How do I talk to a pain management doctor?
When you’re in pain, getting through the day can be tough. So can finding the right solution for relief. There are many causes and types of pain, and everyone experiences it differently. A pain specialist can help develop a treatment plan for your unique situation. But he or she needs your input.
Effective communication with your doctor is a key piece of the pain management puzzle.
While most people think pain is all the same, there are actually several different types of pain,. Physicians who understand your challenges will have the best opportunity to find treatments directed toward each specific type of pain.
Here’s how you can have more productive conversations about pain with your doctor.
Why pain is hard to diagnose
In the most basic sense, pain is a biological process that protects you. When you get injured, your body produces chemicals that send pain messages to your spinal cord. The spinal cord delivers those messages to your brain, which process them and produces the sensation of pain. That’s called acute pain.
Chronic pain — which lasts for weeks, months or years — is a little more complicated. It often does not have an apparent purpose. It can hang around after an injury or surgery, or arise from a medical condition like arthritis or fibromyalgia. Over time, it can also result in changes to your nervous system that affect how you perceive pain. Rather, chronic pain is often associated with a number of complex interactions that play different roles in the creation of pain signals from a site of injury to the brain.
Help your doctor help you
If you’re seeing a pain specialist for the first time, here’s what to bring to your appointment:
- A list of medical diagnoses, recent surgeries or procedures.
- An up-to-date list of medications you’re taking. “We specifically want to know how you’re actually taking the medicine, even if it’s slightly different from what’s written on the bottle. If it’s supposed to be taken three times a day and you only take it once, this is an important detail which will help enhance the way we construct your treatment plan.
- A list of treatments you’ve tried and why you stopped them. Perhaps there was a side effect, or they simply didn’t work.
Keep a pain diary
No, I don’t mean the angsty journal you kept as a teenager. (Although those aren’t a bad idea either.) A pain diary is basically a symptom log — but the main symptom you’re tracking is pain. Tracking your pain levels can provide helpful context to your doctor, helping them identify patterns and understand how your pain impacts your life. And if your appointment happens to be on a low- or no-pain day, your diary can show your doctor that the pain is still a problem even if you’re not expressing it right at that moment.
You can keep a pain diary on paper using any number of different formats. This is a great spreadsheet that also includes helpful info on how to identify and record pain. You can also use an app. Apps can send notifications to remind you to make an entry. They can also track patterns for you and export your data in a convenient spreadsheet to take to your doctor. Try a few and see which one works best for you!
How to discuss your pain level
Bender notes to seek help if your pain, chronic or acute, is interfering with your quality of life. Since everyone measures quality of life differently, this judgement is subjective. If your pain is impacting your sleep, eating habits, desire to be social or your capability to go to work or school, then it is time to seek help.
Because pain is so subjective, people often have trouble communicating how they feel to their health care providers. To circumvent this difficulty, health care providers often give their patients different tools like surveys or scales to measure pain.
Pain scales often have the user rank their level of pain from one to 10. These scales can use colors, pictures of facial expressions or numbers to represent the increasing or decreasing severity of pain
Explain exactly how your pain limits your life
Medical professionals sometimes take pain more seriously when they see that it’s impacting your ability to work, maintain relationships, care for yourself, or have an acceptable quality of life.
Does your pain reduce your ability to focus on things? Play with your children? Drive or use public transit? Are you late to work because it hurts to get out of bed? Do you avoid exercising or going out to see friends?
As you know if you’ve dealt with it, untreated serious pain impacts just about every part of our lives, no matter which parts of the body it effects. We become more easily fatigued and quicker to anger. We stop doing things like exercising, cooking, and cleaning, which are necessary for health and self-care.
If the spoons metaphor resonates with you, you can use it to show your doctor that you have to make tradeoffs every day when deciding what to do with your limited spoons — shower or laundry? Go to work or be an attentive parent or spouse? Take a short walk or cook a healthy meal?
Pain isn’t just an unpleasant experience. It leads to a whole cascade of forced choices and compromises that diminish our lives. Make sure your doctor knows that.
Tips for Talking With Your Doctor
Before you go:
Think about what you want from your doctor.
- Do you want analysis?
Question: Are there scans or tests to better diagnose my condition?
- Do you want information?
Question: What causes my pain?
Question: Does my daily diet, exercise or sleep pattern help or worsen the pain?
Question: What are the pros and cons of available treatments?
- Do you want advice?
Question: What treatments do you think are best for me?
Question: Are there things in addition to medical treatments that could help?
- Do you want reassurance?
Question: Will you continue to work with me to find the best treatment for me?
Question: Will you tell me if you think another treatment or second opinion may help?
Create a list of the questions you want answered.
Review the list before your appointment. Revise to form the three top questions you want answered. Practice asking the questions with another person to test their clarity. If possible, include words that reflect what you want (advice, analysis, etc.) identified above.
Bring notes about your pain.
Be able to clearly describe its location, intensity, changes over time, and how it affects your life.
Be assertive, but don’t blame healthcare providers.
They cannot feel your pain, so you need to communicate clearly and work together for a solution. If your questions are not answered, ask for a follow-up appointment or email to get the answers you seek. Referrals to other providers may be needed to help you think, feel and do as well as possible despite ongoing pain.