What Types of Stigma Surround Chronic Pain?

Individuals with chronic pain often experience stigma, which can negatively impact both their mental and physical health. Stigma is defined as a set of negative beliefs about others with a specific characteristic or trait, including, but not limited to, a health condition, disability, religion, or sexual preference. Stigma can be categorized into three main types: public stigma, systemic stigma, and self-stigma. Unfortunately, all three types can affect individuals with chronic pain.

Public stigma

Public stigma is a set of negative beliefs or prejudices held by society that lead people to discriminate against individuals with certain characteristics, traits or conditions.

Examples of public stigma surrounding chronic pain:

• A medical professional assuming that an individual with chronic pain is drug-seeking or exaggerating the severity of their pain
• An employer making a hiring or promotion decision based on the belief that individuals with chronic pain are lazy

Systemic stigma

Systemic stigma involves stereotypes and prejudices that are embodied in laws, policies, or institutions.

Examples of systemic stigma surrounding chronic pain:

• A physician’s office instituting a policy against prescribing narcotics, potentially preventing individuals from receiving adequate pain relief
• A medical facility requiring individuals who require strong pain medication to submit to random drug screenings or sign a “pain contract” that uses demeaning language, conveying suspicion and disbelief
• Blood tests or X-rays required as “proof” of disability to receive Social Security disability or other necessary benefits even though some chronic pain conditions do not produce any abnormal test results

Self-stigma

Self-stigma occurs when an individual internalizes stigma from the public, systemic policies, medical professionals, employers, friends, or family members. Individuals with chronic pain may begin to see their pain as invalid or illegitimate. This can negatively affect self-esteem and mental health as well as making them less likely to seek necessary treatment.

Examples of self-stigma surrounding chronic pain:

• An individual with chronic pain not seeking treatment because health care providers have doubted the reality of their pain
• An individual with chronic pain questioning the validity of their pain because friends and family don’t understand the impact that chronic pain has on the individual’s life.

Additional sources used to create this article include Stat News, National Alliance on Mental Illness and Tennessee Department of Mental Health and Substance Abuse Services.