the last few years. I love how soft they are, and I love that they have pockets! 

But any comfy clothes, from sweat shirts to pajama pants, make a great gift for those with chronic pain. 

Find Women’s Jogger Pants on Amazon 

2. Heated Blanket

There’s nothing better than getting under a cozy heated blanket when you’re dealing with chronic pain. Even if someone already owns one, there’s always a need for one more! 

This heated blanket is my favorite and not only do I own two myself, I’ve also purchased it as a gift for loved ones over the years. And all of them always come back to tell me how much they love it! 

Find this Heated Blanket on Amazon

3. Reminders of Your Love

Little trinkets like a keychain can be a great way to give a constant reminder of your love for someone. Every time they see it, they can think of how much you care about them. 

This keychain features the phrase, “May you always have one more spoon.” It’s a reference to the Spoon Theory, which uses spoons to illustrate the limited energy that people with chronic pain and illness often have. 

It doesn’t have to be a key chain though. A special coffee mug or a bracelet can also make great gifts! 

Find the Spoon Theory keychain on Amazon 

4. Lego

Of course, it doesn’t have to be Lego specifically, but any sort of home-based hobby activities are great for people with chronic pain. 

I personally love this Lego Cat because I’m a huge cat person as well as a huge Lego fan. 

But you can also get your loved ones art supplies, crafting tools, or any other projects they can work on at home.

And bonus points if they can do it from the couch on bad pain days. 

Find the Lego Tuxedo Cat on Amazon 

5. A Good Book

Some days, a pain flare means I don’t have the energy to do anything other than read a book. So having good ones around that I know a loved one recommends is always welcome! 

I recently read The Frozen River by Arial Lawhon, and I really enjoyed the cozy winter setting and completely immersive 1700s plot. 

But you can really buy any book that you’d recommend to share as a gift with your loved ones. 

Also be sure to check out PNN’s holiday reading guide, which has books to help you better understand and treat many chronic pain conditions.  

Find The Frozen River on Amazon 

6. Bread Machine

While a bread machine may not seem like a gift typically associated with chronic pain, it’s actually perfect.

A good bread machine makes it super easy to whip up homemade bread, even when you’re also dealing with a pain flare. You just toss the ingredients in, hit start and presto! A perfect loaf of homemade bread!

It’s also great for anyone on a restrictive diet, since you can easily customize the ingredients. There’s even a setting for a gluten-free loaf! 

Find the Bread Machine on Amazon 

7. Gift Cards

Of course, when in doubt, it’s always a good idea to go with a gift card, especially if you’re shopping at the last minute — because the cards can be instantly delivered via text. 

That way your loved one is guaranteed to get the perfect holiday gift, because they pick it out themselves!

Happy shopping this holiday season!

Find Gift Cards on Amazon

We hope you have happy holidays, and many low pain days in the year ahead! 

PNN makes a small commission, at not additional cost to you, on items purchased through Amazon. 

Does Mindfulness Really Help with Chronic Pain?

By Neen Monty

“Mindfulness” is one of those words that’s been stretched so far it’s almost lost its meaning. We’re told it will calm our nerves, ease our pain, and maybe even transform our lives. 

But what is mindfulness, really? And what can it actually do for people living with chronic pain?

The popular definition goes something like this: Mindfulness is the practice of focusing your awareness on the present moment, without judgment.

Does that make sense to you? It didn’t make sense to me the first time I heard it. It sounds so simple… but it’s not so simple to do.

Most people think mindfulness is meditation. It’s not. Mindfulness is a state of awareness, a way of relating to your thoughts and sensations, while meditation is a tool that helps you develop that state. Meditation is how we practice mindfulness, the training ground for the skill of self-awareness.

Clear? As mud…

Okay, let me try again. At its core, mindfulness rests on two ideas:

1. Paying attention to the present moment.

2. Doing so without judgment.

That second part is the hardest. It can take a lot of practice. But in practical terms, living mindfully is living in the present moment. It’s not wasting time worrying about a future that may never happen, or dwelling on a past that can’t be changed.

The Difference Between Pain and Suffering

Let’s use pain as an example. Being mindful doesn’t mean ignoring pain or pretending it’s not there. It means noticing it: “I feel pain right now” and stopping there.

What we usually do next is the problem: “Oh no, it’s back. The pain is so bad! It’s going to get worse. I can’t take this anymore.”

Those thoughts are the suffering part. They layer emotion, fear, and meaning on top of the physical sensation of pain.

Mindfulness helps peel that layer away. Pain still hurts, but without the extra story, the extra worry, the panic, the hopelessness and the emotional response. It’s just pain.

Pain then becomes something we can observe, without emotion, rather than something that swallows us whole. This distinction isn’t just philosophical. Brain imaging studies show that mindfulness changes the way we process both thoughts and sensations.

Meditation strengthens brain regions that regulate attention and emotion, such as the prefrontal cortex and anterior cingulate cortex, while reducing reactivity in the amygdala, the brain’s alarm system. Other reviews confirm that meditation produces measurable neurobiological changes that are associated with greater emotional stability and self-regulation.

Over time, meditation helps the mind become less reactive. We learn to notice sensations, thoughts, and emotions without immediately trying to fight or fix them. 

