Randall H. Duckett

I wrote Chronic Pain Chronicles after years of experiencing, researching, and pondering chronic pain

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They say, “Write about what you know.”

I know pain.

When it comes to hurt, I have a PhD (Personal history of Disease).

This is a book about my life in pain, but it’s much more. It also features stories from other sufferers (see Pain Profiles and Pain Points). It offers reporting about chronic pain, including advice from experts and the latest research into it. It’s designed to capture what it’s like to live in chronic pain and, if you are a fellow sufferer, to help you feel understood and less alone. 

My story

Diagnosed at age 6, I suffer from a rare genetic condition called multiple epiphyseal dysplasia (MED), which caused my joints and bones to deform as I grew and aged. 

I share this rare distinction  —  MED occurs in about one out of every 20,000 births  —  with It’s Always Sunny in Philadelphia actor and Jersey Mike’s pitchman Danny DeVito (though I am of average height as compared to his 4'11" frame) and former Secretary of Labor Robert Reich.

To understand MED’s effect on my body, think of broken gears constantly grinding against each other and wearing down with use. Over time, this has resulted in osteoarthritis and severe chronic pain (technically known as chronic pain syndrome). 

Every day, I ache head to toe, mostly with osteoarthritis in my legs, torso, arms, and neck. I get frequent stress headaches and jaw pain, likely from the tension of girding myself against hurt. I suffer from comorbidities that go with pain, like depression (see chapter 10) and anxiety. I have neuropathy in my lower legs and scoliosis, stenosis, and bone spurs in my lower back. My left foot constantly spasms due to nerve damage from an ankle fusion. My right elbow freezes up frequently and I sometimes have a pain in my left hip from some leftover hardware from a hip replacement. My tail bone gets painful when I sit on hard surfaces, which was caused by years of slouching in a wheelchair.

Pain infuses my body, which feels like a sponge dipped in acid. 

Examining my pain

Ack! Enough complaining. I’m not a whiner. I tell you all this not to get sympathy, but to establish my bona fides as someone who knows what it’s like to have chronic pain. Throughout the years, I’ve done an untold number of things to control my pain and find relief. 

I’ve had eight joint replacements (both hips twice, both knees, and both shoulders) plus had both my ankles fused. I have more metal in me than the X-Man Wolverine (played in the movies by Hugh Jackman), whose skeleton is laced with the indestructible and fictional metal adamantium. (See comic books and movies.)

I’ve taken thousands of pills and used countless opioids (see chapter 7). I’ve done dozens of procedures like injections and epidurals. I spent hundreds of hours doing physical therapy. I’ve tried everything from complicated knee braces to a TENS unit, which sends electronic pluses to disrupt pain signals.

I’ve lived with chronic pain for decades, but until a couple of years ago, I didn’t really examine it. For all my experience with hurt, l didn’t know a lot about it. 

It was just a given, a part of my life. It had brought extreme consequences, including crashing my career (see chapter 4) and forcing me to retire at age 53 due to disability. It cost me an estimated $2 million (see chapter 5). It affected my relationships with my wife (see chapter 2). As I aged, it threatened to take over my life. 

In late 2023, after a decade of surgeries (see chapter 4), I felt well enough to apply my skills as a journalist of 40 years experience to studying chronic pain  —  mine and that of others. The result of my research and thinking is this book. 

A whole lot of hurt going on

It took me about two seconds of googling to discover I am not alone in my pain. 

According to the National Center for Health Statistics, “In 2023, 24.3% of adults had chronic pain, and 8.5% of adults had chronic pain that ... limited life or work activities (referred to as high impact chronic pain or HICP) in the past 3 months.” Doing the math, that translates to more than 60 million American adults with chronic pain. That’s about twice the population of Texas. About 21 million have HICP — more than the number of folks who live in Florida.

What’s most astounding is how pain has skyrocketed recently. A previous report from the Centers for Disease Control and Prevention (CDC) showed that the rate of chronic pain stayed relatively steady between 2016 (20.4%) and 2021 (20.9%), then shot up by 3% in just two years (2021 to 2023). That’s 8,670,000 more American adults who reported chronic pain. This time correlates to the pandemic, of course. Whether the rate of increase will continue is unknown. 

