My Resting Pain Face

By Elizabeth Medeiros

3 min read

I was indoors at a family party and trying to hold it together. The humidity that day was oppressive, something my joints didn't appreciate. The sky opened up outside, and it poured for the next two hours. My pain level increased bit by bit.

I went from socializing and smiling to sitting stiffly in the corner. I did my best to keep my face from twisting into a grimace, but I probably looked miserable and unapproachable. When it was time to leave, I got into the car, shut the door, and sobbed from the pain. Not to mention the grief of sitting in the car for an hour-long ride home.

Struggling to hide the pain

I repeatedly hear from others living with chronic pain that they've learned to push past the pain. They learn to function as if nothing was wrong - without others even realizing it. And frequently, they talk about the mask they wear, forcing a smile and wearing makeup to hide dark circles. I have also learned to do this, to the point I have 'tricked' many of my acquaintances. And we do this for many different reasons.

But sometimes, I just can't help it. When my pain levels are soaring, it's hard to put on a happy face. Especially in those moments where I'm not talking to someone or doing work, but just taking a moment to sit and rest.

I have seen myself in the background of photos, I know I can seem quite unapproachable. Sometimes, I wish I could wear a sign around my neck that says, "not angry or mean- just in pain" because it's the truth! While I may look angry, anxious, or overall displeased, in reality, I'm just in pain.

My face and body react to how I'm feeling

Aside from my clumsiness, the way that my pain shows itself is through my expressions and body language. It tends to come at some of the worst times- at special gatherings while meeting someone new, or at work. It's during those times I really don't want to share how I'm feeling.

Yes, I can work through a decent amount of pain without showing it. But after a while, it visibly takes a toll on me- just ask the coworkers who sit across from me. I furrow my brow, bite my lip, or look very overwhelmed at times, even if I think I'm coping just fine. Plus, my body language can also become quite closed off.

Finding easy ways to manage my pain

For those times that it's important to make a good impression or when I don't want to give away how I'm feeling, I've learned a few ways to cope physically and mentally.

I have a hard time controlling my body language because joint stiffness can make me hold myself stiffly and in closed-off positions. So when I start to feel myself close off, I do my best to stretch out a little. I try not to cross my arms, but I might still keep them close to my body. Keeping compression gloves in my purse also helps, because I can put those on when I feel like I want to ball my hands into fists.

I also make an effort to frequently unclench my jaw, which helps my face appear less tense as well as improves my TMJ pain (usually). Actively reminding myself to relax muscles in my face and body helps me look less tense and improves my pain a bit.

I'm always kind to myself

But first and foremost, I'm always kind to myself. I don't think having a reaction to the pain is a bad thing- in fact, it's the most natural thing in the world. I'm not hard on myself when I catch myself in a closed-off position or grimace. I just do what I can to loosen up a little and try again.

I also don't feel pressure to try to put on this facade all the time- just when I feel it's best. Working in my own cubicle, taking public transport, or being around others who "get it" are times I don't feel particularly pressured. Anyway, if anyone says anything to me, I just remind myself they might react the same way if they walked a mile in my shoes.

