Reflecting on 13 Years of Chronic Pain

By Crystal Lindell

I first developed chronic pain in February 2013. I remember the month because it was Super Bowl weekend and I went to a party to watch the game.

That was the year they had a long blackout delay, so the game ended up running super late. I stayed until the end.

I woke up the next morning with some soreness in my right ribs, and I assumed that I must have just lifted something wrong at some point. It got so bad I went to the ER.

While I had no idea at the time, my life was changed forever that weekend.

I was 29.

Within six months I was celebrating my 30th birthday at my new place: my mom’s house.

I had moved back home, an hour and a half away from my old apartment. I quit my second job, and shifted my full-time job to mostly work-from-home.

I spent the next few years desperately seeking answers, while trying to figure out a medication regimen that actually worked for me.

I also got extremely depressed.

I watched the entire TV series House, hoping to find an episode about a patient with the same symptoms as mine. I never did.

I mostly lingered without a diagnosis.

Eventually, the doctors decided to call it “intercostal neuralgia.” But that basically just meant “rib pain.” And how it had happened or why, they had no clue. They also had no idea how to treat it beyond managing the pain.

My long-term boyfriend – the one I had been with long before I got sick -- cheated on me. We broke up.

I cried a lot. I cried because my heart was broken, but also because my body was broken. I cried because of the physical pain, and I cried because of the emotional pain.

Then, finally, on March 15, 2018, I was diagnosed with hypermobile Ehlers-Danlos Syndrome (hEDS). I remember the date because it was the Ides of March. And the day felt just as ominous to me as I imagine it was for Julius Caesar.

A moment I had long hoped for, one where I finally got some answers, instead turned to extreme grief.  

But that night, I went to a local political event in town and ran into this guy I knew named Chris. A week later we went on a date to see the movie Black Panther, and we have been together ever since.

In fact, we are celebrating our eight-year anniversary this Sunday.

At the time of my hEDS diagnosis, I was so worried that I would never find a man who could love my broken body. But within just a few hours, I was proven wrong.

Lessons Learned

Over the last 13 years of life with chronic pain, I have learned that I was wrong about a lot of things. As it turns out, pain is an extremely strict, rigid teacher. 

I used to believe the government messaging that “all opioids are always bad for you.” But these days I now advocate for patient access to opioid pain medication.

I used to think that if you told a doctor your exact symptoms, that they would be able to find out what was wrong with you and be able to fix it. 

Now I know that if you want to get treated, you have to be your own biggest advocate.

I also honestly believed that I had good health insurance. I truly did think it would cover most of my medical expenses if I ever got sick. 

But after drowning in medical bills for more than a decade, I have come to realize that the only people who like their health insurance are the ones who never need to use it.

I also thought my ex-boyfriend and I could get through anything together. Clearly, that was not the case.

I assumed that my friends would be sympathetic with what I was going through. But in the end, chronic pain left me with a much smaller circle of loved ones. 

I also like to think that chronic pain has made me a more empathetic person. When I meet other people in pain, I do my best to show them empathy and to give them realistic advice that could actually help them.

Today, over a decade since I first woke up with chronic pain, it’s difficult to envision what my life would have been like if I had never gotten sick. 

So many of my life choices have revolved around my pain – from who I live with, to who I love, and to what I do for work.

To be completely honest, I like my life right now. Yes, I wish that I didn’t have to arrange my entire day around my physical pain. But I love what I do, I love the people I spend my days with, and I am content.  

I think that, in a lot of ways, chronic pain forced a contented life onto me. It forced me to evaluate everything I did, to see if it was actually necessary and if it was actually worthy of my time and energy. What was left was only the best parts. 

It is noteworthy that my pain is pretty well managed these days, at least compared to how bad it was in 2013. I still have bad flares, but for the most part, my medications help me get through the day. 

Looking back, there are so many dark nights in my past where I felt like the best choice was to just give up. So many painful hours in bed where I genuinely considered killing myself. 

But now, after 13 years of this life with chronic pain, I am so relieved that I decided to keep living it.

I Am Being Forced Off Oxycodone in the Name of Opioid Rotation

By Neen Monty

The current myth in opioid science is that buprenorphine is inherently safer than oxycodone.

The truth is far more ordinary: it depends on the individual. Some people do better on buprenorphine. Others do better on oxycodone. There is no universal “safer” opioid for every patient.

I have trialed buprenorphine before. It was profoundly sedating. I could not function on it.

Despite this, I was required to trial it again.

Here’s what happened.

Week One: Hope

The first few days were incredible.

Less pain.

More functional hours.

And I was sleeping until 5am!

I was thrilled to be wrong about buprenorphine. I ignored the severe nausea and the nagging headache because I could go back to the archery range. I started planning a fitness routine. I allowed myself to feel hopeful.

Week Two: Wearing Down

The nausea intensified. Even with ondansetron (Zofran), it was relentless.

The headache persisted. Not dark-room migraine territory, but just constant enough to make thinking difficult.

Panadol. Nurofen. Naproxen. Nothing touched it.

I also realised my mood had shifted. I felt low. Irritable. Short-tempered. Sad. Defeated.

I controlled it. I always do. I don’t take out my moods on others. My children didn’t see it. They saw normal. They did not see the enormous effort it took for me to stay calm and reasonable. 

The crying happened in the one private space I have: the bathroom. The sadness stayed hidden.

Week Three: Something Was Wrong

By week three, I was done.

My pain doctor told me to persevere. I did, as long as I could. At the end of week three, I ripped the buprenorphine patch off and did not apply the next one.

Enough was enough.

Within four days the nausea was gone.

The headache was gone.

I could think again. I could function again.

You never realise how severe something is until it stops.

Why did I tolerate it for so long? Because if I am labelled “non-compliant,” if I am judged not to be trying hard enough, I risk being forcibly tapered off all opioid medication.

And that would be catastrophic for me.

So, I tried.

Positive attitude! Yes, Doctor. I will trial it. With a smile on my face.

But I cannot continue with buprenorphine.

Next: Palexia

Now the rotation moves to another opioid: Palexia (tapentadol).

Doctors have been convinced that these newer opioids are “safer” than oxycodone. There is no high-quality evidence showing they are safer for stable, long-term chronic pain patients. But the safety narrative has been repeated so often, it is treated as fact.

Palexia is now the most commonly prescribed opioid in Australia. It has overtaken oxycodone. This did not happen because Palexia offers improved pain control. Or because it has fewer side effects. Or because it’s safer.

It happened because doctors were encouraged — in some cases pressured — to rotate patients off their “old school” opioids, to “atypical opioids” like Palexia, buprenorphine, and even tramadol.

A patient’s preference is no longer central. Being stable on a dose is no longer enough.

Opioid rotation is being enforced on me for two reasons.

First, because policies and guidelines position buprenorphine and tapentadol as the “safest” opioids. This is not evidence based; it is opinion.

