A phenomenological hermeneutic study into unseen chronic pain.

Acute pain is often accompanied by physiological changes, such as increased heart rate, unlike chronic pain, which in sharp contrast is often unaccompanied by any physiological changes other than the patients' self report of pain. Coupled with the lack of physiological changes, chronic pain will outlive the usual healing period if an injury has been sustained thereby leading to the unseen nature of the chronic pain phenomenon. This study (n?=?8) adopted a multi-method approach - a low-structured interview coupled with patients' diaries - and was analysed hermeneutically. 'Unseen pain' was identified as a category with subsequent themes of 'isolation', 'needing to prove the existence of chronic pain', 'in their head' and 'depression'. The unseen nature of the chronic pain phenomenon caused further distress to patients as they could feel disbelieved by society as well as by healthcare professionals. This has a profound effect on patients who then channel valuable psychological resources into appearing credible to society and healthcare professionals in particular. The lack of clear explanations and a definitive diagnosis or acceptable label also adds to the invisible nature of the chronic pain phenomenon and as healthcare professionals we need to confirm the validity of the expressed pain narrative through means that do not enforce illness behaviour, but empower the patient to accept their chronic pain and live with it rather than be ruled by it.