COMPANION ESSAY
I first felt the pain in my back at age 15. At the time, I had no reason to think of it as anything more than a temporary sports injury. I had been figure skating for six years at that point; I was working on landing all of my double jumps and passing skills tests to advance in competition level. It started as a slight strain in my mid-lower back if I didn’t properly engage my core. I stubbornly refused to take an extended break and instead started wearing a back brace for most of the day. I spent the next few months in and out of medical imaging and physical therapy, but never completely off the ice.
My coach and I eventually made the decision to have me stop jumping and focus solely on developing other skating skills. One such skill was spinning. Eleven months after I felt that first twinge in my back, and three months after I stopped jumping, I pushed into a spin and my entire back froze up. I knew instantly that this wasn’t one of the low-level strains I had grown accustomed to. My entire spine felt stiff and wooden, with any slight movement sending shocks of pain up my upper body. I left practice early and went about the rest of my day as normal, including an excruciating hour of PE class and an extremely tepid two-mile walk home.
This finally pushed me to take a real break from skating. I had always planned to return once my back healed, but with the pandemic arriving in the U.S. that March, weeks turned into months and months turned into years. As the time passed and the bruises on my legs disappeared, the pain in my back persisted.
I can count on one hand the number of times I’ve stepped onto an ice rink in the last five years. After a year, it was clear to me that what started as a sports injury would now be a constituent part of my reality. I never got a straight answer on the cause of my back pain. MRIs revealed nothing; alternative medicine treatments proved unfruitful. Physical therapy was useful, but only if I was consistent with it, and then only to quell the pain temporarily; it was never a permanent fix.
These days, my pain management strategy is mostly painkillers. I have configured an ergonomic sleeping setup, with an expensive memory foam mattress and a meticulous curation of pillows. I try to stand up and walk around at least once an hour. I’ll often stretch backwards and then reach for my toes, to the misfortune of everyone who has to hear the ensuing visceral cracking of my spine. I try to work on my core exercises and apply the fragments of physical therapy practices that remain in my memory, but more often than not, I just take ibuprofen and move on.
I know that over-the-counter pain medications are not a great permanent solution, and that they can be damaging long-term. My mother was always against me taking pain medication, saying it would desensitize me to its effects. She’s probably right about that. I think she’d be horrified at the Advil-Tylenol-Zyrtec-Lactaid bottle I carry around and refill much too often.
I started taking ibuprofen daily shortly after the pain first started on a doctor’s suggestion. At the time, I thought it was just a temporary thing, that I could go back to my painkiller-free life as soon as this little issue resolved itself within four to six months. Six years later, I still catch myself thinking that this will be over soon, that it’s okay that I take the pills now because this pain won’t be around forever.
It probably will. I am fully cognizant of the fact that only two things have really changed since I first started regularly taking pain medication: I don’t skate anymore, and I know not to take NSAIDs on an empty stomach.
At all times, I am operating at some level of pain. Sometimes it is at a low level, it is not top of mind, and it is enough to mostly ignore, but still present in one way or another. This presents a problem when I am simultaneously injured or otherwise impaired. I started seeing a physical therapist for running-related injuries late last year, and I remember being asked to rate the pain in my ankle on a scale of zero to ten. I was actually feeling less pain in my ankle compared to my lower back, but it was an issue I both should and could address through physical therapy. Because my baseline for pain is greater than zero, I had trouble articulating the pain in my ankle with a number.
Having chronic pain is an invisible illness. Those who fail to find treatment or management solutions must carry on with their lives as normal. Those who find medical remedies must bear the cost of American healthcare and insurance. The pain may not always be debilitating, but it is pervasive.
Though chronic pain is a physical issue, not a mental one, it can profoundly impact how someone views the world and how their body operates in that world. The philosophical view of embodiment, also known as embodied cognition, states that the body and the mind are integrated. We are our bodies as much as we are our brains.
A significant proportion of children and teenagers suffer from chronic pain, which is formally defined as “persistent or recurring pain or pain lasting longer than 3 months.” Among children and adolescents, one literature review from 2024 puts it at 1 in 5. There is a lot of heterogeneity in the severity and types of pain that people experience, which can make it difficult to study, measure, and diagnose.
Despite what the numbers say, chronic pain is not generally considered to be a “young people problem.” It is for this reason that I focused my work on chronic pain in adolescence specifically. I think it creates a reality that is distinct from adult-onset chronic pain, which is more prevalent in our collective understanding of the condition.
Over the past few months, I conducted a series of interviews with other young adults suffering from early onset chronic pain. This project features a series of essays on each of these interviews. Some of these conversations I had with longtime friends, others with people I was meeting for the first time. Every individual shared an indispensable perspective, each of which I hope to do justice through my reflections on our conversation.
As I hope you will come to understand through these writings, experiencing chronic pain in one’s formative years, in the “prime of one’s life,” is uniquely impactful. Chronic pain does not necessarily have to be a part of one’s identity, but as time passes, the perception of self and one’s pain become inextricably bound.