Second, because I am not getting enough pain relief from my current regimen. My 20mg of oxycodone stops working after 6-8 hours, when it should last 12 hours.

The obvious solution is to prescribe it every 8 hours, instead of every 12 hours. That’s what happened in the past and was the standard of care. Because it is well recognised that the 12-hour formula rarely lasts 12 hours. 

But that would put me over the arbitrary daily dose ceiling of 100 MME. Which is also not evidence based. 

What is evidence based is that I was happier, healthier, fitter and more functional on 120 MME, rather than 100 MME.

But my well-being, pain control and function are not the important issues here.

Instead of the simple and obvious solution, the only solution is opioid rotation. The theory being that I have built up tolerance to oxycodone, but I have not built up tolerance to buprenorphine or tapentadol. So those medications will supposedly work better for me.

Except that’s not how it works in the real world.

Pain relief is not the goal here. It’s just not that important. It’s a money-making policy masquerading as “safety.”

Follow the money if you want to understand rapid prescribing shifts. Pharmaceutical policy rarely moves without financial incentive.

But here is the uncomfortable truth: My GP is not corrupt. She is not malicious. She is a very good GP. She is following guidelines.

She does not have time to audit every citation behind every recommendation on every guideline for every condition she treats. She has to trust her medical college, her training, and the documents placed in front of her.

That trust is not deserved. At least when it comes to treating chronic pain.

The current Australian guidelines are built on expert opinion, not randomised controlled trials. Opinion, layered over selective and cherry-picked evidence. Shaped heavily by academic pharmacology and population-level policy concerns. Not patient outcomes, preference, function or stability.

And patients like me pay the price.

A Four-Week Pause

I told my GP I cannot continue buprenorphine.

She immediately began discussing Palexia.

I asked for four weeks. Just four weeks to stabilise. I am only just beginning to feel like myself again. I am only just becoming functional again. I just lost four weeks of my life to the last rotation attempt. I don’t feel ready to tackle the next medication yet.

I need to take a breath. I need to get back to “normal.” Albeit my normal.

This rotation destabilised me. Made me far worse, not better. 

Also, it would make medical sense to start the next medication from a steady baseline, not during biochemical and emotional turbulence.

She agreed. Very readily. I didn’t have to argue my case. I very much appreciate that. She prescribed my usual regimen of oxycodone extended release and immediate release.

So, for four weeks, I remain on oxycodone. For four weeks, I will stabilise. And feel like myself again.

After that, the forced rotation begins again. I have trialed Palexia before, a few years ago. It did not go well. But still, I am being forced to trial it again.

Round and round.

None of this is my choice.

None of this is evidence based.

None of this is for my benefit.

The Systemic Problem

This is not just about me.

Patient choice has been steadily displaced by policy-driven prescribing. Stability is no longer considered sufficient. Long-term patients who are functioning are being told their medication is “unsafe.” Not because of their individual outcomes, but because of population-level risk narratives built on low-quality evidence and relative risk framing.

Meanwhile, newer opioids are positioned as “safer” without robust comparative long-term data in stable chronic pain populations. 

When prescribing patterns shift this dramatically and this quickly, it is reasonable to ask whether evidence alone is driving the change.

Medicine should be individualised. Instead, it is being standardised around risk optics, regulatory anxiety, and market forces.

And patients bear the instability.

Yes, some patients can safely be rotated, with no adverse events. But not all patients.

A large percentage are objectively and substantially worse off. But this does not matter. Patient satisfaction, patient function, pain relief are all secondary concerns. Often not considered at all. Or, if acknowledged, are dismissed as the patient being difficult or non-compliant.

Patients no longer have any agency, any choice, any control, or even a voice.

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. For more information on chronic pain, the science, the politics and the lived experience, got to Pain Patient Advocacy Australia. You can also subscribe to Neen’s free newsletter on Substack, “Arthritic Chick on Chronic Pain.”

Why I Recommend Living with Family if You Have Chronic Pain

By Crystal Lindell

Last summer my fiancé and I moved in with my mom, my grandma, and my brother. Essentially, I was moving back home – and truth be told, I felt like a failure.

I hadn’t been able to find full-time work after being laid off in 2022, and the bills were just getting to be too much. Actually, let me be more accurate. It’s not that I couldn’t find full-time work, it’s more that I hadn’t been able to bring myself to go back to a corporate job while dealing with burnout and chronic pain.

And so, we made the hard choice to move in with my family in hopes of saving some money and getting our bearings.

Almost every day, we all disagree. There are debates over who needs to do the dishes; discussions about how often the bathroom needs to be cleaned; and lots of arguments about someone in the house being too loud when someone else in the house wants quiet.

Yet, even with all that, my only regret is that we didn’t move in here sooner.

In the United States, it’s still often culturally frowned upon to move back home. It’s often framed as a failure to be an adult living with your parents, regardless of the circumstances. But for most of human history, living with family wasn’t just accepted practice, it was the norm. 

And if you have chronic pain, living with family could be exactly what you need, if that’s an option for you. Especially if stigma is the only thing holding you back.

There are so many practical reasons that it just makes sense to live with family if you have a chronic illness.

First and foremost, chronic pain is expensive in so many ways. There are medical bills, reduced ability to work, and all the convenience fees you have to pay for services because you can’t just go out and do it yourself. Living with family almost always makes life cheaper.

But chronic pain is also draining. And living with family helps fend off the depression that creeps in on bad pain days. Even more so during bad pain months.

It’s hard to wallow in my room all day when someone in the house is always checking on me, keeping me in conversation, and wanting to hang out.

Yes, it can be frustrating to have arguments about who is responsible for vacuuming the hallway, and whether or not we can put the couch on the left side of the living room. But that frustration is more than countered by the benefits of living with family.

If you are at a place where dealing with chronic pain is just draining all the life out of you, then I would highly recommend moving in with relatives, if you can. 

And if you love someone with chronic pain, an invitation to live with you could be the thing that saves their life. 

Today’s Wounded Troops Are Tomorrow’s Chronic Pain Patients

By Crystal Lindell

This week Reuters reported that as many as 150 U.S.troops have been wounded so far in the War on Iran. Of those, eight were seriously injured.

That’s in addition to the 7 U.S. service members who have been killed in the conflict, which started less than two weeks ago.

Those numbers will continue to rise the longer the war drags on.

It can feel tempting to dismiss wounded soldiers as no big deal, and that’s how the Pentagon is framing it, saying the vast majority of injuries are minor and that 108 of the wounded had already returned to duty.

But many of those who get wounded in conflict zones will experience life-long symptoms, including chronic pain, post-traumatic stress disorder (PTSD) and traumatic brain ​injuries, which are common after exposure to blasts.

According to the National Institutes of Health, about two-thirds of U.S. veterans (65.6%) have  chronic pain, and one in ten (9.1%) live with severe chronic pain. 

Of course, it’s not just U.S. troops who are casualties in the war. Estimates vary, but about 1,200 Iranians have died, 28 Israelis and nearly 600 in Lebanon. The number of injured is well into the thousands.