And it’s not just adults in enduring hurt. According to the journal Pain, in the 70 countries studied: “The overall prevalence of chronic pain in children and adolescents was 20.8%, with the highest prevalence for headache and musculoskeletal pain (25.7%).” 

That means one in five kids is in chronic pain. As a lifelong sufferer, I can testify that pain in childhood shapes you as a person. 

Digging into the numbers, chronic pain is more prevalent in females (see chapter 19), in older people, and in rural communities.

The CDC also reports:

• Pain is the number-one reason Americans use the healthcare system.

• Chronic pain is the leading cause of long-term disability in the United States.

• Chronic pain disproportionally affects the poor. 

Chronic pain has an impact on us all, not just its sufferers. A 2010 estimate found that America spends up to a whopping $635 billion each year on chronic pain in terms of medical treatments, disability payments, and lost productivity. That’s a 15-year-old number, so I’d wager that the economic impact of chronic pain in 2025 is about $1 trillion annually (see chapter 5).

The legions of people with chronic pain and their loved ones and healthcare professionals who tend to them is predicted by the National Institutes of Health (NIH) to grow in coming years due in part to an aging American population, the prevalence of long COVID-19, and better understanding of how chronic pain really works. (NIH referred to it as its own separate disease in 2005).

Numbers don’t tell the story

Some 60 million people (including 21 million of them with HICP) represent enormous numbers, yet they, by themselves, don’t tell the story of chronic pain. 

That’s because these stats represent tens of millions of individual people who hurt. This may be you, your family members, your friends, your coworkers, or others you know. The gross numbers belie the suffering that these folks endure  —  the aches, stabs, zaps, burning, soreness, stinging, pangs, agony, anguish, searing, misery, torture, and more that make up the lexicon of symptoms of chronic pain.

Exaggeration? The impact is not only physical, but mental. Think about what it must be to feel trapped in your own body, at the mercy of pain that’s often out of control, hurt that doesn’t heal, hurt that’s permanent. 

Some conditions might be merely irritating, like a hitch in the hip, but can drive a person crazy, like having flies constantly buzz in your ear. 

Some are excruciating, like extreme lower back pain (the most common kind of chronic pain), and leaves sufferers confined to their chair or bed.

There is not one kind of chronic pain because there is not one kind of human. Each person’s pain is unique. I cannot feel your pain and you cannot feel mine.

Those of us who suffer from chronic pain are caged in our bodies with a hungry tiger stalking us. Not only is there physical danger; there is mental anguish as we, being human, try to think of solutions to our pain, ways that will make it more survivable, ways to outfox and “fix” it.

The brain is flexible

But pain is a cruel opponent. 

The nature of chronic pain, though, is that it often can’t be completely cured. It may be eased by medication, operations, and other treatments, but, by definition, it endures. Most often, it cannot be fixed in the conventional sense of completely going away. It can only be managed. 

That is not to say there is no hope. Emerging science sees chronic pain as an aberration of the body, biology gone wrong, but more so, it’s something that happens in the brain, where pain is perceived (see chapter 15). 

More research has uncovered that the brain is flexible, which is called “neuroplasticity.” As such, conscious thoughts and conditioned responses can be manipulated.

In short, the brain is where pain is processed. It can decide pain is agonizing or it can take it away. In fact, some have retrained their brains to cure chronic pain (see Pain Profile: Cured By Brain Retraining).

The advice to sufferers I hear most often, from patients to experts, is to not give up. Chronic pain can be conquered. 

Thoughts on pain

Why did I call this book Chronic Pain Chronicles? It speaks to the diverse feelings sufferers have about being hurt, the many stories that go with pain. The aim of the book is to answer a simple question: What does living in chronic pain really feel like?

In the following pages, you’ll find essays on various aspects of chronic pain, from its mechanism (see chapter 15) to how to reach acceptance (see chapter 36). These essays reflect my unique perspective on pain. But I’ve found they are topics others can relate to, common feelings that span sufferers.

At its essence: Chronic Pain Chronicles offers perspectives on pain from me and many other sources. Its core is my life story and those of people who suffer, along with thoughts from doctors, physical therapists, and other experts who work with such people. I hope they offer information, insight, and inspiration.

