15.5 million people in England live with chronic pain. Almost one-third of people with long-term pain experience high-impact chronic pain, which means it hinders their ability to participate in daily activities and enjoy life.
However, even though this condition is disabling, the government does not count it as a disability—and that should change.
Although there are various yardsticks to measure disability against, commonly assessed barriers are those of environment, attitude and institution.
Environment pertains to daily activities and interactions, attitude relates to whether that person is discriminated against and institutional barriers highlight how someone’s rights and dignity are preserved through policy and procedure.
High-impact chronic pain undoubtedly shapes and limits people’s daily activities. From ‘normal’ tasks taking much longer to not being able to do certain things at all.
Due to the lack of awareness and understanding of chronic pain, people can also face prejudice from larger society because of the invisibility of their condition, social isolation from severe symptoms and difficult-to-explain absences where diagnoses are lacking or private.
I am personally convinced that the notion of laziness was invented to demonise the sick and tired.
Further, the lack of recognition of chronic pain as a disability adds to institutional neglect because policies cannot be developed and the condition cannot be taken seriously according to routine procedures in the workplace and social sphere.
When Black women make up the majority of those with chronic pain, it becomes less surprising that chronic pain goes under-reported, under-investigated and under-resourced. As a historically marginalised group, when an issue disproportionately affects them, it gets less limelight.
Scientific research on chronic pain shows that people who already experience adverse social and psychological conditions (like racism, sexism and economic disadvantages) are more likely to develop chronic pain.
When those experiencing the most oppression experience the most chronic pain, it becomes the canary in the mine.
If the government were to start recognising chronic pain as a disability, this would not only open doors to provide support to the most under-served in our communities, but would also shift the conversation about disability to more closely honour self-knowledge and self-diagnosis.
Pain is almost impossible to measure or diagnose because it does not show up on tests or scans and relies on self-reporting and people’s abilities to convince primary healthcare workers of their symptoms.
Other recognised disabilities, like chronic arthritis or premenstrual dysphoric disorder (PMDD) can take years or even decades to diagnose and find appropriate treatment while in the meantime, patients experience severe symptoms and are unable to access support.
Adding chronic pain to the list of disabilities would allow these people to get care earlier on in their journeys. This will prevent worse outcomes and improve their quality of life.
Further, when classified as a disability, clinical terminology for chronic pain becomes standardised, allowing for the improved recording of the condition in people’s health records which leads to better healthcare.
When it comes to the workforce, musculoskeletal conditions like back pain and arthritis make up 20% of work absences due to illness. They account for almost 30 million working days lost to the UK economy yearly.
This results in a high unemployment rate of 66% for severe chronic pain sufferers, with one in five reporting they are permanently unable to work.
Chronic pain is often an additional symptom of an already occurring illness or condition, like diabetes, lung disease or Fibromyalgia, some of which are already recognised disabilities.
However, there is still a portion of people with chronic pain with no other diagnosable disabilities – so they need chronic pain to be a separate disability category.
By adding chronic pain to the list of disabilities, people will be able to more easily access life-altering healthcare.
Ultimately, recognising chronic pain as a disability would serve the aims of reducing its incidences where possible and minimising its impacts for all.
As disability activists have long touted, disability is not a mere matter of “impairment”.
Rather, the movement highlights the socio-political implications of a society which judges people on their ability to a) Work, and b) Conform.
Classifying chronic pain as a disability simultaneously places well-being above work while acknowledging the spectrum of disability and the myriad of ways it presents.
By recognising severe chronic pain as a disability, the government would be committing to ensuring this issue does not get ignored and that there is a higher chance of fair treatment and equitable support for those that need it.
With thanks to Uzoamaka Anita Asiegbu for her invaluable contribution regarding the process of defining disability.
Stats from the Versus Arthritis study Chronic pain in England: Unseen, unequal and unfair
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