Instead of launching into fight or flight, we remain calm and in control. Meditation, in that sense, is kind of the laboratory in which mindfulness is trained.

The Limits of Mindfulness

Does mindfulness cure pain? No. It does not.

Systematic reviews and meta-analyses find that mindfulness training has only small effects on pain intensity. What it does reduce is distress — the anxiety, fear, and emotional turmoil that often surrounds chronic pain.

That distinction matters. Mindfulness was originally designed as a treatment for stress and anxiety. And therefore, its benefits for pain are more indirect. It helps people who are fearful of pain or overwhelmed by it, to regulate their emotions and cope better.

But, if you’re already calm and accepted your pain without fear, mindfulness won’t make the pain go away. It won’t have much effect at all on your pain.

Most importantly, mindfulness is not a treatment for severe pain. You cannot be mindful and you cannot meditate, when you’re in severe pain. Mindfulness is not an intervention for 8 or 9/10 pain. That’s pure cruelty. I would even call that medical negligence.

Mindfulness is a treatment for fear and anxiety in the setting of chronic pain. In that sense, mindfulness may be helpful for someone in mild to moderate pain, where there is a lot of negative emotion surrounding that pain – such as fear, anxiety and catastrophising.

Mindfulness is a psychological tool, a treatment for fear and anxiety that’s been repurposed for pain. 

And often oversold as something it’s not.

Why Mindfulness Is Still Worth Trying

Even within those limits, I still believe mindful living is the best way for me to live. It doesn’t make my pain stop. My pain is caused by disease, pathology and biology, not by anxiety or fear.

Mindfulness does make my days quieter. It keeps me from being dragged into fear or frustration. I don’t worry about the future and don’t dwell on the past. Mindful living keeps me grounded. In the present moment. Because that’s where life is happening – the here and now.

That’s what mindfulness is, living in the present moment.

Mindfulness won’t fix what’s broken in the body. Mindfulness cannot fix pathology. But it can help restore what pain often breaks in the mind: calmness, control, and your sense of peace in the middle of chaos.

And sometimes, that’s enough.

Neen Monty is a patient advocate in Australia who lives with rheumatoid arthritis and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), a progressive neurological disease that attacks the nerves.

Neen is dedicated to challenging misinformation and promoting access to safe, effective pain relief. She has created a website for Pain Patient Advocacy Australia to show that prescription opioids can be safe and effective, even when taken long term. You can subscribe to Neen’s free newsletter on Substack, “Arthritic Chick on Chronic Pain.”

5 Tips for Surviving the Holiday Season with Chronic Pain

By Crystal Lindell

The holiday season kicks off this week, but for people with chronic pain, this time of year can be difficult to navigate. 

Below are some tips for surviving the season while also dealing with chronic pain and illness. You can trust that they actually work, because all of them are gleaned from my own experiences of surviving the holidays while dealing with chronic pain myself.  

1. Check Your Pharmacy Schedule

A lot of pharmacies are closed on holidays or they close early, so if you have refills scheduled on those days, it’s best to plan ahead. Make sure you know when they are open so you can get your medications.

If you have a refill scheduled for a day when your pharmacy is closed, you may want to ask your doctor if they can send in any refill prescriptions the day before the holiday.

In my experience, a lot of doctors are surprisingly accommodating about this. Of course, if they refuse, you can ration out your medication a little so that you have enough to cover the holiday.  

2. Embrace Pre-Made Food

One of the most draining tasks over the holiday season is cooking. So, I highly recommend embracing pre-made food options.

Whether that means grabbing pre-made sides from the grocery store or ordering a fully prepared holiday feast from a local restaurant, outsourcing the labor of cooking can be a huge help if you have chronic pain.

Obviously though, buying pre-made food does usually cost more than cooking from scratch, but if you’re really in a pinch, I do have one more suggestion: Order takeout.

Fast food is usually inexpensive and quick, which means you’ll have more time and energy to actually enjoy the holiday season with loved ones.

Later, when you look back on those memories, it won’t matter if dinner was tacos or chicken wings, as long as you were all together. 

3. Include Rest Days in Your Holiday Plans

If you have multiple family functions to attend, try your best to plan days of rest into your schedule. 

Put “Rest” on your calendar as though it were any other required activity. And if it conflicts with other events, don’t be afraid to say that you just can’t make it. 

I know that saying “no” is easier to suggest than actually accomplish, especially when it comes to family. So if you do get pressured into doing multiple events in a row, just do your best to schedule an equal number of guilt-free rest days afterward. Emphasis on the “guilt-free.”

For example, if you have plans on Christmas Eve and Christmas Day, try to use Dec. 26 and Dec. 27 to recover. And I don’t mean, spend those days cleaning up, I mean actual rest.

When you’re dealing with chronic illness, providing your body with rest is just as important as providing food. 

4. Wear Compression Socks on Long Trips

Swollen feet and ankles are a common side effect of both chronic illness and many prescription medications.

So, if you’re traveling this holiday season — whether it’s a three-hour flight or a one-hour drive — I highly recommend wearing compression socks during your trip. Aside from preventing swelling, they can also help prevent dangerous blood clots.

