Pain And Disability: Overcoming Challenges With Resilience

Coping with pain and disability can be a daunting task, often giving rise to distressing emotions, disruptions, and added stress for both patients and their support networks. While the complete eradication of pain and disability may remain elusive, the prospect of leading a more fulfilling life and triumphing over these challenges through resilience is entirely within reach.

The ideal outcome of resilience is to recover from the painful feeling and move forward while coping with these stressors.  

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899321/
• https://pubmed.ncbi.nlm.nih.gov/23442430/

Introduction 

Pain and disability, while distinct, are two intricate facets of the human experience that often intersect. Pain, whether physical, emotional, or a blend of both, can profoundly affect an individual's well-being. 

Disability, on the other hand, reshapes the way people interact with the world, both physically and emotionally. Resilience helps people overcome tough times and allow them to bounce back from difficult situations.

Understanding pain and disability

Pain

Pain is an unpleasant feeling or signal, it can show that something hurts and is dangerous to us. It is both physical and emotional, and the pain we feel varies from person to person. 

We sense pain through a kind of specialised sensory nerve cell called a nociceptor. Research has shown that pain is processed in several brain structures, such as the thalamus and primary somatosensory cortex. 

There are three patterns of pain, defined by their duration: acute, episodic, and chronic. Acute pain often comes suddenly and is regarded as a protective response to damage to the body. It typically happens for a limited period but still can turn into chronic pain. Episodic pain is pain that occurs occasionally, sometimes sporadically, and is often associated with a long-term medical condition. Chronic pain usually lasts for a long time and is hard to control. Its severity can increase due to environmental and psychological factors.

A person’s physical health is greatly affected by pain, with chronic pain often leading to reduced mobility and activity, hindering one's ability to engage in everyday life. Disrupted sleep patterns and fatigue become more frequent, further compromising the individual’s overall well-being. Mental health is equally affected, as persistent pain can give rise to a host of emotional struggles. Anxiety, depression, and heightened stress levels are common in those enduring chronic pain. 

Disability 

According to the Equality Act 2010 from the Government of the UK, the definition of disability is “a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities”. This means that someone is disabled if there is any physical or mental impairment that affects their daily lives significantly for more than 12 months. 

Disabilities can be categorised into four main types: mental, physical, sensory, and developmental. 

• Mental disability includes anxiety disorders and dissociative disorders. People with mental disabilities may find it difficult to control their mood and feelings. 
• Physical disabilities can sometimes be observed clearly, especially when affecting movement and motion. But many are ‘hidden’ disabilities like epilepsy, brain injury, and respiratory disorders. Sometimes, pain can accompany these disabilities. 
• Sensory-impaired disabilities affect a person's sensory function. Their vision, hearing, touch, smell, and taste are processed differently than in people without said disability. 
• Developmental disabilities occur mostly during childhood and affect their development. This can impair their ability to learn, communicate, and respond to their surroundings. Examples of developmental disabilities include attention deficit hyperactivity disorder (ADHD), autistic spectrum disorder (ASD) and learning disabilities.  

What is resilience? 

Resilience is not just a trait but a dynamic and transformative force that enables individuals to confront life's challenges head-on. This unwavering assurance propels people to rise above their circumstances and discover newfound strength during adversity. 

Through resilience, individuals find their innate ability to endure, thrive, and grow. When talking about resilience with disability and pain, it can be seen as a person maintaining their daily functioning while adjusting to their disability, pain, and subsequent impairment.¹ 

The authors of the “Handbook of Adult Resilience” proposed two factors related to resilience: recovery and sustainability. ‘Recovery’ represents the ability to bounce back from stressful events, and ‘sustainability’ refers to the ability to move forward from stressful events.² 

Components to achieve resilience

There are some essential components in the pathway of achieving resilience. The first one would be “resilience resource”. This refers to the person’s positive traits and social situations. For example, extraversion and optimism are considered positive traits, while a healthy and supportive family relationship can be a beneficial social situation. 

Resilience mechanism is similar to resilience resource, but it has distinct characteristics. The resilience mechanism emphasises the action performed when stressful events occur to achieve recovery and sustainability, for example, positive social interaction.

Pain acceptance is another variable that may have a significant impact on one's resilience to pain. Pain acceptance involves a broad readiness to accept pain as a way to enhance personal involvement and overall well-being. This approach differs from avoidance or control-based coping strategies. Accepting pain or disability helps us direct our energy towards manageable things.³

Psychological resilience 

Psychological resilience is the cornerstone of navigating life's challenges. Developing mental strength, or emotional resilience, is a crucial aspect of cultivating a resilient mindset. It involves honing the ability to face adversity head-on, reframing setbacks as opportunities for growth, and maintaining a positive outlook. Building mental ‘strength’ helps people endure pain and disability, making them stronger and more resilient.

Seeking professional help is a good way to find support in developing resilience. Current treatment guidance for coping with pain aims to promote pain management and cognitive and behavioural changes.⁴ It provides resilience resources to patients. 

There are different types of resilience training programs for both pain and disability, and whether through therapy, counselling, or other mental health services, seeking professional help is a testament to one's resilience. It recognises that strength lies in acknowledging vulnerabilities, thereby taking steps to address and overcome them. Recognising weaknesses and actively working to overcome them is a sign of strength.

Physical resilience 

Physical resilience is also important for overcoming difficulties with pain and disability. Research suggests that maintaining good physical health through exercise, a balanced diet, and healthy habits improves resilience to pain and disability.³

Especially for people with disabilities, rehabilitation is important for their resilience development. Rehabilitation involves tailored exercises and therapies that aid in restoring physical functionality and mobility. Rehabilitation is not limited to those with physical disabilities; it is also crucial for those with chronic health conditions and others who may require it. The benefits of rehabilitation can vary from facilitating medical and surgical intervention to reducing or controlling other complications of pain and disabilities. 

Adaptive approaches, on the other hand, encompass innovative strategies and tools that enable individuals to navigate their daily lives despite physical limitations. Adaptive approaches also benefit patients’ mental health, promoting psychological resilience.

The role of social support 

Social support comes in various forms, be it from family, friends, or belonging to support groups and communities. These networks serve as practical assistance. They offer a safe space for individuals to share their experiences and seek guidance. 

Several studies indicated a negative relationship between social support and reports on pain and disability levels. For example, studies have shown that the more social support received by patients with multiple sclerosis and chronic back pain, the less they reported pain and disability levels.^{5, 6} 

The role of social support is a reminder that resilience is often a collective effort, and the encouragement and care of others play an essential part in helping individuals overcome the challenges of pain and disability.

Navigating everyday life

Adapting to a ‘new normal’ is a fundamental aspect of this transformation. It requires embracing change, adjusting to the limitations imposed by pain and disability, and finding innovative ways to continue leading a fulfilling life. While this adaptation may bring challenges, it is also an opportunity to explore new horizons and discover strengths that may have otherwise remained hidden.

Building a supportive environment encompasses the creation of a network of individuals who understand and assist in navigating the challenges posed by pain and disability. Authorities propose rules and laws to support disabilities and disabled facilities have special services to support individuals. 

Summary 

In our exploration of pain and disability, one thing shines clear: resilience is the bedrock upon which individuals can build their path to recovery and transformation. Throughout this article, we have witnessed how resilience empowers individuals to confront and transcend the challenges of pain and disability. We have also covered the importance of social support and self-awareness in overcoming challenges brought by pain and disabilities. It is vital to seek help if necessary and get support from others.