Navigating Negotiations With Chronic Pain or Illness

I write from my own experiences and from the submissive perspective.  I realize there are many s-type identifiers (slave/sub/bottom/brat, etc.) and many D-Type identifiers (Master/Dom/Top/etc.). However, for the sake of simplicity for this article, I will use sub and Dom going forward. The same is true of gender identifiers that correspond with s-types and D-Types. However, again, for the sake of simplicity for this article, I will use she/her for sub and he/him for Dom.

How do you negotiate a scene when you have a chronic physical condition or limitation, especially one that is not immediately noticeable to the naked eye?

Invisible illness and chronic pain can be especially difficult to navigate because we look perfectly fine to everyone around us. However, we’re typically working overtime to make it appear as if we’re fine while we’re actually in excruciating pain.

This can lead to questions, fears, and concerns like:

  1. How much information about my condition do I need to reveal to a new play partner?
  2. At what point in our play relationship do I reveal the WHOLE STORY about my illness or condition?
  3. What if I tell my play partner about my condition, and they are fearful or do not wish to play with me?

So…Let’s tackle each of these questions one at a time.

First, how much information about my condition do I need to reveal to a new play partner?

There are a couple of possible ways to approach this. You could reveal just enough so your partner has the information necessary in order to keep you safe and not cause additional harm while still maintaining your privacy.  For example, my pain is primarily in my right leg, hip, and pelvis. So, I must tell my play partners not to hit me too hard on that side, or when doing any kind of rope bondage not to leave me standing on just my right leg or to bind my right leg too tight. With a new partner I do not go into the history of why I have this pain or the illness that caused it (However, you can now read all about this in the last article I wrote for KinkWeekly).

The other way of approaching negotiations would be to reveal everything in an attempt to be completely transparent. I applaud anyone who would be willing to do this with a virtual stranger or acquaintance. Perhaps, this would work with a friend or someone you’ve known for some time and are just now starting to play with. However, in my opinion and from personal experience, I don’t think it’s necessary when you are first starting to play with someone to disclose everything. You only need to disclose as much as you are comfortable with while also giving your partner the necessary information to keep you safe.  Ultimately, it comes down to what makes you comfortable and the level of trust you have with your partner.

Next, at what point in our play relationship do I reveal the WHOLE STORY about my illness or condition?

I capitalize WHOLE STORY in this question because for me, my chronic pain is the result of a 10 year struggle with a chronic illness that is quite personal. It’s taken me a very long time to be willing to talk about it privately, let alone publicly.  I only recently told my WHOLE STORY to a play partner with whom I’ve been playing for quite some time. He had questions, but his response was otherwise very positive and supportive. In the beginning, I was cautious and gave only enough information to keep myself safe and make sure he did not cause further damage to my body. If there was anything happening in a scene that I knew would not work with my body, I spoke up. Otherwise, I didn’t feel like I had to immediately disclose very personal medical and health information until our play relationship progressed, and I felt I could trust this individual.  Trust is paramount. If you cannot trust the person you are negotiating with to a certain degree, you should not be playing with them in the first place, especially if you have a medical condition. Do you know their reputation? Are you confident in their skill level? Have you seen them play with other people? Are they established in the Community?

I am writing from the perspective of a submissive, but let’s not forget about the other side of the slash. It’s just as important for Dominants to inform their partners regarding any conditions that may affect how they play or things that could cause them real harm in a scene. Just because they are in charge of a scene, does not mean Doms are exempt from informing their sub(s) about something as serious as a medical condition that could affect the scene or the health or safety of either party. A favorite example of mine is: perhaps the Dom is diabetic and this is the first time the two are playing together. It’s impossible to tell by looking at someone if they are diabetic, so it would be necessary for the Dom to disclose this to the sub for many reasons. For example, he may need to take a break during the scene for a snack if his blood sugar is getting low. It’s best for the sub to be aware ahead of time that this may happen, so she is not caught off guard during the scene. What if the sub is bound, and the Dom has a diabetic attack and passes out? The sub needs to be able to respond to this and know what is happening. I realize these situations may sound extreme, but they are completely possible.

Lastly, what if I tell my play partner about my condition, and they are fearful or do not wish to play with me?

It is possible that some people may react this way. However, there are some things you can do to mitigate fear and make all parties more comfortable. Be as open as you comfortably can be about your situation and answer your partner’s questions. Allowing your partner to ask questions during negotiation regarding your limitations and medical issues and giving open, honest answers can go a long way towards making them more comfortable with the situation. Be clear about anything you may need during or after play to insure yours and your partner’s safety. Let your partner know specifically if there is anything they cannot do or anything they need to have on hand that is out of the ordinary for you. Ask your partner if there is anything you can do to ease their mind or make them more comfortable. Remember, you are in this together. Clear, honest communication and a little extra preparation can make all the difference when negotiating a scene involving individuals with any kind of chronic pain or illnesses. Ultimately, you have no control over someone else or how they are going to react. It may be difficult, but if they simply cannot handle the responsibility of playing with someone who has some limitations, it’s best to move on.

Some final thoughts….

Checking in every time you play with someone is always a good idea. Don’t assume that just because you’ve told your partner once about your condition they will remember every time, especially with a newer partner.  Also, the sub is just as responsible (or more responsible) as the Dom for checking in and speaking up about how they are feeling and what is going on with them physically and mentally before play. It’s not pushy or controlling to express your needs during the negotiation process and to take care of yourself. You are not “topping from the bottom” or any of those other things outspoken subs are often labeled. Talking about these things is exactly what negotiation is for. It’s a huge red flag if any Dom is not interested in listening to your needs and wants- especially regarding your physical safety.

The sub is also 100% responsible for their own safety during play. Your Dom is incapable of knowing if something he is doing is truly causing you harm. If it is, speak up. Use your safe word or  if possible, gently let your Dom know to make a change or adjustment to what he is doing. This does not mean you must stop the scene altogether. This is where the negotiating comes in. Because you have already talked about your illness or limitations, if you make a small request during a scene due to a physical condition or illness, your Dom won’t be surprised. He will be much more aware and receptive to you speaking up. Also, a small adjustment will be much less likely to disrupt the rhythm and energy of the scene if you’re both on the same page.

What are situations, positive or negative, that you have encountered surrounding negotiating a scene involving chronic pain or having to disclose a medical condition to a play partner? I would love to hear your thoughts and perspectives on this topic. Please share in the comments section.

About the Author

When looking for a way to turn what had always been kinky ideas and submissive desires into a tangible reality, blushangel discovered the Los Angeles BDSM Community a little over 2 years ago and has not looked back. Besides exploring kink and submission, her favorite things are yoga, the beach, and incorporating her love of fashion into her fetishes of corsetry, lingerie, and erotic photography.


  1. So helpful! Thank you for writing this!

  2. Amazing article!

  3. Confirming the way I started…for me to be as safe as possible I stay completely transparent about my own condition from the get go. It is hard sometimes BUT if I dont feel comfortable enough to divulge my particulars I am NOT going to play with that person.

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