5. Use Gift Bags

Wrapping gifts is a lot more time consuming than people usually like to admit, so do yourself a favor and just use gift bags instead. And save the ones you get, so you can reuse them next year.

Gift bags don’t have to be expensive either. If you head over to Dollar Tree, you can find a wide assortment of gift bags for just $1.25 each. 

The holiday season can easily turn into a series of stressors and pain triggers, but if you plan ahead and allow yourself some grace, you still can enjoy it — even with chronic pain. 

Winter Taught Me a Better Way to Cope with Chronic Pain

By Crystal Lindell

We’ve already had our first snowfall here in northern Illinois. Regardless of the official day winter begins next month, the first snow marks the start of winter for us.

And when you have chronic pain, the season brings with it cursed gifts, offering both a time of guilt-free rest and more days of ache.

During the summer, there’s a guilt that accompanies any days spent inside, even if you’re doing it because your pain is too intense to allow for anything else. Watching TV all day makes me feel like I am personally wasting the warm weather and sunshine.  

But that is not the case in winter. Instead, the long nights and cold days allow me to embrace the comfort of staying in, curled up under layers of blankets. 

I already have my Christmas tree up, and the warm glow makes being a couch potato seem almost magical.

And since the sky turns midnight blue at 5 pm, it suddenly feels almost natural to go to bed early. 

These are things my chronic pain-riddled body enjoys year-round. But in the winter, societal expectations allow me to indulge in the impulse to take full rest days or even rest weeks, without feeling the summertime angst about it.

The change in seasons also brings with it lots of changes in barometric pressure, which means all those cozy evenings come with a downside.

My body always knows when it’s about to snow, or sleet or both. It also feels every temperature change as it happens. Anytime it goes from -10 degrees to 40 and back again, my ribs feel it. 

The result is often multiple days spent with the type of excruciating pain that barely even responds to opioid pain medication.

Over the years, I have found that the only treatment that works for those pain flares is to accept them. I can’t stress myself out about it, because it only serves to escalate the pain. So I have to try to stay as calm as possible. My body can’t handle activity under those circumstances.

Which brings me back to those guilt-free rest days that winter supplies in ample amounts. And embracing things instead of trying to fight them.

Growing up in the Midwest, I was often taught that winter was a season to be fought and denied. Just a few months that we all had to endure until the “real” weather came back. Most people here spend the winter complaining, cursing, and just trying to survive.

A few years ago, I took a trip to Montreal, Canada in January, and witnessed an entirely different approach. Despite the fact that the holiday season was well behind us, the city was filled with winter festival activities, ice statues, colorful lights, and just a general sense that the dark and cold days were actually a good thing.

The experience has since shaped my own approach to the coldest months of the year. I do my best to appreciate the gifts that gray days and eternal nights bring. It’s a time for all of us to rest, refocus, and embrace the downtime the cold weather affords us.

Embracing pain has the same effect. When you learn to let it exist, it is paradoxically easier to keep it confined to smaller flare ups.

Weather forecasters predict many of us are in for a particularly harsh winter this year, with more snow and colder temperatures. 

But that doesn’t mean it has to be a slog.

When we take the winter season as it is, it can bear its gifts of rest and time. And who among us doesn't need more of both?

Chronic Pain Raises Risk of High Blood Pressure

By Pat Anson

Having untreated or poorly treated chronic pain is known to raise the risk of serious health problems, including high cholesterol, elevated pulse, arteriosclerosis, and heart attack..

So it should come as no surprise that chronic pain also increases the risk of high blood pressure, according to a new study by the American Heart Association, which found that the extent and location of the pain may determine the level of risk. 

Someone with chronic widespread body pain, for example, has a 74% higher risk of developing high blood pressure; while chronic headaches are associated with a 22% higher risk and chronic back pain has a 16% higher risk.

“The more widespread their pain, the higher their risk of developing high blood pressure,” said Jill Pell, MD, Professor of Public Health at the University of Glasgow in the UK and lead author of the study published in the journal Hypertension.

“Part of the explanation for this finding was that having chronic pain made people more likely to have depression, and then having depression made people more likely to develop high blood pressure. This suggests that early detection and treatment of depression, among people with pain, may help to reduce their risk of developing high blood pressure.”

Pell and her colleagues analyzed over 13 years of health data from more than 200,000 adults enrolled in the UK Biobank Project. Participants completed a baseline questionnaire that asked if they had experienced pain in the last month that interfered with their usual activities. 

They also noted if the pain was in their head, face, neck/shoulder, back, stomach/abdomen, hip, knee, or all over their body. If they reported pain, they indicated whether pain persisted for more than three months.

Depression was measured based on participants’ responses to questions about the frequency of a depressed mood, disinterest in activities, restlessness or lethargy. Inflammation was measured with blood tests for C-reactive protein (CRP).

At the end of the study period, nearly 10% of all participants developed high blood pressure, which is considered a blood pressure measurement higher than 130/80 mm Hg or 140/90 mm Hg.

Compared to people with no pain, people with short-term acute pain had a 10% greater risk of high blood pressure, while those with chronic localized pain had a 20% higher risk.

