When Touch Hurts: Navigating PsA in Relationships

Chronic illness can be complicated to navigate in relationships. Here’s how I ditch the guilt and approach physical affection.

Less than a year ago, I married my now husband on a beautiful spring evening. Everyone said our love and happiness were contagious, and we’re still clearly crazy for each other.

But it hasn’t all been honeymoon bliss — when my psoriatic arthritis (PsA) flares up, physical affection is often the last thing on my mind. And that can be hard for both of us.

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Balancing PsA and touch

It can be so hard to live with a disease that causes pain, fatigue, and skin issues. But it’s tough balancing your own needs for affection as well as your partner’s when dealing with PsA.

And the issue goes beyond sex. Sometimes, you don’t want to be touched when you don’t feel your best. Diseases like PsA and other types of arthritis can affect you in a variety of ways:

• Even a gentle hug can hurt or be uncomfortable during a flare. I find touch to be agitating if I’m already in pain and feeling overstimulated.
• Exhaustion from battling an autoimmune disease can also make touch and physical intimacy undesirable. Sometimes, you only want to lie there and not think about anything.
• Insecurity can also play a role. If your skin or nails aren’t doing well, being touched can cause physical and emotional discomfort.

While relationships can take the brunt of this, this can apply to other people. I’ve received many painful hugs, handshakes, and pats. And I imagine parents can quickly feel “touched out” with their small children, too. But for me, this has been hardest in the context of my relationship because physical affection is so important to both my husband and myself.

How to cope

When touch hurts, it can be hard to move forward. It can be tempting to avoid your partner and avoid the issue until you feel better. But avoidance can cause your partner to have hurt feelings, too.

You owe it to your partner, yourself, and your relationship to try and address the issue. It’s essential to take care of your mental health, communicate with your partner, and find solutions if possible and desired.

It’s not your fault

First and foremost, self-acceptance is critical. You’re going through a lot. Feeling put off by physical touch is a natural reaction to feeling in pain and exhausted. So, please be kind to yourself during these times.

When touch hurts, there can be feelings of dread and insecurity. You might experience feelings of guilt or even obligation, especially when your partner’s love language is physical touch. I’ve experienced feeling guilty for not wanting to cuddle with my husband because even lying next to each other was too much on my hips.

It can be easy to assign blame, but you shouldn’t have to bear the weight of the situation on your shoulders. Unless you came into the relationship feeling uncomfortable with physical touch (which is valid but a different topic), you couldn’t have known how things would change. We’re all human, and things change over time. No one anticipates chronic illness or how it will evolve.

Communication is key

It’s best to be open with your partner on this topic. Otherwise, it can lead to more pain over time. Starting the conversation can be challenging and may bring up strong feelings if there have already been feelings of resentment or guilt brewing. But a good partner will understand and work to compromise and find solutions.

Compromise can mean many things in this scenario, but at the heart, it should be about respecting each other’s needs and boundaries. That can mean there are periods with less touch, with promises to get back into the swing of things over time.

It can also mean finding different ways to be together that are more comfortable. To be blunt — sex doesn’t have to be the end-all and be-all. There are many ways to connect with your loved one. It may take patience and experimenting.

Make yourself as comfortable as possible

Physically, you might also need to set boundaries to avoid touching certain painful areas, which can cause (bad) tension and make it harder to feel relaxed. I can’t handle people touching my back, and that’s a boundary for everyone. (My husband can, but only because he knows to be very gentle.)

You could also ask your partner to be patient about touching, such as needing time to build back up to normal after a flare.

A lot of people also thrive with a routine that gets them ready to relax and be with their partner. That can mean timing medication to “pregame,” taking a hot shower, or resting under a warm blanket. Do what it takes to feel better overall.

There are also ways of making things more comfortable. For example, you might have to be creative regarding comfortable positions to cuddle or be intimate, such as side lying. Pillows can be added as well. For intimacy specifically, you may consider adding massagers and toys to your routine — they can help pick up any slack. A little creativity goes a long way. It can be a bonding experience to think up fun ways to keep the spark going.

Working together

My husband’s love language is very much physical touch, so sometimes, I feel guilty when even a hug sounds painful. I try to remember that physical touch isn’t just about me being touched or having to cuddle. For him, it’s about appreciating physical closeness and connection.

He enjoys all our touches, even just the quick pecks or a touch on the arm. I always try to be extra affectionate in those ways so he still has a physical connection and feels loved and desired. We also have other ways of staying connected, like writing love notes and enjoying time together.

Chronic illness can complicate a relationship in lots of different ways. It’s tough to deal with not wanting to be touched or feeling too sick to want to be affectionate. I genuinely think good communication, mutual respect and understanding, and a little creativity go a long way.