GOOD HUMANS IN PAIN 

GOOD HUMANS IN PAIN 

On chronic pain, what it recruits, and what we do to each other when we haven't dealt with it

We need to talk about pain.  

Not the kind that announces itself clearly the twisted ankle, the broken bone, the pulled muscle that hurts, heals, and moves on. That pain is acute. It's honest. The body signals damage, you respond, and the system works as designed.  The pain we need to talk about is the other kind. The kind that has been there so long you've stopped noticing it consciously. 

The kind you've factored into every morning before you've checked your phone. The kind you've been managing, medicating, overriding, outrunning, and quietly building your entire life around without ever once sitting down and saying ‘this is pain, and it is asking something of me.’

That is chronic pain. And according to NHS and ONS data approximately 28 million adults in the UK.  Roughly 43% of the adult population are living with it right now. Not recovering from it. Living in it. Daily.

That is more than an abstract statistic. It is most of the people you know. It is us.

The ecosystem we built around not addressing it

We are, collectively, extraordinarily creative about not dealing with pain.

We have built an entire industry around it. Over the counter analgesics. Prescription pain management. Opioids, NSAIDs, gabapentinoids, the NHS spending over £500 million annually on prescription pain medication alone. Direct healthcare costs related to chronic pain run between £12 and £15 billion every year. These are not small numbers. They are the financial footprint of a society in sustained, unaddressed pain.

And that's just the official management. The unofficial ecosystem is considerably larger.

Ultra processed food delivered to the door in under thirty minutes. Alcohol, alcohol-specific deaths in England rose nearly 30% between 2019 and 2023, reaching 8,276 in that year alone. Over 329,000 adults were in contact with drug and alcohol treatment services in the year to March 2025 (ref), the highest number since records began, and rising year on year. Scrolling. Gaming. Overtraining. Overworking. Staying so perpetually busy that the body's signals get filed under background noise and never quite reach the front of the queue.

And it is not only the overtrained, the overworked, the perpetually busy who mask.

Chronic unaddressed pain also produces its opposite. The person who has gone quiet. Who has stopped trying. Whose ambition, creativity, or appetite for life has contracted to almost nothing, and who has quietly stopped expecting anything different. Underperforming is not laziness. It is frequently exhaustion wearing a different coat. The gym addict running toward something and the person who cannot leave the sofa are often running the same programme in opposite directions. Both trying, in the only way currently available to them, to manage something that has never been named.

None of these are moral failures. They are adaptations. Intelligent, if temporary, solutions to the problem of feeling something the person hasn't yet found an adequate way to address. The problem is that they don't resolve the pain. They redistribute it. And eventually sometimes quietly, sometimes dramatically it finds another way out.

What chronic pain actually does

Here is where the clinical picture matters, and where I want to be precise.

NICE guidelines now formally recognise what practitioners have known for years that chronic pain is not a purely physical phenomenon. It is biopsychosocial. Meaning it lives simultaneously in the body, in the psychological landscape of the person experiencing it, and in the social and relational context of their life. Treating only one dimension while ignoring the others is, by definition, incomplete treatment. The data supports this most chronic pain patients report little improvement in quality of life after a year of standard medical management.

Because chronic physical pain recruits. It reaches into the places where old grief lives, where unprocessed loss is stored, where the emotional transgressions and battle scars of a life fully -or otherwise,  lived have never quite been resolved. Chronic pain amplifies everything it finds there. Physical and emotional pain are not separate systems running parallel programmes. They are one system, in constant conversation, and chronic pain has a way of turning up the volume on everything you thought you had managed to put down.

I know this from the clinical literature. I also know it from my own body. I lived with chronic pain for longer than I allowed myself to acknowledge years of overtraining, attributing the signals to exertion rather than listening to what was actually being communicated. Processing the pain into a fuel called rage. Adding plates to the bar. Pushing my personal best. Somehow believing that if I could just outperform the pain, I could diminish what the system was actually feeling.

Eighteen months ago, my body stopped allowing me to ignore it. It flattened me. And in being flattened, I learned something no training programme had fully prepared me for, the intimacy between physical pain and every other kind of pain a person carries. For me, they were not neighbours. They shared the same address.

As humans we have a sophisticated system designed to protect us from immediate danger, fight, flight, freeze. Acute pain is part of that system. The hand recoils from the flame before the mind has formed the thought. But we have no equivalent alarm for chronic pain. No sharp signal. No reflex that fires when the slow burn has been burning too long. Just a gradual dimming, or amplifying, that we learn to call normal. We recalibrate our baseline so incrementally that we stop noticing the distance between who we were and who we have become.

Until we can't any longer.

The moment of reckoning arrives differently for different people. For some it is an implosion, a quiet internal collapse that happens behind closed doors, invisible to everyone, including sometimes themselves. For others it is an explosion, the outburst, the rupture, the relationship that ends or the job that is lost in a moment that felt sudden to everyone watching but had been building for years. For others still it is burnout, professional, creative, physical, the body and mind arriving at a full stop after being run past empty for longer than was ever sustainable. And for some it is a mental health crisis, anxiety, depression, dissociation. The system finding the only exit available when every other signal has been ignored.

These are not character flaws. They are not weaknesses. They are the body and the mind finally, emphatically, saying enough.

I have sat with people in all of these moments. In the implosion and the explosion. In the burnout and the breakdown. What I have found, consistently, is that the crisis was rarely the beginning of the problem. It was the end of a very long silence. And underneath that silence, almost always, was pain that had never been properly met.

That is not only a clinical observation made from a safe distance. I have lived versions of this myself. Which is why when someone arrives in that place undone, exhausted, not sure how they got here I am not alarmed. I am not distant. I know the terrain. And I know that it is, with the right support and the right container, navigable.