When comparing sites of pain, there was a wide variation in risk levels:

• 74% higher risk for chronic widespread pain

• 43% higher risk for chronic abdominal pain

• 22% higher risk for chronic headaches

• 19% higher risk for chronic neck or shoulder pain

• 17% higher risk for chronic hip pain

• 16% higher risk for chronic back pain

Depression and inflammation accounted for 11.7% of the association between chronic pain and high blood pressure.

The findings highlight the need for good pain management to prevent or reduce the risk of hypertension and other health problems.

“When providing care for people with pain, health care workers need to be aware that they are at higher risk of developing high blood pressure, either directly or via depression. Recognizing pain could help detect and treat these additional conditions early,” Pell said.

Pain Relievers Can Cause High Blood Pressure

Another consideration is the need for further studies on the role of pain medicine in high blood pressure. Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) may increase blood pressure and worsen pre-existing hypertension. They can also interfere with the effectiveness of some blood pressure medications. 

The effect is more pronounced with some NSAIDs over others. Aspirin, for example, appears to have less effect on blood pressure than naproxen, which can cause the body to retain salt and water, leading to fluid buildup and hypertension. 

Opioids can cause both low and high blood pressure, depending on the dose and duration of use. Sudden discontinuation of long-term opioid use is associated with increased blood pressure

“Chronic pain needs to be managed within the context of the patients’ blood pressure, especially in consideration of the use of pain medication that may adversely affect blood pressure,” said Daniel Jones, MD, Dean and Professor Emeritus at the University of Mississippi School of Medicine.

One limitation of the study is that participants were middle- and older-aged adults who were mainly white and of British origin – therefore the findings may not apply to people from other racial or ethnic groups, or who live in other countries.

Other contributing factors is that participants reporting pain were more likely to be women, have an unhealthy lifestyle, larger waists, higher body mass index (BMI), more long-term health problems, and live in areas with higher unemployment, lower home and car ownership, and more overcrowding.

Opioid Prescribing Down Significantly for U.S. Nursing Home Residents

By Pat Anson

Opioid prescribing to U.S. nursing home residents declined significantly over the past decade, the latest sign that efforts to limit access to opioid medication are impacting patients who need them for pain relief.

Researchers at University of California San Francisco (UCSF) looked at health data for nearly 3 million Medicare beneficiaries and found that the likelihood of nursing home residents receiving a prescription opioid fell from 48% in 2011 to 33.5% in 2022. 

The chances of a resident receiving a high daily dose above 50 morphine milligram equivalents (MME) also declined, from 25.1% to 21.9%. 

Over half of nursing home residents have chronic pain from arthritis, osteoporosis, degenerative disc disease and other age-related conditions. The average age of residents in this study was 84.

“We weren’t expecting to see a decline, especially for people who are actually reporting high incidence of chronic pain,” first author Ulrike Muench, an associate professor at UCSF School of Nursing, told the San Francisco Chronicle. “It might be a good thing that opioids are used less, but at the same time it raises concerns about potentially untreated pain for individuals who are in need of pain medications.”

The study is believed to be the first to examine opioid prescribing to nursing home residents after the release of the CDC’s 2016 opioid guideline. Although that voluntary guideline was intended only for patients being treated for chronic pain by primary care providers, it essentially became the default guideline for all patients and doctors of every specialty.

Opioid prescriptions to nursing home residents were falling even before the CDC guideline was released, with the decline affecting every racial and ethnic group. 

Opioid Prescribing to U.S. Nursing Home Residents

JAMA INTERNAL MEDICINE

“These reductions parallel national patterns in primary care and may reflect implications of opioid-related policies, such as the 2016 Guideline, extending beyond their intended setting. Some residents may have benefitted from opioid reductions, but others may face barriers to adequate pain control,” researchers reported in JAMA Internal Medicine.    

“We also observed that minoritized residents were consistently less likely to receive opioids and higher daily MMEs, suggesting that prescribing decisions may not be based solely on clinical need.”

White nursing home residents were significantly more likely to be prescribed an opioid for pain than residents who are Black, Hispanic, Asian or Native American, even though minority residents are more likely to have severe pain.   

Previous studies have also documented declines in opioid prescribing to cancer patients, as well as seriously ill patients in palliative or hospice care  – groups that were supposed to be exempt from the CDC guideline.

Eli Lilly Abandons Another Experimental Non-Opioid Pain Reliever

By Crystal Lindell

Eli Lilly's experimental non-opioid pain medication – named LY3857210 – had lackluster results in clinical trials, the latest setback for Big Pharma in developing alternatives to opioid analgesics.  

The pharmaceutical company told Fierce Biotech that the oral medication, which is a P2X7 inhibitor, "did not meet our high internal bar for success and is being removed from the pipeline for pain."

P2X7 inhibitors are being studied for their potential to relieve chronic pain and cancer-related pain by inhibiting inflammation and nerve signaling. 

But when Lilly tested LY3857210 in Phase 2 trials on patients with osteoarthritis and diabetic neuropathic pain, it performed no better than a placebo in relieving pain. 

The company originally purchased licensing for the drug from Asahi Kasei Pharma in 2021 for $20 million. The Japanese pharmaceutical company had already put the drug through Phase 1 testing when Eli Lilly stepped in.

Although it did not prove to be helpful for pain, Lilly said they were still exploring other uses for it.

