August 2023

Wellness: Navigating chronic pain, Lawyers’ edition

By Sarah Soucie Eyberg

Describe your average pain on a scale of 1 to 10, with one being little to no pain, and ten being pain that would require a trip to the emergency room.” This is a question I hear over and over from administrative law judges speaking to my clients. In the Social Security Disability system, chronic pain is a factor in almost every case I bring to hearing. Most of my clients have been living with pain—whether it’s dull, burning, aching, sharp, or throbbing—day in and day out for years. Most of them will tell you there is no such thing as an “average” day. And most of them will tell you they have zero “pain-free” days.

This kind of unrelenting pain, even when “mild”—say, a 2-3 on that infamous pain scale—can have disastrous effects to people over time. 

As one writer has put it, “The burden of chronic pain is not only personal, but societal.”1 Studies show people with chronic pain struggle with daily activities like getting dressed, cooking, cleaning, driving, and attending work. And it is unfortunately very common. By some estimates nearly a third of all people worldwide suffer from chronic pain. According to the British medical journal The Lancet, “Pain is the most common reason people seek health care and the leading cause of disability in the world.”2

Chronic pain causes significant psychological distress. Clinical studies have found chronic pain actually induces depression.3 Research has also shown that brain pathways associated with injury sensors are the same brain regions that deal with mood management.4

What research has also revealed is that chronic pain can cause actual physiological changes in our brains. According to a CNN summary of one study, “People with higher levels of pain were also more likely to have reduced gray matter in other brain areas that impact cognition, such as the prefrontal cortex and frontal lobe — the same areas attacked by Alzheimer’s disease. In fact, over 45% of Alzheimer’s patients live with chronic pain.”5

Until 2018, chronic pain was not recognized as a discrete medical diagnosis.6 Doctors and researchers are still finding the best ways to effectively treat chronic pain. Most are familiar with the opioid crisis we are facing as a nation, which was partially fueled by the need to help people with chronic and intractable pain. Unfortunately, the pendulum has swung the other way and many chronic pain patients have been forced to seek other means of pain control.

Lawyers are not immune to the realities of chronic pain. And unfortunately, stress—a common denominator across most fields of legal practice—has been found to increase chronic pain.7 As a wellness article at CNN noted, “Stress can also modulate how pain is perceived by the body; it can cause muscles to tense or spasm, as well as lead to a rise in the levels of the hormone cortisol. This may cause inflammation and pain over time.”8

Lawyering is a profession that is cerebral in nature, with attorneys relying on their cognition to effectively write, communicate, balance caseloads, direct staff, argue orally, and come up with trial strategy. Chronic pain compromises our cognitive abilities over time. It affects mood, recall, affect, understanding and retaining information, and maintaining concentration. 

Attention to well-being can be a saving grace in living with chronic pain. Activities like meditation, yoga, and other forms of mindfulness practice have been shown to reduce pain.9 “[Mindfulness] doesn’t make the pain state any less real [but it] demonstrates that changing the way you think about your pain condition [can] help you deal with that pain condition,” says Dr. Tony Yaksh, professor of anesthesiology and pharmacology at the University of California, San Diego.10

Physical exercise has also been linked to better outcomes for chronic pain sufferers. There are a few reasons this may be true. One study has linked physical exercise to higher pain tolerance.11 That study was based on subjective reporting of both levels of pain and frequency of exercise, though, so the findings aren’t particularly precise. But as the authors note, we do know exercise releases endorphins, which are “natural pain-relieving chemicals in the brain.” Physical activity also improves cardiovascular health, controls weight, enhances mental health, builds stronger bones, increases lifespan, and boosts your immune system.

Chronic pain poses unique challenges for lawyer wellbeing, affecting both the attorney’s personal and professional lives. It is crucial for attorneys to recognize the impact of chronic pain and take proactive steps to address it. By fostering a supportive environment, implementing strategies for pain management, and prioritizing self-care, lawyers can better navigate the complexities of their profession while managing their chronic pain. A healthier lawyer is a more empowered and effective advocate. 

Sarah-Eyberg-2023Sarah Soucie Eyberg is the principal attorney of Soucie Eyberg Law, LLC, a client-centered and future-oriented law firm focused on helping people suffering from disability get benefits to which they are entitled. She is also an active member of many legal professional organizations and serves in several leadership roles.

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