Does Fatigue Worsen Chronic Pain Or Does Chronic Pain Cause Fatigue?
- Jean Jordan
- Mar 29
- 8 min read
Updated: Mar 31
What do you notice most - your fatigue or your chronic pain?
The title of this article implies a constant circle similar to the chicken and egg situation. There will be various influences involved such as:
How well you sleep.
Your personal responsibilities.
Your anxiety levels.
Work commitments.
Ongoing thoughts and emotions.
What about the messages you send to yourself?
I'm tired, so my chronic pain is worse!
Or is it that I'm in chronic pain so that makes me tired?
This really, truly is a chicken and egg situation. You need to have chickens to lay eggs, but you need an egg to get that chicken to lay their eggs?
When you're locked in daily chronic pain it is impossible to know, or to break down the connection between tiredness and your pain.
After months or years it becomes an unending a cycle, a pain roundabout you travel every day.
Pushing through is an expression I hear from my chronic pain clients, a lot.
Fatigue is a word, often ticked on my induction form. Fatigue is a favourite, closely chased by anxiety.
So, what is fatigue?
Is fatigue a mental thing?
Okay if you don't sleep due to your pain, then I accept you can be physically tired as a lack of sleep is obviously a valid reason for having worse chronic pain at the same time feeling exhausted and tired.
Most of us will believe that being tired is purely a physical body symptom but why do we feel so tired without doing physical actitivty or strenuous exercise?
Research is now begining to show that feeling tired or the sensation of tiredness is the action of our brains.
If you think of occasions that you felt tired but got distracted by pleasant visitors or a hilarious program on the television, you couldn't stop laughing.
My story of Chronic Fatigue Syndrome or CFS
My chronic fatigue happened several decades ago. At that time, it was called myalgic encephalomyelitis or ME.
I was lucky enough that our small town had the most amazing doctor who could gave me a diagnosis of ME immediately following a bout of shingles. Of course, being a somewhat driven person, I now know I did everything wrong. Instead of accepting that I had shingles, I should go home to bed, rest, and let my colleagues at the high school where I worked look after my pupils for a few weeks while I recovered.
But after training in mind body medicine, I know that certain personality traits, such as being a perfectionist or people pleaser are more prone to developing chronic pain. One of my personality traits is that I'm extremely conscientious. I thought I had to turn up to work every day and to teach my students as I needed to be there - It was important for their education.
Now that we have the knowledge of neuroplasticity and the neural pathways in the brain have given us more options of recovery from such things as:
o Chronic fatigue syndrome,
o long COVID,
o ongoing back pain,
o fibromyalgia,
o and the list is endless.
What medicine calls nociplastic pain and conditions that basically doctors have no idea why we don't get better, and the conditions continue, often worsening over time.
But as this article is about fatigue one of the major symptoms of CFS.
Let's return to my fatigue story.
I don't remember having any time off with my shingles other than a couple of days. Then I returned to work with strong pain medications that had me climbing up the wall after three hours, but I had to wait another hour before I could take the medication.
o But I continued to work.
o I continued to drive for over 30 minutes to work and back.
o I continued to do all aspects of my job.
o And I continued to collapse on the sofa as soon as I got home.
As some of you will know CFS is not an easy fix and can go on for months or years. It may affect your life for decades. Chronic fatigue syndrome is also something that may tend to get worse as time goes by and includes all those lovely things on the list at the beginning of this article.
Therefore, returning to the topic of fatigue. At the time of my fatigue, I did make some changes not immediately but sometime later. Unfortunately, I was determined to push through - remember that conscientious trait of mine.
I was lucky enough or maybe essential enough at my high school for the management to change my timetable so that I could take every Wednesday off. Also there was a colleague who lived quite close and picked me up on the remaining days I went to work.
These were changes that I made after not recovering as I expected..
o I had a Wednesday off to rest.
o I also could sit back in the car and not use up any energy driving to work.
o I had the recognition that I was respected enough at work for them to accommodate my health issues.
o I also had a colleague to have a chat with every day driving to work and coming home who was an interesting character.
o Also at this time I met and started a new relationship with someone who is very, very supportive and seemed to really enjoy taking care of me.