Even if the war ends tomorrow, its effects will likely linger for generations. Living with chronic pain can impact your life until you die — and enduring it can impact everyone around you, including your children.

It can make you more short-tempered, less productive, and more depressed. It can make you harder to live with emotionally, and harder to live with logistically because you need extra care.

I doubt most of the wounded understand the ramifications. I don’t blame them. It’s almost impossible to understand chronic pain until you suffer through it yourself.

But as a chronic pain patient, I know what their future holds.

It’s years, even decades, of dealing with dismissive doctors; fighting for pain medication; and spending your days and nights in bed because it hurts too much to move.

I think, if they truly understood, many members of the military would tell you it’s not worth it.  

A recent report from the Department of Veterans Affairs found that 6,398 U.S. veterans died by suicide in 2023. While that’s down slightly from 2022, the veteran suicide rate actually increased to 35.2 deaths per 100,000 veterans. That’s about twice the suicide rate of civilians.

It averages out to over 17 suicides by veterans each day. Most of them probably suffered from chronic pain.

It’s easy to skim past headlines about the number of people wounded in the War on Iran. But for the people who are enduring it, and those who love them, nothing about their future will likely be easy.

Why Is There Always Money for War, But Never Healthcare?

By Crystal Lindell

When Sen. Bernie Sanders was running for president in 2020, he campaigned for universal healthcare, also known as “Medicare for All.”

As someone with a chronic illness that started to impact my life at just 29 years old, it’s a program I supported. I was too young for traditional Medicare, and was quickly getting too sick for traditional work. So, I was desperate for a realistic alternative.

But any time Bernie’s Medicare for All proposal was mentioned, people always responded in the same robotic way: “How are we going to pay for it?”

They were not calling for the federal budget to suddenly be balanced. The question was solely intended to make advocacy for Medicare for All sound childish. And unaffordable.

Nobody ever asks that about war though.

As the United States showered multi-million-dollar bombs and missiles on Iran this week, the war was framed as such a national security imperative that the cost was barely worth addressing.

Questions about how we’ll pay for the war were dismissed as absurd by the political class and by many Americans.

But no mistake, there is a price tag — and it’s a large one.

Kent Smetters, director of the Penn Wharton Budget Model and one of the nation’s foremost fiscal analysts, told Fortune that the total economic cost of “Operation Epic Fury” could reach $210 billion.

It’s tempting to think of these things as separate problems. War in one bucket, healthcare in another.

But the thing about my federal taxes is that I don’t pay them in separate buckets. I pay my taxes and let someone else decide how to spend it.

That means, when they take my tax money and give it to weapons manufacturers, that’s money not spent on funding things that would actually improve my life as a citizen, like universal healthcare.

It’s a lose-lose option.  

I was laid off from my full-time job in 2022 — and that was the last time that I had health insurance. In the years since, I have navigated life with a mix of freelancing, DoorDashing, and cash payments for medical care that I couldn’t avoid.

In fact, I have a prescription to pick up this afternoon, and my main concern is a familiar one: “How am I going to pay for it?”

When our government abandons us, our problems don’t go away. Rather, they just turn into personal struggles that we are expected to figure out on our own.

So, if it’s childish to not want my taxes used to kill people in Iran, and childish to prefer that money be use for universal healthcare – then call me a little kid, because that’s not the type of adulthood I want to be a part of. 

Chronic Pain and Suicide: Three Ways to Recognize and Reduce Risk

By Dr. Thomas Rutledge

Suicide is a cause of death that haunts the living in perpetuity. After a suicide event, those left behind are tormented by questions:

"Could I have done something?"  "What did I miss?" "How could this happen?" "Was it my fault?" 

Even the best answers fail to return the person lost, and natural grief is often compounded with unnecessary blame.

Discussions about suicide prediction and prevention primarily focus on known risk factors such as mental illness and suicidal ideation. 

In comparison, far less attention is paid to another common contributor to suicide present among a staggering 24.3 percent of the adult U.S. population. That makes this risk factor as prevalent as clinical depression, yet far more likely to be overlooked due to suicide stereotypes.

This unheralded suicide risk factor is chronic pain. In this post, we'll dive into three specific ways that chronic pain increases suicide risk, practical signs by which to recognize the patterns, and general strategies to help.

The Perfect Storm for Suicide

More than perhaps any other medical condition, chronic pain poisons the emotional well of what it means to be human. Although people differ in countless ways, our similarities are even more striking. Across time and cultures, for example, people universally share fundamental needs for meaning, interpersonal connection, safety, contribution, personal growth, and adventure, as articulated famously in psychological theories such as Maslow's hierarchy.

Many medical conditions compromise our ability to fulfill these fundamental human needs. Emotional struggles and mental health conditions are often a result of a medical condition impairing a person's ability to function in an important human need domain. Yet what makes chronic pain uniquely psychologically damaging is that it doesn't impact just a single human need. Chronic pain jeopardizes all of them.

As a psychologist who specializes in helping U.S. military veterans living with chronic pain, my aim is to share three of the most common patterns I see where pain becomes an existential threat.

1. Pain Without Purpose

One of the most profound ways that chronic pain increases suicide risk is by taking away a person's North Star for living. Like a sailor at sea without stars or a compass to guide them, chronic pain can remove the sense of purpose that allows people to endure in the face of suffering. Without sufficient purpose, pain becomes unbearable.

Scenarios: A retiree whose pain leaves them mostly housebound, estranged from friends, and increasingly unable to live independently. A veteran living on disability who has lost any sense of mission or way to contribute. A young adult whose pain condition limits opportunities for work, isolates them from others, and undermines their belief in a worthwhile future.

Characteristic thinking: "What's the point?" "Why go on this way?" "I feel like giving up."

Solutions: Based on the person's own values and lived experiences, explore flexible ways to reconnect them with their sources of meaning. Retirees may volunteer or consult in an area of interest. Former athletes may coach. Veterans may engage with military organizations and causes. Parents may become involved with youth activities. And, due to the staggering advances in technology that enable online and virtual participation, developing meaning-oriented lifestyles with chronic pain has never been more practical or lower cost.

2. Suffering in Solitude

No relationship is 100 percent safe from the corrosive effects of chronic pain. Chronic pain can ruin once-strong marriages, corrupt lifelong friendships, and erode the parent-child bond. Even as the person with chronic pain may need more social support in light of their condition, they frequently experience less in both quantity and quality.

Scenarios. There are two classic versions of this scenario. In the first, other people pull away or drift apart over time. In the second, the person living with chronic pain themselves retreats from others, usually because they feel like a burden or that they are holding other people back.

Characteristic thinking: "I'm useless this way." "I'm no good to anybody like this." "They would be better off without me."

Solutions: Consider all options for rebuilding a healthy social network. Although in-person activities may be best, virtual options—phone calls, text messaging, even multiplayer virtual reality or video games—may be good starting points. Aim, where possible, for relationship settings and activities where the person is an active contributor and teammate, where they can give as much or more than they receive. 