In August of this year, Lilly also halted development of mazisotine, another non-opioid pain medication it was developing. Mazisotine blocks pain signals in peripheral nerves, but also had disappointing results in Phase 2 trials.

Lilly is still focused on finding non-opioid pain treatments. In May of this year, the company acquired SiteOne Therapeutics in a deal worth as much as $1 billion. At the time, SiteOne said it was “dedicated to the development of safe and effective pain therapeutics without the significant addiction potential and side effects of opioids.”

SiteOne had been working on a new class of non-opioid medications that target sodium channels in the peripheral nervous system to treat pain and other nerve conditions. Blocking pain signals in peripheral nerves before they reach the brain means the drug theoretically is less likely to lead to addiction or overdoses.

But that approach to pain relief has had mixed results. In August, Vertex Pharmaceuticals halted development of a drug called VX-993 after disappointing results in clinical trials.VX-993 is another non-opioid that blocks pain signals in peripheral nerves, but when given to patients recovering from bunionectomy surgery, it was only slightly more effective than a placebo.

VX-993 is similar to Journavx (suzetrigine), a non-opioid developed by Vertex that also works on peripheral nerves. Journavx was approved by the FDA in January to treat moderate to severe acute pain, despite results in clinical trials that showed it was no more effective than Vicodin.

Opioid Prescribing Falls in Canada, But Are Patients Better Off?

By Pat Anson

The number of patients prescribed opioids for pain in Canada has fallen over 11% in recent years, according to a new study published in the Canadian Medical Association Journal (CMAJ). The decline reflects trends in the U.S. and other Western nations, which adopted stronger guidelines to discourage opioid prescribing nearly a decade ago.

Like most studies of its kind, the new research only looked at the number of opioid prescriptions that were dispensed, and did not evaluate the health or quality of life of Canadian patients after access to opioids was reduced, or whether their pain improved using non-opioid pain therapies.

In 2022, about 1.8 million Canadians began taking an opioid to manage pain for the first time, 8% less than when the study period began in 2018.

“Our study provides valuable information on the progressive decline of prescription opioid dispensing for pain and high-dose initiations among new users, as well as the types of opioids prescribed and important geographic differences in these trends across Canada,” wrote lead author Nevena Rebić, PhD, a clinical researcher at Unity Health Toronto.

“Our findings suggest that national efforts to promote opioid stewardship and safer opioid prescribing for acute and chronic noncancer pain over the past decade have had an impact.”

“High-dose initiations” were defined as daily dosages that are above Canada’s recommended dose of 50 morphine milligram equivalents (MME) or lower. Less than 20% of new prescriptions in Canada exceeded 50 MME. Over half of the opioid prescriptions were for codeine.

Patients most likely to be prescribed an opioid were females, older adults, rural residents, and those living in lower-income areas.

Manitoba consistently had the highest rate of opioid prescribing, while British Columbia had the lowest among the six provinces that were studied. The lower rate in BC is somewhat surprising, given the province’s reputation as the being the epicenter of the “opioid crisis” in Canada.

Monthly Rate of Opioid Prescribing in 6 Canadian Provinces

SOURCE: CMAJ

Rebić and her colleagues cautioned that “ongoing monitoring is needed” to ensure that pain patients are not left suffering from inadequate pain management, rapid opioid tapering or discontinuation, or that they turn to street drugs for relief. The authors acknowledge that has occurred “in some cases,” without exploring the severity of the problem.

“If the (opioid) pain prescribing is better, then why do we still get letters from patients in extreme pain telling us they were cut off, tapered or refused medical care?” asks Marvin Ross of the Chronic Pain Association of Canada (CPAC), which has long criticized Health Canada and the authors of Canada’s medical guidelines for discouraging the use of opioids.

Ross said the new analysis of opioid prescriptions was “a waste of time, money and effort,” and called the researchers “inane pill counters” who lack clinical experience with patients.

“The purpose of prescribing a pill is to help the patient get better or to ameliorate their symptoms, so saying we prescribed 10% fewer pills tells you nothing about that. To focus on the number says nothing about achieving prescribing goals unless you begin from the bias that prescribing any of it is bad,” Ross told PNN in an email. 

In a commentary on the study also published in CMAJ, an anti-opioid activist claimed that addiction and other potential harms of opioids are being overlooked by Canadian doctors who still prescribe them too freely.

“Most clinicians have seen first-hand how well opioids can work when first given. But they are at their pharmacologic best in the initial days of treatment. Continue them for weeks, months, or years and the calculus becomes progressively less favourable,” wrote David Juurlink, MD, a clinical internist at Sunnybrook Research Institute, and a member of Physicians for Responsible Opioid Prescribing (PROP).

“In this way, opioids transition from effective analgesics to drugs required primarily to stave off a withdrawal syndrome they themselves created.”

According to a recent analysis by Health Canada, only 18% of fatal opioid overdoses in Canada in early 2025 involved a pharmaceutical opioid. The vast majority of deaths were linked to illicit fentanyl, fentanyl analogues, and other illicit opioids such as heroin.

Does Having Chronic Pain Mean I’ll Die Young?

By Crystal Lindell

This morning I got news that someone I knew had passed away.

