In difficult situations, sometimes a letter is the best way to express yourself or understand another person’s experience. If you have chronic neck and back pain—or know someone who does—a simple letter might offer a bit of respite from the daily pain.

Perhaps your loved one is in pain. You feel disconnected because you don’t know their struggle, but you can still offer support and make their day a bit easier. The letter below offers you an inside look into the feelings of someone with chronic pain and contains tips on how you can be a strong shoulder to lean on.

Or, do you have chronic back or neck pain? Your family and friends try to help, but you know they’re unsure how to be there for you. Share the letter below with your loved ones to help shed light on what you’re going through and how they can help. You can change the letter to make it personal to you.
Dear World,

I’m writing to tell you how you can be a good friend and supportive ally to me throughout my journey with chronic back and neck pain. Years ago, without choice or cause, I was thrust into another world. It’s a complicated place, where physical abilities and mental challenges abound—and you can’t understand what’s it’s like if you don’t live in this world. But I’m here to give you a glimpse into my daily life because the more you know, the better our relationship.

Chronic pain isn’t “normal” pain. It contradicts much of what we understand about pain. When you think of pain, you think of a cause—an injury, illness, or infection. And, you think about pain being temporary. You take a pill, and the pain goes away. You go to a few physical therapy sessions, and your life is back to normal. But chronic pain often flies in the face of all that. Yes, chronic pain can have a cause, and it can eventually go away, but that’s not the case for many who struggle with this type of pain.

My chronic pain is my constant and unwelcome companion. I never know what each day will bring, but I know my chronic pain will be there to some degree.

So, what are the most important things to know about my life with chronic pain? I’ve boiled it down to five main points.

Chronic pain wears a good disguise. When you experience pain daily like I do, you get good at hiding it. I may not use a cane or walker, but that doesn’t mean the pain I endure isn’t significant. And, just because I look healthy doesn’t mean I’m not hurting. It’s not unheard of for people in my shoes to get depressed by their pain. Even if I appear fine, please understand that my pain isn’t taking a day off. There’s a lot going on beneath the surface.

You don’t need to “fix” my pain. I have a doctor who helps me find the treatments that work best for me, so no need to ask, “Have you thought of trying…?” Rest assured, I have. How can you best help? Ask me how I am. Listen thoughtfully to my answer. Give a gentle hug.

Medications are a touchy subject. While we’re on the topic of treatments, please don’t ask, “What do you take for pain?” There are so many stigmas associated with opioids, and this opens up the potential for uncomfortable jokes about prescription drugs or opioid addiction. More importantly, I don’t publicize the medications I use because it increases the risk that criminals may burglarize my home for drugs.

Manners and a helping hand matter more to me than ever. I don’t want to appear helpless or draw attention to my pain, so I might not ask for help. Offering to get me a chair or pillow if I look uncomfortable is a welcome gesture, as is driving me to a medical appointment or running an errand. Also, I know a cane or wheelchair makes people uncomfortable, but please don’t joke about my assistive device or offer to take me “for a spin” in my wheelchair. And, please don’t touch my assistive device without my permission.

Aspects of our relationship may have changed, but I still want to be part of your life. Before I started suffering from chronic back and neck pain, I may have given you a big bear hug when I saw you, but now those embraces are painful. I will let you know how I’m able to show affection comfortably. There may also be times when I have to abruptly end a conversation or cancel plans because I’m in so much pain. Please don’t take it personally, and don’t assume I want to be excluded from plans in the future. I want to be included in your life. I might not always be able to answer your phone call or attend an event, but being invited and knowing I still matter to you means the world to me.

Thank you for reading and taking the time to learn about my journey with chronic neck and back pain. This letter is not just for you but also for me, because I enjoy being around people, having friends, and being a good friend to others—especially you.