Because men often struggle more with forming new relationships, explore options where an activity of interest is the centerpiece, while in a setting where social interactions can spontaneously occur.

3. Loss of Self

Chronic pain can not only steal purpose and corrode personal relationships, it can even threaten personhood and self-image. What are the psychological consequences when chronic pain leaves a person adrift from the core values and ways of living that enable their sense of self?

Scenarios: A person whose pain took away a career that previously gave them a sense of worth and identity. A middle-aged parent struggling with chronic pain and whose grown children have left home. A veteran who spent their military career serving the greater good, who now has nothing but memories. A young adult whose pain condition took away the plan and future they envisioned for themselves.

Characteristic thinking: "I don't know who I am anymore." "I feel lost." "I'm just a disability now."

Solutions: Help people grieve the self they've lost while building a new one. Post-traumatic growth examples through stories, movies, and relatable people can be powerful mental seeds to help people see themselves as a human phoenix—capable of rising from the ashes in a new form—instead of as a person permanently broken by pain and loss. 

As in every hero's journey, people need not just examples but also guides and mentors to construct a new sense of self. A sense of self where their chronic pain helps them help others, view themselves as a survivor and not a victim, recognize hidden personal strengths, and find healthy ways to live their highest values.

Thomas Rutledge, PhD, is a Professor of Psychiatry at UC San Diego and a staff psychologist at the VA San Diego Healthcare System.

This post originally appeared in Psychology Today and is republished with permission from the author.

If you lost a loved to suicide after a change in their prescription pain medication, please consider participating in a survey to help researchers learn more about these tragic situations. Click here or on the banner below for more information.

How Chronic Pain Steals Your Time

By Crystal Lindell

Chronic pain is a thief. It steals your health, relationships, money, motivation, and time.

This week, so far, it has taken one full day away from me. My Tuesday was stolen.

That’s when my fiancé and I were supposed to go visit his relatives, who live about 2 hours away. But as soon as I woke up, I knew we weren’t going to make it. 

It was a bad pain day. Gray, dull, and full of inflammation.

The intercostal neuralgia in my ribs was flaring up, and I was having a hard time sitting upright. It was all I could do to keep myself out of bed long enough to brush my teeth.

Still, I tried to resist.

I told myself I just needed time to let my morning meds kick in. That, maybe, the weather would ease, and so would my pain.

But by 10:30 a.m. I knew I was going to have to tell my fiancé the verdict: there was no way I was going to be able to make that trip.

Thankfully, he didn’t hesitate. Just a quick and comforting “Okay.” And then he called his relatives to tell them we needed to reschedule for later in the week.

But I couldn’t help but feel disappointed and a little guilty. I hate having to cancel plans, and I hate worrying about what others will think when I do.

I was also frustrated with the realization that everything else I had planned for the week was now going to be squashed together or canceled.

Because having a bad pain day doesn’t suddenly mean that I have less to do. It just means I have less time to do it.

There were points in my life when my pain was so poorly managed that it would steal a lot more than one day of the week from me. Sometimes, it would take all seven.

And when those weeks happened, it was all too easy to blame myself. I should have pushed through it, been tougher, gotten it done.

It doesn’t help when other people make you feel guilty. After all, it is a lot easier to call someone “lazy” than it is to sympathize with their health struggles. 

A saying I often repeat to myself in those times is something my mom would always say to me when I was growing up: “All you can do is all you can do.”

I say it a lot because I still don’t always believe it. I have to constantly remind myself that my limits are actually my limits.

Beyond the guilt though, there’s also the sadness that comes when chronic pain steals your time. How many days do I have left on this earth, and how many of them will chronic pain take? How many holidays? How many more Tuesdays?

And how much time have I already lost to my pain?

It’s not fair. I want my time to be mine. I want to use it how I want to use it. 

The right pain medications give me a lot of my time back, and that’s why I treasure them so much. It’s why I work so hard to advocate for pain patients to have access to them. Because we all deserve to keep as much of our time as possible. 

In the end, all we can do is all we can do. But that doesn’t mean we shouldn’t get as much help doing it as possible. 

Food: The Daily Challenge for People With Chronic Pain

By Crystal Lindell

One of the biggest hurdles many people with chronic pain face is finding something to eat. It’s literally a daily challenge that has to be solved.

Personally, it’s something I struggled with even before I started having chronic pain in my right ribs.

Finding food three times a day just isn’t easy. Anyone who tells you it’s easy probably has someone else who cooks for them, and does all the shopping and clean-up.

The temptation is to eat out, but that gets expensive fast – especially if you use delivery apps like DoorDash. So, over the years I have become an expert at feeding myself, even when I feel like crap and have no money.

In fact, these days I’m even a vegan, living in a small town in the Midwest, so the option to eat out most days doesn’t even exist.

Below are some realistic tips for feeding yourself even when you’re sick, broke, and a bad cook.  

Level 1: Heat-and-Eat Meals

The first goal in feeding yourself is to avoid fast food and food delivery apps. Almost everything you get at the grocery store is going to be healthier and cheaper.

To avoid the strain of food preparation and cooking, look for anything that just needs to be opened and heated. This can include frozen meals and pizzas; canned meals like beef stew and ravioli; and refrigerated meals from grocery store deli sections.

When I first made it my goal to avoid eating out, I would literally stock my freezer with 14 frozen dinners each week. One of my friends commented that my refrigerator looked like an ad for Lean Cuisine. They aren’t cheap, but they are easy and they can offer a lot of variety.    

Frozen and prepared foods tend to be more expensive than fresh food at the grocery store, but they are all significantly cheaper than DoorDash. 

Level 2: Easy Cooking

When I say easy cooking, I mean easyyyyy cooking. So easy, you can do it on bad pain days.

If you can master this category, meals are also exponentially cheaper than prepared grocery food.

In this level I would include easy to prepare meals like spaghetti noodles with a jar of sauce, quesadillas, and cereal with a side of toast (warm toast really elevates the experience from sad and cold to warm and comforting). This level also includes sandwiches, whether it’s peanut butter and jelly or lunch meat.

There are weeks when I go days at a time living on vegan cheese quesadillas. For these, I simply put a non-stick pan on the stove, heat up a plain tortilla, add cheese, fold it over and eat. I dip it in vegan sour cream, hot sauce, or even add some microwaved vegan steak if I have any on hand. Voilà! A perfectly satisfying meal.

The trick to this category is to find meals you can make that don’t require you to chop a single thing. However, they may require you to pull out a pan. 

If you have the energy to chop something, even better!  Tomatoes and onions tend to make most things taste better.

For these meals, the microwave is still your best ally. There are a lot of foods usually cooked on the stove that can be cooked faster and easier in the microwave. So, if I’m adding some vegetables to my pasta, I will put the steam-in-the-bag version in the microwave first so they don’t have to be cooked on the stove top. Or if I’m adding vegan meatballs to sauce, I’ll heat them in the microwave first.