I describe him as “someone I knew” because my connection to Rich is difficult to explain. He was my fiancé’s, late-mom’s, long-time boyfriend. Basically, my step-father-in-law. Ish.

After battling a bad cold, which may or may not have been COVID, he had an aneurysm and then spent a couple weeks in the ICU before passing away last night.

It’s the kind of news that’s both expected and painfully shocking.

He was too young. Just 58 years old. But his short life had been hard on him and his body. He had spent years doing manual labor and treating his pain with multiple types of medications. 

So, in retrospect, if you had asked me for a prediction, I would have told you that I never expected Rich to live to see old age.

But I didn’t really expect him to die at 58 either.

Since 2020, nine people I knew have died. Two long-time friends, my cousin, my dad, my aunt, my step-dad, my fiancé’s mom, my former boss, and now, Rich.

My fiancé Chris and I got engaged in December 2020 and he’s still my “fiancé” in large part because the onslaught of death seemed to freeze my brain in such a way that made it impossible to plan a wedding.

And now, a quarter of our would-be guest list is dead.

Many of the dead were very young. My age. All of them were too young. None of them made it to their 70s.

I can’t help but consider my own mortality. And it’s made me realize something I had been trying to avoid: People who develop severe chronic pain at 29, like I did, often don’t live long enough to be considered old. And when they do, they are the exception to the rule.

Even if the pain itself isn’t terminal, everything else will surely have an easier time taking me out. It’s not like I’m in peak disease-fighting shape. 

Not to mention all the damage that taking pills for breakfast every morning must be doing to my organs.  

The thing about the kind of nebulous chronic pain that I have is that I never got to have one of those movie-scene conversations in a doctor’s office where they clearly explain how dire my situation is. I suspect those conversations are reserved for illnesses that show up on blood work and CT Scans.

My pain has always been something only I could feel, and nobody else could see or test.

As such, my doctors have always been some mix of hopeful and dismissive about my ailment. They’d tell me that maybe I’d magically get better one day, while also telling me that they couldn’t find anything wrong with my ribs. 

And none of them have ever spoken directly to me about the many ways that chronic pain and my eventual diagnosis with Ehler-Danlos Syndrome might shorten my life expectancy. Technically, neither one is supposed to on its own. 

That doesn’t mean they can’t though. And I suspect the doctors know this, given the fact that they are willing to prescribe me the kind of opioid regime most people don’t ever go off of.

These days, I’m known among my loved ones as having “a lot of health issues,” while among my acquaintances I’m known as “the one who writes about her chronic pain online.”

So someday, when they all get the news of my death, I’m sure none of them will be too shocked. People aren’t surprised when someone like me, with a rare disease that causes chronic pain, dies young. They’re surprised when we don’t.

There was a time, in my early days with chronic pain, when I prayed for death. A time when I could not imagine spending years of my life with stabbing rib pain.

But over the years I came to accept it, and learned to manage it as much as medication would allow.

I’m 42 now, and a few years ago I started letting my gray roots grow out. 

After being surrounded by so much death, I saw them now as my silver trophy. My prize for making it to my 40s — a privilege that some of my late friends never got to experience.

How lucky am I to have lived long enough to have gray hair?

How lucky am I to be old enough for wrinkles? To have reached the age where I’m now slowly losing my ability to read small print? To be alive to complain about how hard it is to stand up, now that my body is aging.

How fortunate am I? How fantastic for me.

I can only hope that I make it much, much longer. Maybe another 42 years, if I’m truly lucky. But if not, I have faced my own mortality. I can see clearly just how fragile it is. And I’m okay with that.

I will spend my days baking, caring for loved ones, and writing. I will focus on all the things I would be focused on if I had ever gotten to have one of those somber doctor office conversations about my health. All the things that everyone realizes truly matter in life — right when they are about to run out of life themselves.

So even if I’m not OK, I will be OK.

Where Pain Research Is Headed and Why I’m Hopeful

By Dr. Lynn Webster

If you live with pain, you’ve probably heard promises that “something better is coming.” At this month’s Pain Therapeutics Summit in San Diego, you could see that promise taking shape. For two days, clinicians, scientists, companies and advocates compared notes on what’s working, what’s not, and what’s next.

Threaded through much of it was the National Institutes of Health’s Helping to End Addiction Long-Term (HEAL) Initiative -- an NIH-wide push launched in 2018 to accelerate better pain care and reduce opioid-related harms.

HEAL exists because of the opioid crisis; Congress gave NIH an initial $500 million in fiscal year 2018 to jump-start a coordinated research plan, and the NIH has since invested several billion dollars to keep the effort moving. In other words, HEAL is a rare silver lining: a tragedy spurring a sustained, practical response.

(The HEAL Initiative was not directly hit by any funding cuts in 2025. However, the Trump administration has proposed cutting the NIH budget by 40% next year, which could potentially impact HEAL funding.)

Since its launch, HEAL has grown into a national engine for discovery. NIH reports a cumulative investment approaching $4 billion, supporting more than 2,000 projects across all 50 states, and helping advance 40-plus new drugs and devices to FDA investigational status.

This is a sign that the pipeline is broader and closer to patients than it has been in years. Think of HEAL as scaffolding: trial networks, shared data standards, and coordinated teams that help good ideas climb faster from lab to bedside.

