What is pain normalisation?

Pain normalisation is when you are told that the pain you are experiencing is ‘normal’, that is, it falls within the range of what is normal for most people and is nothing to worry about.

When is pain normalisation an issue?

When your gut feeling is telling you that the pain you are experiencing is not normal or not normal for you and your pain has changed enough for you to feel concerned. 

Woman sitting alone on the floor hugging her knees

 

Who normalises pain?

It could be a parent (‘get ready for school, this is normal and you should be able to cope. There is nothing wrong’), a sibling, a friend, a colleague or a health professional. Even you may normalise your pain: ‘I’m sure this is not as bad as I think’; ‘Other people seem to cope with period pain’.

How will you know if your pain is being normalised?

You will know when that your pain is being normalised if you experience feelings of being dismissed and not listened to. You may feel embarrassed, as if you are making a big deal out of something and wasting everyone’s time. You may struggle to understand the pain concern that you have, with no reason to explain it.

If you have felt concerned enough to make an appointment to see a doctor, paid money and taken time out of your day to go, then you clearly have a concern. In general, people don’t make up pain. When they don’t have pain, they are not thinking about it and won’t spend time and money going to a doctor for no reason. They are happily getting on with living their life.

It is then upsetting when you are told that the pain is ‘completely normal, nothing to worry about’ or that ‘everyone has some pain with their periods’. You may be told (or it may be implied) that you are ‘soft’, ‘weak’, are a ‘drama queen’ because everyone else can put up with it – what’s wrong with you? You may feel frustrated that the doctor or health professional didn’t take you seriously. You struggled to adequately describe the pain and symptoms and feel that the doctor didn’t ‘get it’ or understand you.

You may come out of the visit feeling crushed because you thought your concern would be taken seriously. You are there because there is some element to the pain that is different (severity, frequency, duration, type of pain) and you are not managing, or you feel that it has changed enough to warrant seeing somebody about it. 

WHY does pain get normalised?

There are a number of reasons why pain normalisation happens. These include:

  • Comparing yourself to other people
  • Not knowing what is normal (knowing what is normal is challenging for everyone – people experiencing pain and medical professionals)
  • Not necessarily describing the pain or impact of the pain very clearly – we know pain can be difficult to describe.
  • The doctor or health professional not understanding your concerns
  • The doctor or health professional lacking knowledge about period pain, pelvic pain and endometriosis

How can you work out what is not normal?

Because people are so different from one another there is a huge range of ‘normal’. Things for you to consider are:

  • Is this pain new?
  • Is this pain different to what was previously your normal?
  • Can you manage the pain by trying the usual ‘first line measures’ for the pain that you have e.g. period pain? 
  • How much impact does the pain have on your life? (e.g. 1 or 2 days off school or work with some periods; or pain most days of the month)
  • Do you experience:
    • Pain during or after sexual intercourse?
    • Pain while passing urine / doing a wee?
    • Pain while passing bowel motions /doing a poo?
  • If period pain causes you to stay in bed all day, it is not normal.
  • Painful periods that cause tiredness, fatigue, and exhaustion. 

Steps you can take:

  • Check your symptoms and create an EndoZone Health Report and take it to your next appointment. If you go to the doctor with a clear summary of your pain and symptoms then this helps the doctor understand what is going on.
  • Chart your pain and symptoms and how they change over time. You could use a diary or journal to do this. You could also jot down how the pain feels (see point below) and any questions that arise that you want to remember to ask.  You may like to use the QENDO app to track your symptoms daily.
  • Learn to describe your pain and symptoms: doctors usually need to know the qualities of your pain such as severity (how severe it is – score it out of 10 with 10 being the worst), frequency (how often you experience it), duration (how long the pain lasts for), type of pain (throbbing, burning) and where it is usually located or felt (e.g. left or right side, lower pelvis). 
  • Do your own research and learn more about what is normal (e.g. pain and symptoms caused by prostaglandins during periods that interfere with your daily activities) or are not normal for you (lots of school or work absences, pain during or after sexual intercourse, pain while passing urine or doing a poo, or the need to take lots of pain killers)
  • Book a longer appointment. Pain is a complicated topic that can take some time to unravel. It is worthwhile booking a longer appointment or booking a series of appointments to ensure you and your doctor have enough time to discuss all your concerns.
  • Take someone to the appointment with you if needed (but make sure the doctor talks to you and not them)
  • Make sure you tell the doctor or health professional what the impact of your pain is and what has changed for you – this really helps the doctor work out how different from ‘normal’ this is for you.

Additional Resources