I firmly believe that a mix of Level 1 and Level 2 cooking can get most people through most days of the month when needed.  

Level 3: Meal Prep

That brings us to the most difficult level of chronic pain cooking: Meal Prep.

For this category, you will probably need to chop things, and you may need to dirty multiple pots and pans.

The shopping, cooking, and the clean-up are both more extensive, but if you can pull it off, the rewards can last for weeks.

When I have a good pain day, I try to use some of my time in the morning to make a large dish, whether that’s a soup, chili, or a casserole. There’s no rule that says you have to cook dinner at dinnertime. 

And I always triple the recipe so that I can eat leftovers for days. I’ll even make enough to freeze portions of it, essentially making my own frozen dinners.

Midwest cooking has a lot to offer for this category because our winters often make it hard to go to the grocery store more than once a week.

For example, chili is an especially great recipe in this category because you can do the whole thing with cans of beans and cans of tomatoes mixed with a chili seasoning packet in the crockpot. I add dried lentils to mine to give it a meaty texture, but you can also add something like cooked ground beef if you have the energy to make that on the stove top

I also love making vegan pot pie (I use chickpeas instead of chicken), potato soup, or a large batch of enchiladas.

I also have a bread machine, so when I have the energy, I like to throw the ingredients in there so I can have fresh, homemade bread for a few days. When I don’t want to deal with that, a loaf of $2 French bread from the grocery store bakery also hits the spot.

Eating three meals a day takes a lot of effort, and it’s understandable that a lot of people with chronic pain don’t have the physical or mental energy needed for cooking. But that doesn’t mean you have to eat out for every meal. Or starve yourself.

The trick is to forgive yourself for taking kitchen shortcuts, start off easy, and to find just a couple go-to homemade meals that you can make on autopilot. That’s more than enough. Then it’s just a matter of bon appétit! 

You Might Have Chronic Pain If…

By Crystal Lindell

Back in the 90s, comedian Jeff Foxworthy had this whole bit about, “You might be a redneck if…”  

He’d start off with a funny description and then make the obvious conclusion, like: “If you ever cut your grass and found a car… you might be a redneck.”

It was an in-joke among people who proudly saw themselves as rednecks. Foxworthy wasn’t laughing at them, he was laughing with them — because he portrayed himself as one of them.

Whether or not a rich comedian was ever authentically a redneck is a debate for another day. But regardless, I very much am a member of the chronic pain community, and as such, I think there’s a few of these I could share.

So without further ado:

• If your favorite breakfast is coffee and pain pills… you might have chronic pain.

• If you have ever wanted to argue with a pharmacist… you might have chronic pain.

• If you need at least 24 hours notice to leave the house… you might have chronic pain.

• If you know exactly how long you can go without showering… you might have chronic pain.

• If your favorite outfit is pajamas… you might have chronic pain.

• If you think your “Dr. Google” search results are more valuable than your doctor’s degree… you might have chronic pain.

• If the words “Have you tried yoga?” trigger your PTSD… you might have chronic pain.

• If you have ever slept for 24 hours and then woken up and needed a nap… you might have chronic pain.

• If your medical bills are higher than the GDP of a small country… you might have chronic pain.

• If your “desk” is just your bed with a pillow propped up behind you… you might have chronic pain.

• If you have ever had to diagnose yourself… you might have chronic pain

• If you currently have a 500-count bottle of ibuprofen at home — and another one in the car… you might have chronic pain.

• If your idea of a perfect date night is sitting at home under a heated blanket while watching Lord of the Rings … you might have chronic pain.

• If your favorite food is THC gummies… you might have chronic pain.

• If you ever used up all of your sick days in the month of January… you might have chronic pain.

• If you use more dry shampoo than regular shampoo… you might have chronic pain.

• If you ever hoped that a test actually showed you had cancer, so that then you’d at least have an explanation… you might have chronic pain.

• If your most worn accessory is some sort of medical brace… you might have chronic pain.

• If all your shoes have arch support… you might have chronic pain.

• If your entire social media feed is posts about surviving chronic pain… you might have chronic pain.

• If you have ever worn the same outfit for 5 days in a row… you might have chronic pain.

If you can relate to any of these… you might have chronic pain.

Here’s hoping today is one of your good pain days. 

And if you have any “You might have chronic pain if…” examples that you’d like to share, we’d love to read them in the comments. 

Medicine for the Soul: Friends Are Important When You Have Chronic Pain

By Crystal Lindell

Every month before book club, I count out some pain pills.

I have to make sure I have a dose to take before I leave the house, so that they will be fully working when I arrive. And I have to make sure I have another dose to bring along – in case things run late and my pain starts to creep back before I make it home.

Without doing that, I know there’s no way I’d be able to physically endure the hours-long social interaction – even if that social interaction is literally just sitting on the couch and talking about a book. That’s just how my life is with the type of chronic pain I have. 

And it’s a social interaction that I absolutely love, by the way. In fact, I love it so much that I sacrifice both before and after every meet-up to make sure I can show up for it.  

On the day of a book club meeting, I also have to cut back on things like chores so that I can make sure I have the energy to shower, get dressed and put on makeup before I leave the house. While I’m sure the group wouldn’t mind if I showed up disheveled, I would.  

And I have to plan my schedule after the book club to allow time for me to go to bed early, because I know I’ll need to. Being alert and upright for a few hours is that hard on my body. 

Living with chronic pain means all my friendships require planning, extra work, and usually pain medication. It’s a level of effort that would make it easy, even understandable, to give up on the whole ordeal. But I don’t.

The priorities each day for me with chronic pain are basic hygiene, nutrition, housework, and maybe earning some money. All of that usually only leaves time and energy for one other thing: Sleep.  

Driving somewhere to get coffee with an old friend just doesn’t feel as urgent. Especially if you’re also in a romantic relationship or taking care of loved ones who themselves have health problems.

And making new friends? Forget about it!  

But please trust me when I tell you that “maintaining friendships” and even “making new friends” truly is just as crucial as taking a shower and doing the dishes – especially when you have chronic pain.

I have only been in this book club for about a year now, and most of the people in it are completely new friends to me. But I’m so glad that I have prioritized going, even when my physical pain is especially bad. 

Meeting with them always enriches my spirit in ways I can’t predict. 

That’s the thing about friendships: They are literally medicine in and of themselves. Often comforting, rejuvenating, and even healing.

In fact, a few months ago, during the book club meeting we played a game where we each anonymously wrote three compliments about everyone else in the group. And then we each got to hear what the others said about us.

The things everyone said about me were like medicine for my soul. For weeks afterward, when I felt like the physical pain was too much, I would think of those compliments. And they would help me mentally to endure it.

It’s the kind of thing that makes counting out pills before we meet more than worth it.