A decade ago, analgesic research often looked like isolated bets. Today, it feels more like a coordinated campaign. That doesn’t guarantee success, but it raises the odds that something useful will reach doctors and patients.

Just as important, what’s coming isn’t a single “miracle drug” but a wider toolkit. You’ll see more non-opioid medicines designed around the biology of different pain types; safer use of existing tools that can lower the need for higher doses when opioids are used; devices and neuromodulation approaches that calm overactive nerves or brain circuits; smarter drug delivery systems that make treatments last longer or act locally at lower doses; and digital health that captures how people actually live -- including their sleep, activity, and pain flares -- so that care decisions track real life, not just clinic visits.

The studies themselves are changing, too. Many people don’t have just one pain condition; they have overlapping problems. Newer trials are beginning to mirror that reality and to focus on outcomes you can actually experience -- walking farther, sleeping better, and participating more in life -- rather than only chasing a number on a pain scale.

Researchers are also building better signposts, such as biomarkers and other objective measures, to predict who will benefit from which therapy and who may be at risk of long-term pain after injury or surgery.

Signposts aren’t a substitute for what people tell us about their pain. In research and development, objective measures help compare treatments and identify who is most likely to benefit. Once a therapy reaches the clinic, those measures become guides, not verdicts, and should be read alongside the patient’s narrative so that care reflects how the person actually lives and feels.

HEAL has made these shifts a priority by funding large, practical datasets and endpoints that regulators and payers can use.

Here’s the clear-eyed part: many of the drugs and devices discussed at meetings like this will not make it past the investigational stage. That’s how science works. But when trials are well designed and data are shared, today’s misses can more quickly lead to tomorrow’s wins -- and the lessons won’t vanish into a file drawer.

Some analgesic candidates will cross the finish line, and even modest gains -- better sleep, fewer flares, less brain fog, or an extra hour of activity -- can change a life. Across millions of people, small wins add up to something transformative.

What does this mean if you’re living with pain right now? Expect more choices and more personalization. Conversations with your clinician may start to include options that didn’t exist a few years ago, and you may hear about clinical studies built around everyday life rather than rigid clinic schedules. If a trial is a good fit, participating in one will help move the field forward.

Most of all, there’s a reason for hope that is grounded in real progress, not hype.

None of this happened by accident. The NIH HEAL Initiative has been the engine behind much of it -- steady funding, coordination, and a focus on solutions that reach the bedside. Keeping that engine running is how promising ideas become practical relief.

Lynn R. Webster, MD, is a pain and addiction medicine specialist and serves as Executive Vice President of Scientific Affairs at Dr. Vince Clinical Research, where he consults with pharmaceutical companies.

Dr. Webster is the author of the forthcoming book, “Deconstructing Toxic Narratives -- Data, Disparities, and a New Path Forward in the Opioid Crisis,” to be published by Springer Nature. Dr. Webster is not a member of any political or religious organization.

5 Ways to Support a Loved One With Chronic Pain

By Crystal Lindell

Recently I wrote that one of the most important things you need to enjoy life with chronic pain is supportive loved ones.

But what does that look like in practice?

Below are some tips on how to realistically help loved ones who deal with chronic pain.

And if you’re the person in pain reading this, perhaps you can pass this on to your friends, family and other loved ones. Afterall, sometimes getting advice from a third party can help it land better.

Also, of course, if you have your own tips to share, we’d love to read them in the comments!

1. Keep in Touch With Them

If you care about someone with pain, maybe the most important thing you can do is to just stay in contact with them.

Having chronic pain makes it difficult to attend in-person events, but that doesn’t mean we lose the need for human connection. In fact, it just makes that need much stronger.

Sometimes friends fall off because they don’t see you as often, but other times it’s because they don’t want to have to talk to someone with chronic health issues. Those conversations can force them to face the fact that their own body is also fragile and mortal.

But if you actually care about someone, I encourage you to push past all that.

Texting and phone calls can be a lifeline for people with chronic pain — as can in-person visits.

Your interactions with them may be the majority of human interaction they have, and it can be enough to keep them going for another day.

2. Give Them Meals and Help with Chores

When I first started having chronic pain, one of my friends did one of the nicest things anyone has ever done for me – either before or since. She drove 2 hours to come visit me and then cleaned my entire apartment, including the bathroom.

It is not possible to express how grateful I was and how much of a difference that made in my ability to keep going through one of the darkest times in my life. Just having a clean space to exist was like having a weight lifted off my very painful ribs.

While healthy people can take for granted the ability to do daily household tasks like cooking meals and doing the dishes — a person with chronic pain knows how easy it is to fall behind on those things.

And when that happens, on top of the stress of dealing with a broken body, you also have to deal with a messy house. That can come with a lot of guilt and even physical discomfort.  

So, if you’re able to help them with housework in any capacity, that can also lift a truly heavy burden.

Having someone make or drop off meals once a week, or even once a month can also be a massive help. There’s also the option of sending meals with services like DoorDash or Uber Eats, or giving them food delivery gift cards.

It may seem like cooking and cleaning for someone is no big deal, but when you do it for someone with chronic pain, it can be as helpful as the best medication.