Now with my training as a neuroplastic practitioner I recognize that those changes in the paragraph above allowed me to feel different. By making changes I had effectively changed neural circuits in my brain.
I recognized I needed to take care of myself. I didn't need to continually push to get through the day.
And more importantly there was no medical intervention during this time. When my shingles had resolved I no longer took any pain medication.
Recovery from my chronic fatigue syndrome probably did take several years and I think the most notable proof of this, or indication was when I took up golf.
When I first started, I needed to go home and collapse on the sofa because I was so tired.
But that too resolved, and I was able to play regularly for the ladies pennants golf team.
How To Manage Chronic Pain
Tiredness - I've expended all my energy OR have me and my pain over extended myself.
These are questions for which I don't have the answer, but I'd like you to think about.
Ø Is your brain making you tired?
OR
Ø Is your body making you tired?
Resting, taking a breath, will this help?
Learn techniques or ways to make changes to your thoughts
What if you can find something or some way that can relieve or reduce your pain levels? Check out the example below, a conversation I often have with women stuggling with chronic pain.
They must have a tidy, spotless clean house
Here is one contributing aspect to fatigue I've often had discussions about - housekeeping!
If this applies to you're welcome to try it out. though it does require a change in mindset, the way your brain thinks your house should look.
Reduce - it may be done slowly, step by step, or get others involved - that need to be or to have perfection, in your housekeeping, may impact your pain levels.
I realise not many chronic pain specialists will be asking you about housekeeping or feeling proud of your house and home. But as I said above it is an important key that may open pain-free or painless times in the future.
Memories, thoughts and habits are strange but valuable things. They can be either good or bad but sometimes changes need to be made - change those perfectionist neural pathways in your brain.
I just like to end this blog with a story of my own and it brings in a memory getting planted in my brain that I cannot get rid of, as you've read above a lot of our thoughts and actions and rituals govern much of our day and hence influence the level of pain that we have to live with.
How Memories Impact Chronic Pain
At the time I was living in Perth, post surgery that left me with ongoing pain. Therefore I did what most of us do and end up, via the doctor, going to a chronic pain specialist. Actually, I visited two different pain specialists, each of them twice in fact.
The final appointment was with a professor, therefore top of the hierarchy in chronic pain specialists. This was a second visit. I shared with him the impact of the pain medication he'd prescribed.
I can't describe it as anything else but it sent me "doolally", I really felt everything was not right inside my brain after just a week of taking his recommended medication.
Therefore I told he I didn't want to take the medication anymore. I hoped that he might suggest something else. Perhaps you have found yourself in a similar position?
Shortly after this he examined my arm and my shoulder, which at the time were not working very well, very painful and didn't want to move too much. As a consequence, this is what he said about not taking his prescribed medication.
He said,
"You'll be back in 10 years time and you'll be begging me to give you an injection to relieve your pain."
Now I'm not sure of the date and I don't quite think I've got to the 10 years yet. But you know the sad part is, I was lying in bed one morning, it was our national holiday so didn't have to get up.
That morning I could feel pain in my arms and shoulder mostly because I'd done a lot of gardening the previous day, however his voice and what he said came back to me and it was nearly 10 years ago!
UPDATE: Over 10 years later, definitley not in need of an injection!
Techniques to Change Negative Thoughts
Therefore, time for changing negative thoughts. Time for techniques with some positive thinking and some breathing before I got up. But you know I really, really, really, really, wish that chronic pain specialist had not made that careless remark. It was really unnecessary. Of course I'm sure he doesn't remember it but unfortunately I do, sometimes, it only happens when my right shoulder decides it wants my attention.
Or my over-conscientiousness automatic behaviour trait again!
I hope this article is prompting you to ask questions, first in your own mind and then you are ready to talk to a pain specialist who you can answer your questions!!
Need support for your changing your thoughts
NOTE: The above is the opinion of the author and does not diagnose chronic pain. If you have pain - visit your doctor to fully check your symptoms.
Jean Jordan – about me
After over 20 years of owning pain clinics, I started Natural Pain Solutions (NPS) to reach more people, rather than one person at a time. After studying Postgraduate Pain Management & Freedom from Chronic Pain with Howard Schubiner, I want to spread the word about neuroplastic holistic self-help techniques people can use at home and healthcare practitioners can use in their clinics.
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