Three Clichés That Help Me Get Through Bad Pain Days

By Crystal Lindell

As the old cliché goes: clichés are clichés for a reason. They tend to convey a lot of fundamental truth about the world and life itself.

While dealing with chronic pain for more than a decade now, I have come to appreciate certain clichés in ways that I couldn’t before I got sick and lived to tell the tale.

They may sound corny, but below are three clichés that I have found really do help me get through a day with chronic pain: 

Cliché #1: This Too Shall Pass

When I first started having chronic pain, flares felt eternal. I genuinely worried that the pain would last forever. Any relief felt like an impossible dream.  

But eventually, the pain would ease a bit. Over time, I was also able to find calming techniques, as well as pain medications and supplements that helped relieve my symptoms. 

Even during the worst pain flares, I take heart in knowing that it too shall eventually pass.

It goes both ways too. On the other side of this equation, I’m also now significantly more aware of just how fleeting my health truly is. While the bad pain flares will pass, that also means the good days will pass as well – making it that much more important to savor them.

As it turns out, losing your health is the best way to finally learn how to appreciate the good days.

Cliché #2: Other People’s Opinions Don’t Matter

This concept is, for me, the simplest and yet the most difficult to truly internalize. 

But when you have chronic pain, you have to learn to ignore other people’s opinions about what you’re going through. And trust me, people will rush to share their opinions with you as much as possible, whether you ask for them or not.

You have to tune it out though, otherwise you’ll just fall into a dark despair of guilt and impossible standards.

I also have realized that what people say they would do if they were in pain, and what they would actually do are two very different things. 

People love to say they would never take opioids, or that they would just use yoga to “cure” their chronic pain. But I have been dealing with my own pain long enough now to see those same people eventually have to put their money where their mouth is, and they always fail their own test.

People who are the most judgmental of your choices are also the first to crack under the pressure that pain causes. It then becomes clear that most of their judgmental comments are reflections of their own issues, rather than anything to do with you.  

People claiming they would never use opioids are trying to convince themselves of that, as opposed to making a statement about your choices. 

And people who quickly say they’d just do yoga to cure their pain are trying to mentally process the fear they have at the thought of ending up like us. It’s a coping mechanism that allows them to think that even if it did happen to them, they’d be fine.

If you’re struggling with chronic pain, it’s good to remember you’re doing the best that you can, under the circumstances. Whether or not other people agree is irrelevant.

Cliché #3: The Best Days of Your Life Haven’t Happened Yet

This cliché is honestly the most magical for me, and it has truly helped me get through some rough patches in my own life.

When you’re drowning in chronic pain, it’s easy to spiral physically and emotionally, and to assume that nothing good will ever happen to you again. But take it from me, good things will still happen.

When I first developed chronic pain in 2013, I still had not met the love of my life, I’d never had a cat, and I had never gone to Paris. In the years since though, I met my fiancé; I acquired six cats (all of whom I’m obsessed with); and I have been to Paris not once, but TWICE!

There are incredible things in store for you, too — and that’s worth hanging around for. 

While none of these clichés can cure chronic pain, they do make it a little easier to endure. And sometimes, that little extra is all you need to make an extraordinary life. 

If you have any clichés that you find helpful, I’d love for you to drop them in the comment section below. After all, we could also use a little life advice, especially when that advice has been tried and tested by people strong enough to survive chronic pain.

Prohibition Medicine and the Collapse of Patient Safety

By Michelle Wyrick

For more than a decade, the United States has been running a vast, uncontrolled policy experiment in medical care. Under the banner of “opioid reduction” and “overdose prevention,” regulators have steadily restricted, stigmatized, and in many cases effectively eliminated access to stable, physician-supervised treatment for pain, anxiety, and other chronic disabling conditions.

The results of this experiment are now visible everywhere, and they are not subtle. Patients are sicker, more desperate, more marginalized, and more exposed to dangerous unregulated substances than at any point in modern medical history.

This outcome should not surprise anyone. It is not an accident. It is the predictable result of applying prohibition logic to medicine.

When legitimate patients are cut off from stable, supervised, pharmaceutical-grade treatment, they do not stop having pain. They do not stop having anxiety, severe depression, neurological disease, connective tissue disorders, autoimmune conditions, or the many other illnesses that produce chronic suffering.

They look for substitutes. And there will always be substitutes.

This is not a moral statement. It is a basic fact of human biology and behavior.

Demand for relief from suffering is not eliminated by supply restrictions. It is merely displaced into less safe, less predictable, and less medically supervised channels.

This dynamic is not unique to opioids. It is a universal feature of prohibition systems. Alcohol prohibition in the early 20th century did not end drinking. It drove production into unregulated, often toxic forms and empowered criminal supply chains. Modern drug prohibition has not eliminated drug use. Instead, it has ensured that the drugs people do use are increasingly potent, adulterated, and dangerous.

The same pattern is now playing out inside medicine itself.

For decades, physicians used opioid analgesics, benzodiazepines, and other controlled medications in a personalized, risk-benefit framework. This was not perfect medicine, but it was recognizable medicine. Doctors assessed individual patients, monitored them, adjusted doses, and discontinued treatment when risks outweighed benefits. The vast majority of stable patients used these medications without chaos, without dose escalation, and without the kinds of outcomes now routinely attributed to the “opioid crisis.”

Beginning in the mid-2010s, this model was replaced with something very different. Guidelines were transformed into rigid limits. Clinical judgment was replaced by fear of regulators. Medical boards, insurers, pharmacies, and hospital systems began enforcing population-level dose ceilings and forced tapering policies that took little or no account of individual patient physiology, genetics, or clinical history.

This shift was justified using public health language, but it was not actually evidence-based medicine. It was administrative medicine.

The core assumption behind this approach was simple and deeply flawed. If you reduce access to prescription opioids, you reduce addiction and overdose.

In the real world, the opposite happened.

As prescription access fell, overdose deaths rose. Not slowly. Not ambiguously. They rose sharply and continuously, driven almost entirely by illicit synthetic opioids such as fentanyl and its analogues. This is not a coincidence. It is substitution.

When patients and non-patients alike lose access to regulated, dosed, known substances, the market does not disappear. It mutates. It becomes more concentrated, more dangerous, and more lethal.

From a pharmacological standpoint, this is exactly what one would predict. When supply is restricted, traffickers move to higher potency products that are easier to transport and conceal. This is why fentanyl replaced heroin, and why heroin replaced opium, and why alcohol prohibition favored spirits over beer. The same pressure operates everywhere prohibition is applied.

In medicine, this has produced a grotesque paradox. The very policies sold as “harm reduction” have forced more people into the most dangerous drug environment in history.

But the harm does not stop with overdose statistics.

For millions of legitimate patients, the new regime has meant something quieter but equally devastating. Forced tapers. Sudden discontinuations. Blacklisting by pharmacies. Doctors who will not treat pain at all. Clinics that advertise only “non-opioid” care, regardless of diagnosis, severity, or prior response.