3. Don’t Be Offended If Someone Needs Rest

I need more sleep than the average person, I assume because my body is using so much energy to just exist with chronic pain. I also need more time to recover after big events like parties.

It can mean that I can’t respond to calls or text, and that I need a lot of time alone to sleep and rest.

But even my most well-meaning loved ones can take this need for rest as some sort of indictment — as though I just don’t want to be around them or to interact with them.

It’s not about them though, it’s about me and my defective body.

If someone you love has chronic pain and they need a nap, or a couple days to respond to a text, don’t take it personally. It probably just means they needed some extra rest.

4. Go to Doctor’s Appointments With Them

Chronic pain can make it more important than ever to have productive doctor appointments — but it can also make that task more difficult.

That’s why having a loved one attending doctor’s appointments with you is truly invaluable.

A second person being there to focus on what the doctor is saying and to ask questions on your behalf can mean the difference between finding treatments that actually work or not.

It also usually makes doctors take a patient more seriously when they know that a loved one is keeping tabs and will be holding them to account for their treatment outcomes.

So, if you’re able to go to doctor appointments with your loved one with chronic pain, I highly recommend doing so.  

5.  Be Accepting of their Use of Pain Medications

A lot of people face stigma for using pain medications, especially opioids.

But oftentimes, pain medication can become a point of friction between patients and loved ones, who don’t fully understand the importance of alleviating chronic pain.

Other people’s pain is always easy to endure, so it’s always easy to tell someone else that they don’t need to treat their pain.

While loved ones who say such things are usually well-meaning, those conversations can cause a lot of unnecessary stress for people in pain.

It’s best just to assume that if someone is using pain medication, then they need that pain medication.  

In the end, the best advice for supporting a loved one with chronic pain is to treat them how they want to be treated. And to accept that whatever they are going through is at least as bad as they are describing.

When you approach help from that mindset, you’ll often naturally find the best ways to support them.

Having support from loved ones can mean the difference between being able to endure a life with chronic pain or not. It’s just as important for their health as a good doctor is, and it can have just as much impact. 

3 Things You Need to Enjoy Life, Even With Chronic Pain

By Crystal Lindell

If you want to enjoy life again while also living with chronic pain, you need just three things.

1. An effective pain medication.
2. The ability to pace your activity level
3. Supportive loved ones

If you have all three of those things, it’s very possible to enjoy life while also enduring chronic pain. In fact, you could have a very happy life even with severe, debilitating pain every single day.

Unfortunately, of course, many chronic pain patients do not have all three of those things.

Even if they have access to opioids and other pain medications, they may not have the option to pace their activity levels due to things like work and parenting commitments. Or they may not have loved ones who show sympathy for what you’re going through and offer accommodations to make your life easier.

Sadly though, most doctors don’t recognize the importance of having all three things when they are treating chronic pain patients.

“Enjoying life” is usually not something doctors measure during treatments or appointments.  

Personally, I don’t think I have ever had a medical doctor ask me how much I’m enjoying life. Rather, they ask you to rate your pain level, and then either ignore you or send you off to another random specialist.

It’s why they don’t value the importance of prescribing pain medications that actually work, and why they rarely offer education for loved ones about how to better support the people in their life who have chronic pain.

It’s also why doctors rarely explain the importance of pacing your activity levels.

While I have had medical doctors tell me to quit working, I’ve had only one psychologist explain to me that instead of fully quitting, I could just cut back on some activities and plan more rest days.

In other words, stop pushing myself to the point of exhaustion before taking time to rest.

I assume that many doctors don’t grasp the concept of pacing, in large part because of their medical training. Residency scheduling makes it so that they are often working 24-hour shifts, with little time to recover before the next one.

In other words, the exact opposite of pacing.

When you have chronic pain, you can’t live that way though. Of course, technically, you can live that way, but you won’t enjoy life if you do.

If you accept the fact that you need to rest your body from time-to-time, you can actually do more activities in the long run.

However, under a capitalist system that prizes work, sometimes that is just not possible, no matter how much you want to pace yourself. In fact, the same applies to the other two things you need to enjoy life: Sometimes doctors just won’t give you pain medication and sometimes loved ones just will not support you.

There is good news though.

Even if you don’t have all three of those things, you can still find some joy in a life with chronic pain, as long as you are very stubborn and tenacious.

You just have to find alternative pain medications, like kratom or cannabis. And insist on creating a life that allows for pacing, whether that means changing jobs or moving in with family to help with daily life tasks. 

Then you have to educate your loved ones on how they can better accommodate you – and be prepared to pull back if they are mean or rude about it.

When I first developed chronic pain, I genuinely thought life was not worth living. That was more than a decade ago, and I’ve experienced countless joys since then: trips to Europe, meeting the love of my life, getting cats, and hugging my new niece.

Not to mention all the little joys, like fresh baked bread, cozy heated blankets on a cold winter night, and getting lost in a corn maze with my family.

I am very lucky to now have effective pain medication, a life that allows for pacing, and supportive loved ones. But I didn’t start that way. I rearranged my priorities to make it so. And it is possible that you can do the same.

You just have to stop trying to fight the pain, and instead learn to accept it. Then you can be free to live your life, while finding as many joys as you can along the way.