For those living with chronic pain, life is a constant, exhausting juggling act. Yet, much of the effort required just to get through the day remains unseen, misunderstood, or deliberately hidden. I struggle with this hidden existence, often referred to as the invisible workload or invisible labor of chronic pain, which is a heavy, relentless burden that can profoundly harm the very person carrying it. 

It's time to pull back the curtain on this hidden labor and understand why so many Pain Warriors feel compelled to fight their battles in silence, and why this silence is so damaging.

Why Pain Warriors Hide Their Suffering

It's a common, tragic paradox: the people who need the most understanding are often the ones who show the least amount of true suffering, something which I am guilty of. This concealment is not a failure to cope; it's a deeply ingrained defense mechanism fueled by several powerful factors:

• The Fear of Burdening Others: This is perhaps the most significant reason. I know it’s one of my main fears about sharing my pain, especially the really hard to talk about stuff. As Pain Warriors, we often feel like a constant source of bad news. We worry that our constant suffering will be a perpetual drag on the mood of friends and family, leading to guilt, shame, and the desire to protect loved ones from our reality. The last thing I want is to feel like I am more of a burden or worry for others. Also, I can have some pretty dark thoughts about my pain and the distress it causes me. I have a real intense fear that I won’t be understood or that I will be judged or looked at as crazy for having those thoughts. That means I usually only share those things with a few select people that I trust to hear and understand those thoughts. That fear of a negative reaction for the most part, makes me keep certain things to myself. 
• The Pursuit of "Normalcy": Everyone craves to feel like a contributing, active member of society. Faking wellness—a process often called "pain-masking"—is a desperate attempt to grasp a temporary feeling of normalcy and to avoid the feeling of being perpetually "sick" or "disabled." All we want is to be normal again, to have normal aches and pains, and normal daily struggles. Not the overwhelm and chaos that is “our” normal. For once I’d like to be able to do something without overthinking about what the fallout will be and is it worth the recovery time and pain flare. We have to constantly weigh our options, with none of them being appealing. And we have to find a way to make peace with ourselves so that we aren’t in the perpetual pursuit of normalcy anymore. That we’ve found acceptance in what is and are living mindfully. 
• The Battle Against Disbelief and Stigma: Many pain sufferers have endured skepticism ("It's all in your head," "You look fine," or "Are you sure you're not exaggerating?"). To avoid having their pain dismissed, invalidated, or judged, they simply stop sharing. It's often easier to suffer in silence than to constantly prove your pain is real. I know people don’t mean any harm, but these statements are really damaging. Just because we “look” normal, doesn’t mean our pain isn’t real, or isn’t as bad as we say it is. I have to say, I am really very lucky when it comes to this point, because my loved ones and people in my life have never questioned me in any way so as to make me doubt they think I’m telling the truth. I have always felt believed and heard. There are very few people that are in my life, relatively speaking, that I have come across since my fall and car accident that have doubted me. I hear from people that struggle to be believed, by medical professionals and their loved ones, and I’ve always considered myself really lucky and am so grateful when it comes to this. 
• The Energy Cost of Explaining: Articulating complex, fluctuating, invisible pain is mentally and emotionally exhausting. It takes precious energy that the Pain Warrior doesn't have. It's less effort to say "I'm fine" than to launch into a 20-minute explanation of the current pain level, fatigue, and cognitive fog. But, there are those friends that understand the kind of code we learn to speak, and know what it means when you say that your pain is bothering you…they know it means it’s really bad or you wouldn’t be saying anything about it. 

These very things are why I think sharing my story is so important. Not just for me to talk about for my own good, but for others to read and know they aren’t alone. That there are other people out there experiencing and feeling those same things I feel about their chronic pain too. I think starting my blog was one of the best things that could have happened to me as it got me more comfortable with talking about my pain. Writing about my pain has been really good for my mental health and has helped with some internal healing and acceptance that needed to happen. Another bonus is I have learned so much researching for blog posts, and that has helped me too. I’ve also connected with a lot of amazing people from all over the world, from other female entrepreneurs and chronic pain advocates, to Pain Warriors and caregivers. I love getting messages from people all over the world that share their story or the story of a loved one with me and to hear how my blog is helping them. I’ve learned that talking about pain doesn’t have to be so scary. 