Essay source

Versions of these essays first were published on Medium.com, an online site where writers and readers come together to share news, perspective, and thinking. I spent all of 2024 and the first half of 2025 researching and reporting on chronic pain  —  mine and that of others. These essays have been edited and slightly rewritten for this book. (For my latest work, follow me on Medium
@randall234.)

Medium welcomes users to comment on pieces like mine, so many of the ones here include what I call Pain Points, thoughts from other sufferers that add to what I’ve written. Commentators are identified by their Medium usernames unless otherwise requested.

Throughout this book, I’ve also done Pain Profiles of people in chronic pain, from a graphic designer in her 20s (see Pain Profile: Craving Relief) to an amateur poet in her 60s (see Pain Profile: Game Pain). I’m grateful to these folks for sharing their stories. 

I am not a doctor

It is important to note that this is not a medical book (and I am not a doctor or healthcare provider).

This is also not a science book. I urge you to learn more about the technical aspects of pain from the sources I’ve included, but you do not need to know them to understand this book.

I interviewed experts, but there are plenty of books about pain by people with letters after their names. 

Precious few are from actual sufferers, and those tend to be memoirs rather than reporting on pain. With this book, I’ve tried to give sufferers a voice. 

As you read further, you’ll get different slices of the chronic pain story.

• If you are a sufferer, Chronic Pain Chronicles is aimed at helping better understand pain by exploring key aspects of what it’s like and offering advice about how to cope. It will give hope to sufferers and help them feel less alone (loneliness is a common complaint; see chapter 16).

• If you are a caregiver or loved one of a chronic pain sufferer, you’ll find a window on the chronic pain and come to better understand what people for whom you care are going through.

• If you are a physician, nurse, or other healthcare provider, you’ll come to better grasp where patients are coming from, where the healthcare system fails them, what can be improved.

• If you are a policymaker, you’ll see that there are real people out there suffering and deserving assistance, not by restrictions on medications but proactive programs to help constituents trapped in their bodies, feeling forgotten.

The book is unique in the chronic pain self-help genre, in that it is about the fierce feelings that come with chronic pain, including the powerful mind-body connection (see Foreword). Physical pain affects emotions and vice versa.

After a long debate with myself about just what to call us, I use the word “sufferer” in this book to describe people in chronic pain. 

“Patient” is too clinical and impersonal. The term doesn’t capture anything near the experience of pain, other than that lots of us spend too many hours in waiting rooms being impatient patients. 

We should not be defined by our pathologies. I hate it when doctors and nurses say things like, “Oh, you’re the hip” rather than referring to me as a person. 

I haven’t found a better word than sufferer. To me, it gets closest to the experience of people in chronic pain  —  we are indeed suffering.

Why me?

Why should you listen to me?

In short: My expertise is my experience. 

Not only have I lived a lifetime of pain, I am a journalist who’s expert at research and storytelling. Just because I was forced to retire relatively young (see chapter 4) doesn’t mean I lost my journalism skills. 

I’ve also done years of research for this book. I’ve read hundreds of stories about chronic pain from dozens of publications. I have more than 125,000 words of research in one Word file and I’ve collected published stories of people in pain in another. I’ve spent hours in online chronic pain groups like those on Facebook and Reddit. I’ve attended scores of Zoom support groups, most often those offered by the U.S. Pain Foundation (see Sources of Solace). I’ve written columns for the America Chronic Pain Association’s quarterly e-magazine. I’ve interviewed dozens of sufferers and experts who have generously shared their perspectives on pain. This book is like a dissertation, my report on chronic pain. 

If you find Chronic Pain Chronicles valuable, tell others. Do an online review and rate it five stars. Gift it to those you know in pain and to their caretakers. Send it to your government representatives. Let’s get the word out that chronic pain is a gigantic problem and tens of millions of us need help dealing with it. 

Also, please visit my website at randallhduckett.com to see comments on Chronic Pain Chronicles and learn more about chronic pain. 

My motivation to do this book is simple: I wanted to understand my pain better. But there was another reason. I, like many chronic pain sufferers, feel very alone in my pain. It’s hard to imagine that there are others feeling the same things I feel, having similar experiences, living like lives. But, indeed, there are tens of millions who are. I researched, wrote, edited, and published this book to help me feel less alone, which it has. 

I hope you feel less alone, too. ​​