These patients are often described in policy discussions as if they were abstractions. In reality, they are people with connective tissue disorders, spinal injuries, advanced arthritis, neuropathies, autoimmune diseases, post-surgical damage, and complex multi-system conditions. Many were stable for years or decades. Many were functional. Many worked, raised families, and lived ordinary lives.

When their treatment is removed, they do not return to some baseline healthy state. They collapse.

Some become housebound. Some lose the ability to work. Some develop severe depression and suicidality. Some are driven, reluctantly and fearfully, to seek relief outside the medical system.

This is the part of the story that is still not being honestly confronted.

People do not seek unregulated substances because they want to. They seek them because the medical system has left them with no humane alternative.

This is not “addiction” in the simplistic, moralized sense that is often implied. It is survival behavior in the context of untreated suffering.

From a systems perspective, the current policy framework violates one of the most basic principles of risk management. If you remove a safer, regulated option while demand remains constant, you do not eliminate risk. You increase it.

Pharmaceutical-grade medications have known dosages, known purity, known pharmacokinetics, and some degree of medical oversight. Gray and black market substances do not. They vary wildly in potency. They are often contaminated. They are frequently misrepresented. The margin for error is small, and the consequences of error are fatal.

This is why the shift from prescription opioids to illicit fentanyl has been so deadly. It is not because fentanyl is uniquely evil. It is because unregulated supply chains, extreme potency, and unpredictable dosing is a perfect storm.

A rational harm-reduction strategy would aim to pull people into safer, supervised, medically controlled channels. Instead, current policy does the opposite.

It pushes people out.

There is also a deeper scientific problem with the one-size-fits-all approach that now dominates pain and psychiatric care. Human beings do not respond to drugs uniformly. Genetics, metabolism, receptor expression, enzyme function, comorbid conditions, and prior exposure all profoundly shape both benefit and risk. Pharmacogenetics has made this increasingly obvious, yet policy continues to pretend that a single dosage threshold can define safety for everyone.

This is not medicine. It is bureaucratic simplification masquerading as science.

Some patients tolerate and benefit from opioid therapy at doses that would be excessive for others. Some cannot tolerate even low doses. Some respond better to one class of medication than another. The same is true for benzodiazepines, antidepressants, stimulants, and nearly every drug class in existence.

The proper response to this variability is individualized care, not blanket restriction.

Instead, clinicians are now taught, implicitly and explicitly, that avoiding regulatory risk matters more than relieving suffering. The result is widespread medical abandonment.

From an ethical standpoint, this should be alarming. Medicine is supposed to be organized around the care of the patient in front of the clinician, not the appeasement of distant agencies.

From a public health standpoint, it is also failing by its own stated metrics. Overdose deaths continue. Illicit markets continue to grow. Patients continue to be driven out of care.

This is not because the problem is unsolvable. It is because the framing is wrong.

We are not dealing with a battle between “medicine” and “drugs.” We are dealing with a battle between regulated, supervised, accountable systems and unregulated, chaotic, lethal ones.

History has already shown us how this ends. Every time.

Prohibition logic has never worked in any domain. Not alcohol. Not drugs. Not sex work. Not abortion. Not gambling. It does not eliminate demand. It ensures that demand is met in more dangerous ways.

If policymakers actually cared about safety and harm reduction, they would reverse course.

They would restore rational, individualized medical prescribing. They would protect clinicians who practice careful, documented, patient-centered care. They would stop forcing stable patients into destabilizing tapers. They would bring people back into the healthcare system instead of pushing them into gray and black markets.

They would also start telling the truth about what has happened.

The current crisis is not the result of doctors prescribing too compassionately. It is the result of a system that replaced medicine with fear, and then called the outcome “public health.”

We can continue down this path, and watch the death toll and human suffering rise year after year. Or we can admit what history, pharmacology, and basic systems theory already tell us.

You cannot ban your way to safety.

You can only regulate, supervise, and care your way there.

And right now, we are doing the opposite.

Michelle Wyrick is a Board Certified Psychiatric Registered Nurse and a Clinical Hypnotist in Gatlinburg, Tennessee.

In More Pain? Blame the Weather – and Climate Change

By Crystal Lindell

On Wednesday, three people I know all had a migraine. My mom also told me that her hip joint was suddenly much more painful than normal. And the intercostal neuralgia in my ribs hurt so bad that I spent most of the day in bed.

The next day, the temperature here in northern Illinois suddenly spiked to 53 degrees Fahrenheit – an unusual occurrence for Januar. Then the rain started and never really stopped.

The random spike to 50 degree weather – when most people here still have their Christmas lights up – felt almost ominous. And it seems our bodies agreed.   

If we lived in the 1800s, all of us could have served as our town’s meteorologist, accurately predicting both temperature changes and precipitation.

But here in 2026, many people still don’t even connect their pain flares to weather changes. And I still hear doctors dismiss the idea that weather can impact pain.

As someone who lives with chronic pain, I think the connection is obvious. I can tell you almost down to the hour when it’s going to snow. I have learned to plan my rest days around rapid temperature changes in the forecast. And when it’s sunny and clear, I sometimes find myself wondering if I have somehow been cured – because I feel so little pain!

The thing is, the reason we had a 53 degree temperature spike in the middle of winter in northern Illinois is likely due to climate change. While the warm front may have come in regardless, just how warm it got was likely amplified by global warming.

In fact, the shifting global climate means we are all experiencing weather fluctuations and temperatures that had previously been considered rare.

And our bodies have noticed.

A recent story by Inside Climate News discusses the link.

"Global warming is bringing more heatwaves and an atmosphere that sucks up more moisture to feed storms. Those thermodynamic effects of climate change often have more clear ties to pain," wrote Chad Small, a PhD student in Atmospheric and Climate Science at the University of Washington. 

“For example, gout sufferers living in Arizona—which will continue to get hotter and dryer as global temperatures increase—will likely experience worse pain due to more frequent and severe instances of dehydration driven by the increasing temperatures and aridity. That’s on top of the exacerbation of the pain by the heat itself.” 

In 2023, The University of Pennsylvania published an article titled, "Why climate change might be affecting your headaches" in Penn Medicine News.

“Rising global average temperature and extreme weather events are likely to become more frequent or more intense,” they wrote. “Experts suggest that the stress of these events can trigger headaches.”

Society at large seems to still be in denial about all of this though, at least in my experience.

For example, when the weather changes, people who get migraines don’t get more sick days or easier access to government assistance.

And while weather changes are causing more pain flares, government regulators and health officials still limit access to opioid pain medication.

Not to mention the lack of social accommodation. Friends and family aren’t more understanding about the increase in pain because of climate change. In fact, most people aren’t even more forgiving of their own bodies in that situation.

The ableism at the root of our culture in the United States still expects people to push through the pain and show up anyway – and that social pressure only increases when someone’s pain flares get more frequent.

In other words, the more climate change increases pain, the less accepting people are of it. Perhaps that’s because many are still in denial that climate change even exists.