What pain does to the people around you

This is the part of the conversation that doesn't happen enough. Because we tend to talk about pain as something that happens to a person. We talk far less about what a person in unaddressed pain does.  Pain that hasn't been processed doesn't disappear. It redistributes. Into behaviour. Into relationships. Into the people closest to us who didn't choose to carry it but do anyway.  It solidifies into patterns. Ways of being. Ways of living.

The colleague who snaps at someone who asked a reasonable question. The parent who withdraws just at the moment their child most needs presence. The partner who punishes through silence, through distance, through a low-grade hostility that nobody can quite name or challenge. The manager who leads through intimidation because control feels safer than vulnerability. The friend who cancels, again.  Not because they don't care, but because showing up requires a resource they genuinely don't have right now.

The person who goes online and says the thing they would never say to someone's face. Nearly one in five children in the UK experienced online bullying behaviours in the last recorded year. Nearly all cyberbullying victims, 93% report adverse mental health effects. Behind every perpetrator is a person. And behind most people who cause harm in the ways that pain causes harm, there is something unaddressed, something recruited, something that found the wrong outlet.

And here I want to say something that rarely gets said.  We speak, rightly, with enormous compassion for the person on the receiving end of cruelty, online and off.  But we speak far less about the person steadily delivering it. The one sending the message at midnight. The one who casually, consistently excludes, humiliates, dismisses. Who weaponises silence or sarcasm or contempt in the workplace, in the family, in public, in the comment section.  That person is also, almost always, in pain.

I say this not as an excuse. Not as a reason to tolerate harm. But as a fact worth understanding if we are serious about changing the systems we live inside. Hurt that has nowhere appropriate to go finds somewhere. The person causing harm is rarely someone who has been well held, well met, and genuinely supported through their own difficulty. They are more often someone whose pain found an outlet in the wrong direction.

Compassion for the person in pain includes, sometimes uncomfortably, the person causing it.

This is not about blame. It is about recognition. And it is about the particular kind of responsibility that comes with understanding the system you are part of.  The relational system, the family system, the organisational system and what your unaddressed pain is doing within it.

The question worth sitting with

Here is the marmite part. The part I raise not to judge, but because I think it matters.

Sometimes chronic pain does the recruiting. It reaches in and amplifies what it finds. That is physiology, psychology, and lived experience it happens, it is real, and it deserves care and attention. In my work with clients, I find that separating physical pain from emotional pain through body scanning can be a powerful part of the therapeutic process. Particularly when considered through an intersectionality lens. Working through transgenerational pain, genderised pain, cultural pain, racialised pain, pain rooted in identity and belonging. For many clients, this has been genuinely transformative.  Understanding not just that they are in pain, but where in the body it lives, and what it is carrying.

And sometimes, not always, not in every case, but sometimes the recruitment runs the other way.

Sometimes we use chronic pain. Consciously or not. Cynically or not. But we use it nonetheless as a container for the tears we haven't cried, the failures we haven't forgiven ourselves for, the grief we haven't named.  The human condition we haven't yet found the language to describe. Pain becomes a home. Familiar. Structuring. Easier to explain to ourselves and to others than the confronting thing underneath it that actually needs attention.

The question worth sitting with is this:

Is the pain recruiting you — or have you, quietly and without judgement, recruited the pain and if so what is its function?

And a second question, which matters just as much:

Who else in your life is living inside the answer to that question — whether they know it or not?

This is us

I wrote the title of this essay carefully. Good Humans In Pain. Not broken humans. Not failing humans. Good humans people who are doing their best, carrying what they carry, managing as intelligently as they know how, with the tools and the understanding they currently have.

The data isn't a judgment. The 28 million people living with chronic pain in the UK are not a cautionary tale. The people self-medicating, overworking, scrolling at midnight, snapping at their families, going quiet when they should be present.  These are not bad people. They are humans, people in pain, in a society that has built an enormous infrastructure around managing pain and a comparatively tiny one around understanding it.

This is us. And we are us. So, who are you in this?

That is not a rhetorical question. It is an invitation. Because the first step toward anything different is the willingness to look clearly at what is actually happening.  In the body, in the mind, in the relationships, in the patterns that keep repeating despite your best intentions.

Change is possible. I have staked a practice on it. More than that, I have staked my own life on it.

Good humans quietly focus and evolve. Sometimes the focusing has to start with pain.

If something in this essay has stayed with you  a recognition, a question, a quiet discomfort you haven't quite named yet that is worth paying attention to.

You don't have to have it figured out to take a next step. You just have to be willing to look.

Start wherever feels right.

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References 

1. Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open 2016;6:e010364. bmjopen.bmj.com

2. Faculty of Pain Medicine. UK Pain Key Messages. fpm.ac.uk/patients/uk-pain-key-messages

3. Public Health England. Chronic Pain in Adults 2017: Health Survey for England. Published 2020. gov.uk

4. NICE Guideline NG193. Chronic pain (primary and secondary) in over 16s: assessment and management. 2021. nice.org.uk/guidance/ng193

5. Office for National Statistics. Adult Substance Misuse Treatment Statistics 2024 to 2025. gov.uk

6. Office for National Statistics. Alcohol-specific deaths in the UK: registered in 2023. ons.gov.uk

7. Office for National Statistics. Bullying and online experiences among children in England and Wales: year ending March 2023. Published March 2024. ons.gov.uk

8. NHS England Digital. Mental Health of Children and Young People in England, 2023. digital.nhs.uk

9. Shetty S, Scuffell J, Aitken D, Ashworth M. Chronic pain: prevalence, demographic inequalities, and healthcare utilisation. BJGP Open 2025;9(3). bjgpopen.org