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As someone who has been in constant pain for six years, you’d think that I would be used to the fatigue that pain brings. You would be right, partially, but there are still times that it surprises me. Now that I’m dealing with an acute knee injury, I’m having to relearn how to navigate pain-related fatigue.
I think there are interesting things to be learned about the relationship between pain and fatigue. Things that both help people understand the real toll pain can have, and help those of us in pain remind ourselves to take it easy. As I am prone to doing, I’d like to talk about this while dealing with a lot of fatigue.
So, shall we?
Table of Contents:
- The basic relationship
- Temporal elements of pain and fatigue
- Why does pain cause fatigue?
- What this means for us
The basic relationship
Anyone who has ever been in pain will readily tell you one thing: pain makes you tired. It’s such a basic concept, and yet so many people seem to forget it once the pain passes, or misunderstand how deep the fatigue can run.
It’s also true that being tired can increase pain levels, especially for chronic pain. There are myriad theories to explain this relationship, most of which I will not get into. Suffice to say, we don’t really understand exactly what biochemical processes occur when pain meets fatigue.
When someone has an acute injury, they need more rest. This advice is given by doctors and friends alike, because it helps them heal. What a lot of people seem to misunderstand is that sleep isn’t a magic cure-all, although it does promote many processes that aid healing.
Instead, part of the reason you need more rest when you’re injured is that you’re more tired. Having to deal with pain takes a toll on your bodymind, even more so when it’s pain you’re not used to. Expending that energy means you will need more rest.
But why does pain make you tired? Does one always lead to the other? Can we even answer those questions? (Spoiler alert: not fully.)
Temporal elements of pain and fatigue
While doing some reading on this topic, I came across a 2022 study exploring the temporal relation between pain and fatigue. I have a special fondness for considering temporal aspects of various concepts and experiences, maybe because time baffles me.
This study goes over both their results, based on monitoring patients with chronic pain over the course of 10 weeks, and what previous studies have found.
Not only did they find a direct link between measures of pain and measures of fatigue (of course), but they found that measures of pain could predict future measures of fatigue.
Interestingly, they did not find the inverse; fatigue did not accurately predict pain. They note that this might be because of the timeframe of their study, as other studies have found a link between the two.
I encourage you to read that study, but I’ll also illustrate it with a more personal, easy to parse example.
This morning, I woke up in far more pain than usual. The temperature dropped overnight, and it snowed. As I understand my bodymind, I’m more inflamed today, leading to more pain.
I knew this meant my capacity would be lower, and I’d tire quicker. And sure enough, in the early evening, I’m already starting to feel like it’s late into the night. I’m exhausted.
Part of that exhaustion was caused by my increased pain, but not all of it. Some of it might be caused by an underlying factor that influences both fatigue and pain, something the study hints at. Regardless of all the contributing factors, it’s clear that an increase in pain meant I’d have an increase in fatigue later.
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Why does pain cause fatigue?
That’s the million-dollar question! The study linked above gives some interesting theories, but that’s all they really are: theories. Each one of them may be a part of it, or only half of them. Science doesn’t fully know.
But I find that these things are best understood by combining scientific knowledge with the lived experience of people we know. In this case, myself, and others I know, filtered through me.
One definite element is the fact that dealing with pain takes up energy. Even when you’ve been in pain your entire life, you have to spend energy each day managing that pain. Some days it may be a minimal ask, and some days it might take everything you have.
Pain is, understandably, hard to ignore in most situations. Actively ignoring it takes energy. And when you’re not ignoring it, it makes it harder to focus, converse, move, and generally exist.
As I mentioned above, another possibility is that underlying factors affect both pain levels and fatigue. On high-inflammation days, my pain is worse. This makes me tired, but it’s possible that the inflammatory process itself also contributes to fatigue.
Of course, there are a host of other possibilities, including:
- Pain disrupting sleep and making rest harder
- Chemical imbalances that contribute to, or arise from, pain
- Side effects of pain medications
- Bacterial ghosts that siphon human lifeforce to feed their god
What this means for us
Pain is difficult to deal with, and hugely detrimental to our lives. I also believe that it is something we can learn from. After all, pain signals are intended to get our brains to make a change.
Of course, that doesn’t mean we should always celebrate pain. Some days you don’t care about learning from your pain. You just want to hate it, and that is perfectly ok.
One of the main things pain does for me is tell me when I need to slow down. On days like today, I know I need to take it a bit easier because of impending fatigue. But spikes in pain can also happen when I’ve been overextending myself.
When my upper back is aching, I’ve probably been way too tense, and need to do some soothing things. When I get sharp pangs, I overextended something and need to nurse it. A tension headache could be too much screen time or difficult thinking.
Pain is also a reminder that we’re human, not machines. In a world that wants us to constantly churn out something productive, grappling with pain can return us to the biological reality of our selves.
And some days, pain just sucks. It teaches us that it sucks to be in pain. That’s a lesson we have to sit with too.
So, to quote a very wise T-shirt that hangs in my closet: “Pain is just pain entering the body.”
Do you have other insight you’d like to share about pain and fatigue? You can leave a comment down below or tap it out in morse code with your crutches. And if you liked this post, make sure to subscribe so you don’t miss the next one.
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Ashton Rose 