Man with a walking stick

For Writers

How to Write a Character with Chronic Pain

Writing is all about empathy. It’s about putting yourself in a character’s shoes and doing your best to understand their perspective on life. Sometimes your characters have a lot in common with you, so it’s relatively easy to step into their head. Sometimes they don’t, and it isn’t. When it comes to the latter, research is your best friend.

If you’re here, you’re probably researching how to write a character with chronic pain. Or you’re my mum (hi mum!). So, welcome! I’m here to tell you a bit about what it’s like to be in pain 99.9% of one’s time. Because I have first-hand experience in this arena and boy HOWDY do some writers get it very, very wrong.

Pain Management ≠ Drugs

Medicinal intervention is totally a thing, don’t get me wrong, but it’s only one tool in a chronic pain sufferer’s arsenal. I live with often debilitating pelvic pain. My non-medicinal pain-relief methods include:

  • Heat Packs
  • A Hot Water Bottle
  • Dencorub
  • Heat Patches
  • Stretching
  • Breathing Exercises
  • Pelvic Floor Exercises
  • A TENs Machine
  • Acupuncture

Grouchily popping pills may be a quick and easy way to remind your audience that This Character’s In Pain, but if you’re here I’d wager you want to go beyond the House MD approach.

Depending on the type of pain your character is suffering, they’re going to have a string of non-medicinal approaches to managing it. Google “how to manage x pain”. Seek out forums or Facebook groups where sufferer’s give each other advice. Trust me when I say we’re not shy about sharing tips and tricks on how we manage our pain.

Introducing alternative methods of pain management also lets you drop some physical indications of otherwise invisible illnesses. For example, I’ve used hot water bottles so often that my stomach now has a near-permanent rash-like marking called erythema ab igne.

Opioids Don’t Work Like That

If your character suffers from chronic pain, odds are they’re going to be on a daily medication regime. If your story is set after the early 2000s, that daily medication isn’t necessarily going to be opioids.

The U.S. opioid crisis saw a slew of new laws and regulations put in place that mean opioids are no longer a first-line treatment for chronic pain. Speaking from experience, it’s actually difficult as balls to obtain a prescription. If your character is popping Oxycodone all day long, you’re gonna need to figure out how they’re obtaining it.

You’re also going to have to come up with a reason why their tolerance hasn’t hit the ceiling.

On my worst days I use Endone to help me, y’know, stand up. I don’t use it every day because, even if I could obtain the prescriptions to keep me in stock, my tolerance to the drug would increase so fast it’d very quickly lose its effectiveness. If your character is using opioids every day, they’re gonna gain one hell of a tolerance. Unless you plan to address that in your writing, you’re gonna have to re-think your character’s medication use.

Real life to the rescue!

Opioids aren’t the only pain medication on the block. I’m personally on an anticonvulsant which is designed to interrupt the pain at the brain, rather than the source. I’m also on a bunch of hormonal mediation to manage both my condition and the pain it causes me. Other fun treatments include ketamine infusions, CDB oil (where obtainable), and steroid injections.

A fun side note: If your character is also mentally ill, that’s going to affect the medications they’re on. I personally can’t be on more than the minimum of my anticonvulsant because I get spun into a manic state on higher doses. Others have issues with hormonal meds and depression. Research is your friend, friend.

We Don’t Always Use Our Mobility Aids

I’ve taken to using a walking stick when my ovaries decide that shooting pains down my leg is their new mission in life. I don’t use it all the time because a) those shoot-y pains aren’t consistent and b) I have a tendency to fuck up my neck if I rely on it too long.

If your character uses mobility aids to help them manage with chronic pain, you need to ask yourself when and why they’re using them. The answer will likely be a complex one. Maybe they can walk short distances around their house on their own steam but surviving the weekly shopping trip requires the use of a wheelchair. Maybe they need a walking stick for outings in which they start and stop a lot, but long walks are fine because their pain becomes more manageable once their muscles warm up.

Disability isn’t straightforward. And neither are the people who experience it. Understand that and you’re well on your way to writing more complex and believable characters.

We Are Hyper Aware of Our Bodies

If you want to relay to your readers that a character experiences chronic pain without having them clutch a body part or pop pills, having them be very, very aware of how they’re sitting, standing, or moving is an excellent option.

Posture is a big thing for me. In the early days of my developing chronic pelvic pain, I’d unthinkingly hunch or bring my legs up into a semi-foetal position on the couch. Over time this behaviour led to (drumroll please) chronic back pain. The way I sit at my desk or lean after standing for a while can also contribute to pelvic pain flare-ups.

All of this served to make me very, very conscious of my body and how I’m holding myself at any given moment. This hyper-awareness is great for my posture, but it gets fucking exhausting after a while.

Which brings us to:

We’re Always Tired

Pain is goddamn exhausting. I sleep an average of 10 hours a night and often need to nap in the afternoon.

More harrowing than the physical tiredness though is the mental exhaustion. We’re trapped in a perpetual screaming match with our nervous systems and it takes its toll.

When I’m having a particularly bad day I’ll get snappish, irritable, and more prone to fits of emotion. Before my condition sunk its teeth in I was about as weepy as a brick wall. Now I tear up watching Transformers. I growl at washing machines. I have arguments with my cats. It’s a shit way to be.

That said, being in pain all the time doesn’t automatically make you an asshole. Just because I’m snappish doesn’t mean that irritability is aimed at anything other than my leaky fridge. I hate to pick on House MD again here, but don’t have a character’s chronic pain give them licence to be a tool. It’s hackneyed and overdone and you’re better than that, friend.

Writing a Character With Chronic Pain Isn’t Rocket Surgery

Writing a character with a chronic pain condition when you don’t have first-hand experience is just like writing any other character whose traits you don’t share. The first step is realising you lack the knowledge required. The second is finding reputable sources from which to learn. Build that empathy, friend, and you’ll go far as a writer.

I hope I’ve been a helpful source for you today. If you’d like to say thanks and help me pay my rent at the same time, I’d love to have you over on Patreon. Any questions or comments hit me up below or come at me on Twitter.

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