The Harm of Hiding: A Dangerous Self-Isolation

While hiding pain might offer temporary relief from judgment, it is ultimately profoundly harmful to the chronic pain sufferer:

• Amplified Stress and Cortisol Levels: Constant emotional suppression, the effort of masking pain, and the fear of being "found out" keeps the nervous system on high alert. This chronic stress releases cortisol, which can actually increase pain sensitivity and inflammation, creating a vicious cycle. I’m sure my levels are off the charts. I’m hypervigilant for a variety of reasons, and while I have people in my life that I would trust with my darkest secrets and most personal thoughts, there are some things I experience and feel that I can’t say. Not because I want to keep it secret or anything, but because saying them out loud or typing them out would make them real. And if they are real, then I have one more thing on my already very full plate to navigate through and worry about. I just don’t have the space for anything else. 
• The Erosion of Social Support: By hiding the truth, pain warriors inadvertently push away the very people who could offer support. Friends and family don't know the extent of the need, leading to isolation, loneliness, and depression, which are themselves major contributors to pain severity. This is a common struggle for so many of us, for so many valid reasons, and is something I’ve tried to work on myself over the years. In my case I was unintentionally minimizing my pain to others, mostly due to being embarrassed that as the years passed, I was slowly falling more and more apart. 
• Medical Misunderstanding: If a patient consistently minimizes their pain to their doctor or healthcare team because they are practiced at masking, their true suffering may be underestimated, leading to inadequate treatment plans and a failure to get the necessary interventions. This is also an area I have been really blessed in, as my family doctor is really on the ball. He is the one who diagnosed me in one visit after seeing and hearing what was happening to my legs and someone who knows just how bad Complex Regional Pain Syndrome (CRPS) is. So I think even though I was probably minimizing my pain to him, he understood what I meant. I think it helped that he’s been my doctor since I was a little kid, so knew me to be a very reliable, competent and active person, and when he saw what it was doing to me, I didn’t really need the words, because he knew me so well prior to my fall. Sadly not everyone is as lucky.
• Loss of Identity and Authenticity: Living a double life—the "I'm fine" persona vs. the agonizing reality—is a heavy psychological burden. It leads to a profound sense of isolation and a feeling that no one truly knows the real you. For most of the years I’ve suffered from CRPS in both my legs and chronic back pain, my abilities have shrunk so much that it is actually really embarrassing for me to talk about what chronic pain has reduced me to. It’s like my chronic pain is a fast moving car that is out of control and trailing behind it is a long list of what I used to be able to do. As the years pass, that list gets longer and I get more embarrassed. Since my nervous breakdown in 2023, something I’ve been working on in my recovery and healing process, is to talk about my pain in ways that reflect my reality. To share the things I didn’t used to share, and to talk about how it all makes me feel. 

The Labor of Adaptation: Why Everything Takes Longer

For a pain warrior, the simple act of living is a complex logistical puzzle. What looks like a single task to an outsider is, in reality, a multi-stage, time-consuming adaptation process. This is a core component of the invisible workload:

The reason for this complexity is energy management. Chronic pain is a constant drain on the body's resources. Some chores like cleaning the bathroom can take all day to do if you are pacing like you should be, and even though it shouldn’t be, that is embarrassing for me. To go from being a very capable adult, to having to split up chores the old me would have never thought twice about doing, into small 5 minute tasks, is really hard to accept. One can feel self conscious that they can’t do this, or really struggle with that, and it’s not an easy way to live. Every action must be weighed against its potential cost in pain flare-ups or days of debilitating fatigue. The preparation, the breaks, the strategic adjustments—all take time, energy, and intense mental focus, creating a completely invisible layer of work.

The Workload of Survival: What Pain Warriors Do to Just Barely Survive

The invisible workload is comprised of countless daily tasks that are purely about pain mitigation and survival. These are the non-negotiable, high-effort actions that outsiders never see.

• The Cognitive Load of Pacing: This is constant. It involves moment-to-moment calculations: If I cook dinner, can I attend the meeting? If I walk the dog now, will I be able to sleep? Pacing is a taxing, non-stop mental checklist to manage a finite, often unpredictable energy budget. It’s like your mind is going a mile a minute with pain signals, and a mile a minute with the thought processing and planning that the mental calculations of the day’s goings ons take, and that’s before the bandwidth and energy it takes for the actual tasks themselves. My mind is always racing with something and it’s proving hard to overcome. 
• The Administrative Burden: Tracking symptoms, logging pain flares, coordinating multiple specialists (neurologist, physiotherapist, rheumatologist), managing prescriptions, and fighting with insurance companies. This is a full-time, often frustrating, administrative job that most of us don’t have the energy for. My mom helps me to do a lot of this stuff, and helps keep me organized, because I just can’t do it alone. It’s too much for me. And that takes up mental space in your brain too. Like I said, my brain is always going. 
• The Emotional and Mental Health Work: Actively managing anxiety and depression that are often co-morbid with chronic pain. This includes forced mindfulness, cognitive behavioral therapy (CBT) exercises, and constant emotional regulation to avoid letting pain dictate the mood. I work very hard on this for myself. I journal regularly with pen and paper, as well as my journaling and CBT apps, which all help me manage my mental health. It’s really hard to fight sadness and worry when you feel so awful, and I do what I need to do so that I’m able to live my best life. 
• The Pre-emptive Recovery: This involves constantly resting before a task and scheduling recovery after it. A 15-minute task might require 45 minutes of preparation and a 2-hour lie-down afterward. This mandated inactivity is crucial but looks like laziness to the uninformed observer. This is also where I get a bit embarrassed and worry about being judged. People with chronic pain or illness are often seen as lazy and are told things like they should just “get over it”, and that is so not the case. We want to be out doing things, we don’t want to have to rest for hours in a day, and we are critical and judge ourselves for that. 
• The Sleep Chase: The tireless, often fruitless, pursuit of restorative sleep. This involves rigid sleep hygiene, special bedding, temperature control, and the management of intrusive pain that tries to derail rest every single night. This is something I really struggle with. My sleep is so interrupted I actually don’t get much deep sleep or REM sleep. I’m not able to sleep long enough to get into that stage, and am woken up a lot in the night with pain, and it takes me time to get back to sleep. This means it’s really hard for me to get up earlier in the morning. I feel like I’m wasting my days, but if I have a really bad night’s sleep, when I try to get up, my eyes simply won’t stay open. 

