Despite the daily challenges of living with chronic pain, many of us choose to keep a smile on our face. To those we encounter, this can be interpreted as a sign that we are in good health and pain-free.

However, maybe that smiling individual simply wants to remain positive despite their pain. Thus, many times, a pleasant smile causes others to misinterpret that person’s truth, masking the real struggles of chronic pain.

Why might some choose to put a smile on their face despite struggling daily with medical challenges and pain? Here are some of the potential reasons:

• They realize everyone experiences hardship, and this happens to be the journey they have been given.
• They work to recognize and remember to be grateful for the good they do have in our lives.
• They realize they are not the only ones dealing with unwanted pain and chaos brought into their lives.
• They want to set an example for others to feel hopeful living with a condition like theirs.
• They dream that if they work hard to take care of themselves, they might retain some treasured aspects of the “original” version of themselves.
• They want to be happy and active despite the added challenges their pain creates.
• They want to act and look as normal as possible to prevent judgment from others.
• They want to maintain their friendships.
• They want to be recognized as the full person they are, rather than having their condition define them.
• They realize this is their life to live, and waiting around for things to change would prevent them from living their lives today—so they choose to live.

But here are some examples of what might be the real truth behind their smile:

• They are trying to conceal feelings of discouragement, loss, fright, and hopelessness as their bodies are not cooperating like they used to.
• Their family and friends are judging them as they are attempting to try to cope with their complexities and reality.
• They are trying to be brave in front of family and friends to someday be remembered as a fighter—but this can cause others to believe they are not struggling.
• They are pushing themselves daily to keep their heads above water with all the challenges they face, but they don’t want to complain.
• They face a relentless stream of medical appointments, surgeries, recuperations, and setbacks, all the while wrangling to get the assistance they need from insurance companies.
• They can no longer participate in activities they love due to their health issues, oftentimes remaining on the sidelines as observers instead of participants.
• They face uncertainty and never know what is next around the corner.
• They have lost friends through the years who have moved on while they feel stuck contending with their conditions.
• At times, they are discouraged, frightened, and feeling lost with everything it takes to live their lives with chronic pain.
• They get sad and feel lonely as friends have less and less time to give them, since they are having trouble keeping up.
• They need you to listen and show compassion!

The next time you come across a person dealing with chronic pain who is also wearing a smile, give them credit for their courage. Know that it is not easy to cope with chronic pain, and extend a hand of encouragement for their attitude.

Be compassionate and ask them how they are really doing, and allow them to share in a safe space—for they are working daily to keep that smile intact, despite the truth behind their smile.

May life be kind to you…

—by Ellen Lenox Smith

About the Author:

Ellen Lenox Smith has emerged as a leading voice for patients living with pain. Currently, Ellen serves as Co-Director of Medical Cannabis Advocacy for the U.S. Pain Foundation and is a member of its Board of Directors. She is also active with the EDS RI support group.

Prior to patient advocacy, Ellen was a longtime middle school social studies teacher. She has been married for 50 years and is the proud mother of four adult children and grandmother to five grandchildren. She also is the author of two books, an organic gardener, and was previously a master swimmer and high school swim coach.