Unfortunately, all indications are that climate change is only going to continue getting worse, which means the pain it causes will do the same.

If we are going to endure it, we are going to have to offer grace to others and ourselves when that pain shows up in our bodies.

We can’t control the weather, but we can control how we endure it.  

3 New Year’s Resolutions on Behalf of Pain Patients

By Crystal Lindell

It’s now 2026, which means I’ve spent too many decades making mostly failed New Year’s resolutions for myself. So this year, I’m not going to bother.

Instead, I have some New Year’s resolutions for other people. Specifically, they’re for people with power, like doctors and healthcare policy makers.

After all, it really seems like they need to make some policy changes, given the current state of things for people in pain. Perhaps they are just waiting for someone to tell them what those changes should be. 

Below is a look at three of my 2026 New Year’s resolutions on behalf of pain patients..

Resolution # 1: Fully Legalize 7-OH and Develop New Edibles

There’s so many conflicting local regulations when it comes to kratom and 7-OH, despite the fact that neither one is as harmful as health officials and lawmakers often claim.

For those unfamiliar, 7-OH is short for 7-hydroxymitragynine, an alkaloid that occurs naturally in kratom in trace amounts. Some kratom vendors now sell concentrated versions of 7-OH to boost its potency as a pain reliever and mood enhancer.

A lot of pain patients find both 7-OH and kratom to be effective at treating chronic pain. And while I am glad that both are still legal in most places in the United States, I would really like to see them fully legalized across the country, as municipalities and states realize just how beneficial these products can be.

I also would really like to see 7-OH vendors come out with some new edible formats, like chocolates, gummies and even seltzer.

I think 7-OH in particular has the potential to help a lot of people who have been denied adequate pain treatment. However, many of them may not be comfortable figuring out where to buy and correctly dose a 7-OH chewable tablet, especially if they are among one of the largest demographic of pain patients: the elderly.  

I think of my grandma trying to get 7-OH tablets at a local smoke shop, or having to figure out how to order them online. Both options are bad. 

Ideally, regular grocery stores and local pharmacies would have a display of low-dose 7-OH chocolates available over-the-counter for pain patients like her.

Resolution # 2: Stop Prescribing Gabapentin and Tramadol for Pain

This would be such a relatively easy change for doctors to make, and there’s so much science to back it up.

In October of 2025, PNN covered a study showing that tramadol is often not effective for chronic pain. And PNN has long been covering how ineffective gabapentin is for most pain conditions.  

However, despite the evidence, doctors still regularly prescribe gabapentin and tramadol for chronic pain. 

It doesn’t have to be that way. Doctors have alternatives that actually work, most notably low-dose hydrocodone. Yes, there are more regulations around that medication, making it more difficult to prescribe. But actually giving pain patients real options shouldn’t be so difficult.  

So, I would like doctors and other healthcare professionals to make it their goal to stop prescribing ineffective medications. Instead, offer pain treatments that actually work. Your patients will thank you.

Resolution # 3: Implement Medicare for All

Yes, I know this one is kind of unrealistic. But that’s what New Year’s magic is all about —  putting whimsical ideas out into the universe with the hope of seeing them come to fruition. 

After all, it can’t happen if we never ask for it.

Unfortunately, as the year starts off, we are actually heading in the opposite direction, with many Americans seeing their health insurance premiums soar or even deciding not to buy coverage. 

But I’m hoping that may be the catalyst we need for the public to start demanding real change. Right now, millions of people are losing their health insurance because the Trump administration ended federal subsidies for coverage under the Affordable Care Act. 

It’s an awful and unnecessary situation that our policy leaders have the power to fix, if only they worked together on the issue.

Every human should have the right to healthcare, and Medicare for All would go a long way to making that happen.

I know a lot of these resolutions probably won’t come to fruition in 2026, but I do think they could realistically happen before we start the next decade. And all of them have the potential to vastly improve the lives of millions of people living with chronic pain.

Happy New Year everyone. May your 2026 be filled with low-pain days, too much joy, and lots of love.

A Pained Life: What's in a Name?

By Carol Levy

First, we were called “handicapped." It was a wholesale term to paint all those with physical, emotional or intellectual limitations. One inability meant total inability. Often, it was used as an exclusionary term, to mean someone was “less than.”

Eventually, it was realized that handicapped was a demeaning term. So, they changed it to “disabled.” That too was belittling — a word that tended to make us seem less than whole.

Then came physically (or emotionally or intellectually) “challenged.” That sounds better. After all, being challenged just means you have to try harder to meet goals and objectives.

But even that term carries a subtle meaning: we can overcome challenges if we just “try harder” or “do better.” It suggests we are too lazy, too much of a malingerer, and don't want to even try.

There has to be something better. In thinking about this, I had an “Aha!” moment: I am not disabled, I am “unable.”

That seems more appropriate. After all, being unable in one sense does not mean unable in all. "I am unable to answer the phone right now. Please call back later.".

Because of my trigeminal neuralgia, I can't use my eyes for more than 15 -20 minutes without severe pain. I can't tolerate wind or even a slight breeze against the affected side of my face.

But the rest of me is able and willing. It only makes me unable to do things that require the use of my eyes. I am still able to do things that are physically demanding. I can walk, talk, think, exercise, and thankfully take care of myself. That is far from being disabled. 

Others among us may be unable to lift things, clean a room, or even walk. But we can still think, talk, read, and interact with others, even if only on the phone or online.  We are “unable” in part, but able in many other ways.

But, at the end of the day, does the term used to describe those with inabilities really matter? Most healthy people don’t even consider the label, it’s just a way of quickly describing someone.

Quick descriptions, though, lead to stereotypes and misunderstandings. Take, for example, someone parking in a “handicapped” parking spot.

They may have the placard or license plate that gives them permission to park in these spaces, but when they exit their car and start to walk away, another person may object. They’ll start yelling, “You're not handicapped! How dare you park there and take the space away from someone who actually needs it!”

I have had this happen to me. But it’s too hard to explain what trigeminal neuralgia is, and how the wind or even a breeze could set off a pain flare.

Instead, I say, “I do not need to have a cane or wheelchair to be disabled. I may have a heart condition or emphysema or any number of other disorders that make it difficult for me to park farther away from the entrance.”

Looking abashed, if you're lucky, the person walks away.

It would be nice and so much easier, if I could respond by saying “You're right. I am not handicapped in the way you expect me to be. I am unable physically in a way that may be invisible to you, but necessitates my using this spot.”

I keep my fingers crossed, hoping it’s a teachable moment, that this person will understand that “unable” in one sense does not mean unable in all. Maybe, if we're all really lucky, she’ll be able to pass it on.

Carol Jay Levy has lived with trigeminal neuralgia, a chronic facial pain disorder, for over 40 years. She is the author of “A Pained Life, A Chronic Pain Journey.”  Carol is the moderator of the Facebook support group “Women in Pain Awareness.” Her blog “The Pained Life” can be found here.