10 Coping Strategies to Lighten the Load

While the complexity of chronic pain means there's no magic fix, pain warriors can implement strategies to make their invisible workload more visible, manageable, and less psychologically damaging.

1. 🎙️ Choose Your Confidantes: Identify 1-3 trusted, non-judgmental people (a "Pain Posse") to whom you can be completely honest. Offloading the emotional weight to a select few prevents isolation without requiring you to disclose everything to everyone.
2. 📅 Implement the 70% Rule: Plan your day to use only 70% of the energy you think you have. This buffer prevents boom-bust cycles and builds a reserve for the unexpected.
3. 🗣️ Script Your Disclosures: Have a simple, prepared statement for when you need to cancel or explain a limitation (e.g., "My pain is spiking today, so I need to bow out, but I'll catch up later. Thanks for understanding."). This minimizes the energy spent on spontaneous explanations.
4. 📝 Externalize the Admin: Use a dedicated notebook or a simple digital tool to track symptoms, appointments, and medication. Getting this information out of your head frees up significant cognitive space. I created a detailed pain tracker, which you can buy on Amazon here: https://www.amazon.ca/dp/1069213039, or, if you sign up to my mailing list (sign up form is at the bottom of this blog post) I email you a 2 page-spread pain tracking journal pages that you can print out each day to track your pain.
5. 🚫 Practice the Power of No: Acknowledge that saying "no" to an invitation is saying "yes" to your body's current needs. It’s a boundary, not a rejection.
6. 📊 Assign a "Pain Tax": When making plans, visualize a "Pain Tax" on tasks (e.g., a meeting costs 2 hours of energy, a workout costs 4). This forces you to be realistic about your energy budget.
7. 🙏 Accept Micro-Help: Be willing to accept help for small, specific tasks (e.g., "Could you grab the milk from the bottom shelf?" or "Can you carry this bag for me?"). It's easier for others to help when the request is small and defined.
8. 😴 Schedule Non-Negotiable Rest: Pencil in 15-30 minute rest breaks on your calendar as if they were appointments. Do not skip them. This legitimizes rest as a necessary part of your daily "work."
9. 🛠️ Invest in True Adaptations: Purchase tools that genuinely help (reach extenders, ergonomic kitchen gear, smart home devices). The money spent is an investment in reducing the physical workload.
10. 🧘 Separate Self from Pain: Remind yourself: You have chronic pain, but you are not chronic pain. Your worth is not tied to your productivity or ability to mask your suffering.

The Complexity of Chronic Pain

The invisible workload of chronic pain is not merely a metaphor; it is a measurable, exhausting reality composed of endless tasks, adaptations, and emotional suppression. For too long, the default expectation has been for the Pain Warrior to grin, bear it, and hide the profound effort required just to exist. This expectation is a cruel extension of the illness itself.

The core message remains: the work is real, even if it is unseen.

We must move beyond the superficial judgment of how someone "looks" and recognize that the greatest struggle often happens when the person is alone, executing the intricate, time-consuming labor of survival. By shining a light on this invisible work—from the administrative burden of healthcare management to the intense cognitive load of daily pacing—we validate the immense resilience and endurance of those who carry this burden.

To the Pain Warrior, remember that reducing the invisible workload starts with self-compassion and radical honesty with your trusted inner circle. To friends and family, offer the most powerful support of all: unconditional belief and the willingness to see the labor that is deliberately kept hidden.

Only when the burden is acknowledged and shared can it finally begin to lift.

What is the one invisible task you would like those closest to you to understand better?

What is one small, specific way you can lighten your invisible load this week?

You don't have to manage your chronic pain journey alone. Join our community of pain warriors by signing up for my newsletter on the home page or below any blog post on my website:

https://meredithhutton79.com/meredithhutton79

As a welcome gift, I'll send you two complimentary pain-tracking pages and a 200-page household planner to help ease your mental load.

For more resources, browse my collection of chronic pain-themed trackers, planners, and journals at my shop: 

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and my Chronic Pain Worksheets — To Learn And Level Up e-booklet packaged with worksheets I create and sell in bundles in my Gumroad shop: 

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