By Amber Fonseca

“Pick your poison,” or so goes the expression. But when it comes to living with multiple chronic pain conditions, I think “pick your pain” is more fitting. While I wish that I could choose to lessen my pain or to not have any pain at all, neither quite fits what I mean when I say “pick your pain”.

There are innumerable levels and types of pain: sharp, throbbing, piercing, stabbing, burning, aching, and more. Not all pain is created equally, and neither are the treatments. In fact, many of us with chronic pain find ourselves having to choose between which pain to treat when you have multiple conditions that involve pain, the treatments are different, and often cannot be combined. If you have ever had to choose between a migraine and back flare, you know what it means to “pick your pain.”

If this is you: I see you, and I understand your struggle. When your head feels as though it is going to explode, your back feels as though it is on fire, and your whole body is fighting against your attempts to move… I see you. I see you trying to decide which pain needs treatment the most. I see you frustrated because you need relief from all of your pain, but your medications can’t be mixed. I see you contemplating what will happen if you choose your head over your back, or your back over your head. I see you wishing you could take both medications. I see you considering what might happen if you risk taking both together–knowing it could end badly. Through all the pain, I see you.

Like it or not, a time comes when you must “pick your pain:” pick the pain to treat and the pain you must suffer through. You must pick the treatment that might bring relief, while also knowing that there is a risk that the treatment might not work, or worse– that the side-effects could exacerbate other symptoms. But of course, your ability to function depends on the success of your choice. If you pick your migraine, you risk the chance that your head won’t feel better, or you may be successful in lessening the pain in your head only to discover your mind is alive and racing while your body is locked inside the physical prison of your flared back. If you choose your back pain, you may still be laying flat unable to lift your head, or worse, the pain reliever for your back might make your migraine worse. Roll the dice, play the odds, it’s only one day in the bigger picture of life… Except when it isn’t.

If you are like me, the need to “pick your pain” is more common than just the occasional day here or there. The “right” choice is not always the same option. Some days, the pain I choose to treat is my back, other days it is my migraine. Some days I make the “right” choice and I am able to regain some level of function. Other days, I make the “wrong” choice and I lose the ability to function at all for that day. To my fellow pain warriors, know that there are others out there going through the same thing. When you have a day where you are forced to “pick your pain” in an effort to conquer your day, know that you are not alone and I see you.

Always take your medications as prescribed, and never mix medications, even supplements, without your doctor’s knowledge and permission. Before your appointment, you can use this online tool from the National Institute of Health to identify pills, or this one to check for interactions between different medications. Learn more at

Amber Fonseca is a high school English teacher, blogger, freelance writer, and has been a chronic pain patient for more than twenty years. She is also a single mom to a very special little boy with autism. Despite her multiple diagnoses and personal struggles, she has always found a way to advocate, educate, and support others along the way.