• Chronic pain can have a huge mental health toll, and can put strains on a relationship

  • Karra Eloff, author of The Chronic Pain Couple, explores the hidden battle couples face and shares practical solutions

  • We have therapists who specialise in working with chronic pain here

For most of us, our exposure to chronic health conditions and chronic pain is fairly limited in our young years. So, when we declare at the alter or whisper lovingly to our partner, ‘through sickness and in health’, many of us envision sickness creeping in as we age, after we have lived the happy life we planned together. But what if health problems strike much sooner? What if there is a lot more sickness than health in our relationships or a partner starts to experience chronic pain? Well, the research shows when there is, it definitely puts a strain on a relationship.

1 in 5 adults suffer from chronic pain and this number rises to 1 in 3 for people over 65 years. Research has found a partner with chronic pain can cause a decline in relationship satisfaction, an increase in home life stressors and put both partners at risk of serious mental health problems.

So, what is chronic pain? Chronic pain (also referred to as persistent pain) is defined as any persistent or intermittent pain that lasts more than three months. Perhaps you know this already. Maybe you jumped at the chance to click on an article about chronic pain and relationships because well, there are not many resources out there that follow the problem of chronic pain into our homes and into our bedroom. Yes, a partner with chronic pain also challenges a couple’s intimate relationship. But before we pull back the covers on some solutions for that topic, let’s look at some common problems and practical solutions.

Get on the same team

Chronic pain can certainly wreak havoc in a relationship. It’s the fatigue, the constant problem solving, the unpredictability of pain that results in sudden changes of plans. Also, often difficult to navigate is the loss of shared hobbies, financial stress, changes to career or family planning, mobility changes and intimacy issues (to name a few). 

One fast way to strengthen a relationship when a partner experiences pain is to get on the same team. It’s not one partner with pain vs the other partner, it’s both partners vs the pain. When couples together learn about chronic pain, and work together to navigate it, they take a giant leap on the path to a remarkable relationship in spite of it.

What does this look like practically? A great place to start is to understand the mechanisms of persistent pain (Noigroup have great resources) as well as any underlying health conditions. The more both partners understand the challenge they are up against (pain is a tough component), the easier it is to navigate options and solutions. 

It’s important a partner’s healthcare team include the supporting partner and provide knowledge about all treatment options, strategies for how to help their loved one, but perhaps most importantly, also support the supporting partner. Persistent pain impacts the lives of both partners, not just the partner with chronic pain.


Minds matter

Research has found it is not only pain intensity that determines relationship satisfaction, it is also the mental health wellness of both partners. This is great news because most couples believe the only way to get their happy and passionate relationship back when chronic pain steals it is to find a cure. Yes, we should all chase a cure and healing, but for many there is a moment when the gravity of that word ‘chronic’ hits, and it’s then important to know there is another road to a joy-filled relationship. 

It begins with pivoting attention to both partners’ emotional wellbeing. Caregiver burnout is a common problem that can arise when caring for a loved one with chronic pain. On the other side, chronic pain is a condition that often comes with emotional changes such as depression and anxiety. Actually, part of the definition for chronic pain is that it is a sensory and emotional experience (IASP).

It makes sense that when our lives change so dramatically because of chronic pain, we think pain has to resolve to return to the happy life and relationship with our partner we desire. This is not the case; investing in both partners’ emotional wellbeing is a great first step on a different route to a remarkable relationship in spite of chronic pain.


Intimacy issues are common

Just over 70% of individuals with chronic pain report problems with intimacy. Although this can be a difficult issue for a couple or individual to raise with a healthcare team, it is an important part of relationship satisfaction and health and wellbeing.

Difficulty with desire and painful sex are two common problems people with chronic pain report. Supporting partners can also experience a range of emotions and reactions to the changes to their intimate life. It’s helpful to understand we all have a sexual response mechanism that includes a sexual accelerator, which is always on the lookout for sexual stimuli, as well as a sexual break, which tries to keep our attention on survival (according to Emily Nagoski, a world leading sex expert). Chronic pain is a sexual break. No surprise there.

For partners with chronic pain, there is a barrier to becoming aroused, even before we can get to any problems related to pain due to sex or a supporting partner’s feelings. Other common reasons for a lack of desire for partners in pain might be due to medication side effects, self-esteem issues or mental health difficulties.

It’s important couples have a health professional who is willing to discuss intimacy concerns and that couples have a practical strategy on how to navigate changes in the bedroom due to pain. Perhaps it’s time for the couple to bring intimacy into the everyday or be intimate without the pressure of ‘penetration’. A great place to start is making a list of five intimate activities both partners enjoy that isn’t penetration. 

Couples can also explore all kinds of sex schedules to allow a partner with pain to plan activities around intimacy and their fatigue and pain levels. At first the thought of planning sex may sound unattractive, but a well-executed sex schedule can be a great way for chronic pain couples to reignite their intimate connection.

There are numerous practical strategies couples can use to enjoy a remarkable relationship in spite of chronic pain. These can be found in Karra Eloff’s new book, The Chronic Pain Couple: How to be a Joyful Partner and have a Remarkable Relationship in Spite of Chronic Pain or in workshops and other resources at www.chronicpaincouple.com

Photo of the author and her partner, credit Maryanne Lister

Further reading

How can therapy help with chronic pain and illness?

Chronic lower back pain and trauma: is it time to think differently about pain?

The link between chronic illness and depression

What is intimacy anyway?