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quillingmama Member
That idea of pushing past the pain has left me with a huge amount of regret!!! I had gotten a better job in the factor I worked at. Our daughter was in grade school, I worked 2and shift so I missed the evening activities but managed to go to a lot of the schools field trips and classroom activities. I was working insane hours at the same time so of course I was making the huge mistake of missing follow up appointments with my surgeon. I finally had a friend at work call me out on my BS when I answered I'm okay when he asked how I was. He confronted me cause he also dealt with a high level of pain and he said the way I looked he figured I was actually hurting way worse than he was. Of course Hubby was trying to get me to go even before that. When I saw the xrays across the hall I kept telling myself please don't let that be my xrays. Of course it was mine and it looked so much worse when my surgeon brought it into the room. A few month later he reconstructed the right side of my jaw and then I had a total joint replacement on the left. A couple years later the right side was redone again and there was just way to much nerve damage for me to ever get to go back to work. It just kept getting worse. 7 surgeries including 3 joint replacements. I can't help but wonder would it happen made a difference if I hadn't tried to push though the pain. 
1. quillingmama Member
 <inline-mention username="Lori.Foster" user-id="3297576"/> I am never going to be without a lot of pain but I do have jaw joints that have stayed stable for many years now. You sort of find a new normal and get on with life. I hope that from time to time maybe something I say can help somebody else so they don't make the mistake of skipping important appointments!!!
2. Jill.Brodie Community Admin
 Hi @quillingmama, we are so glad you are a part of our community. We are so grateful for all the posts that our members make as we help each other through the various stages and symptoms of psoriatic arthritis. Jill, Team Member
ralphcook Member
I was diagnosed following a blood test with psoriatic arthritis when I was aged 35 years. The blood test was carried out because I had a swelling in my left knee. Apparently I have a typical case of psoriatic arthritis but it rarely manifests as painful or even an irritation. Why? Well the only difference I can see between myself and other victims of the disease is that I have been vegan for most of the last 42 years. I do not eat any of the main foods that cause inflammation - meat, eggs and dairy. When in Germany (my partner is German) I tended to let my diet slip from fresh, home-cooked vegan food which I always consume in the UK, to highly processed, take-a-way vegan food, which is probably as bad for the human body as meat, eggs and dairy. In August 2013 whilst travelling back to Germany after a short stay in the UK, I had a heart attack (I still travelled because I didn't realise how serious the event was) and later when back in the UK I then suffered an aortic dissection at the beginning of December 2013. I am convinced these events were the result of the inflammatory activity of my less healthy Germany diet. Both in Germany and the UK I now remain strictly adherent to my fresh home-prepared, healthy vegan diet. 97% of aortic dissection victims die within five years - most before, during or immediately following the surgery that seeks to save their lives. I'm not in great condition but I am one of the 3% that have outlived the five year cut off. Two weeks ago, I had a blood test which reported my inflammatory marker stands at "2". The average healthy young person displays a marker of about "5", most "healthy" meat eating adults are over "20". Only a week earlier - with a leg infection following recent surgery to remove infected metal from my leg - my inflammatory marker was "105". My surgical team told me yesterday that my inflammation marker was the lowest they'd ever seen in a person of my age and asked how it was possible! I could tell you a great deal more but I will refrain from doing so because frankly despite numerous reports by myself, not a single fellow sufferer has ever responded to my comments in several years. I'm becoming convinced that people on this forum are not really interested in even experimenting with diet as a means of potentially controlling their symptoms. Whilst I accept I know of no other vegan psoriatic arthritis patients and thus I cannot say it is definitely my diet that distinguishes my experience from that of others, my message to psoriatic arthritis sufferers is to consider stopping the consumption of all animal products for at least six months and eating only a plant-based diet that contains as little processed food as possible. You would also have to accept it's unlikely that after six months, you will experience my level of comfort (because I haven't eaten animal products for decades) but I would hope you would see at least some improvement in your condition which if you continued with the diet would over time further reduce the amount of inflammation in your bodies.
1. ralphcook Member
 <inline-mention username="Lori.Foster" user-id="3297576"/> I found reading that very depressing. I do not want to simply dismiss what the author says but I fear she has not recognised the facts she has uncovered in respect of her own triggers. She notes sugar, alcohol and dairy are the primary triggers of her pain. I concur, all three are certainly causing problems for everyone with psoriatic arthritis and a range of similar diseases as well. Then she says there are other means of controlling her condition - that is true but I don't think she is fully committed to searching for a more natural means than medication. She doesn't mention meat - few people do but that is very clearly - the science concurs - the leading promotor of inflammation and I think most victims of diseases like psoriatic arthritis really just do not want to acknowledge: this is probably because of the new lifestyle that taking it seriously will impose on them. Finally on the potato, tomato etc. What foodstuffs does one eat alongside those two harmless vegetables? Yup, we combine the food types in ordinary parlance all the time "meat and potatoes", "cheese and tomato"! I really believe people blame the veggies because they are distantly related to a poisonous plant, rather than the meat and dairy they are consuming alongside the vegetables and at the same time! It is far more likely that the animal products, rather than the nutritious plant foods that are involved in promoting the pain and joint damage. I really wish people with psoriatic arthritis were offered the opportunity to participate in long, medium and short term diet research designed in consultation with people like me who have independently studied their own health in the context of diet for decades. 
2. Lori.Foster Community Admin
 It would be wonderful to accumulate some long-term research on the impact of dietary changes on PsA, @ralphcook. Thanks for your insight! - Lori (Team Member)