How to talk to your doctor effectively about pain
Getting your provider to understand how you really feel can make all the difference in whether you get the right treatment — or get blown off as exaggerating your pain. Here’s how to be taken seriously.
Americans are no strangers to pain. About 20% of all adults suffer from chronic pain. And more than 7% report having pain so intense that it has limited their life or work activities over the past 3 months.
“Pain is complicated. We all feel it differently. Some of us have a higher tolerance for pain. Others feel it more intensely,” says Caitlin Donovan. She’s a senior director of the National Patient Advocate Foundation.
How we view pain in others can also vary wildly. For example, women are much less likely to be taken seriously than men when they report chronic pain. In one study, researchers asked participants to watch men and women who expressed the same amount of pain. The results: Participants viewed the women’s pain as less intense than the men’s. They also believed that the women were more likely to benefit from talk therapy than pain medication.
Why the gap? Part of the problem is that pain is subjective. There’s no test that can effectively rate your pain. This can make it hard for your health care provider to know what you’re going through. Instead, they will rely on your own words to help them. Which is why how you talk about pain is so important.
Here are some smart ways to do just that.
Get detailed and descriptive.
It’s best to be as specific as possible when it comes to talking about your pain, says Donovan. Here are some good words to use.
- Aching
- Cramping
- Gnawing
- Burning
- Sharp
- Shooting
- Stabbing
- Tender
- Throbbing
It also helps to describe the following to your physician:
- How long you’ve had the pain
- Where you feel the pain
- If your pain is in one spot or spread out
- If the pain is constant, or if it comes and goes
- What helps the pain and what makes it worse
The clearer you paint the picture, the better your provider will be able to see it.
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Focus on function.
Tell your provider how your pain impacts your everyday life. Explain how it affects what you can and can’t do at work and at home. Does your pain stop you from doing activities? Share that too.
It’s also important to set expectations for your care. “Let your doctor know that you assume that your treatment and overall approach to health care will be with the goal of bringing your health back to baseline,” says Annette Ticoras, MD. She’s an internal medicine physician and owner of Guided Patient Services in Columbus, Ohio.
“Give them a snapshot of who you are. For example, you are a busy working mom who can’t let back pain sideline her from going to her job and taking her kids to activities. This way, they are able to get a sense of who you really are, other than just a patient in their exam room,” Dr. Ticoras says.
Share your history of pain and treatment.
For this, it helps to keep a pain journal. Whenever you have pain, try to write down as many details as possible. Include:
- The day and time it happened
- How severe it was
- The type of pain. (Need help? Use the word list above.)
- Where it hurt
- How long it lasted
- What might have caused it
- Any other symptoms you had at the same time
- Any treatment changes you recently made
- How the pain changed your mood
These details help show how much your pain limits your life. It paints a picture of how it affects your ability to sleep, work, exercise, and spend time with friends and family. “It can really make a difference in how a doctor perceives your pain if they hear from you that it wakes you up several times during the night, for example,” says Donovan.
Also, let your provider know what treatments you’ve tried and whether they worked. Include any that they’ve suggested before too. “Recap past medical appointments. Remind them that you did several months of physical therapy for back pain, which didn’t help,” says Dr. Ticoras.
Bring a friend or loved one with you.
You may find it helpful to have a second set of eyes and ears with you. “Sometimes, just the presence of someone else is enough to make a doctor sit up and take your concerns seriously,” says Dr. Ticoras. Plus, you might feel on edge or upset during your visit. That can make it harder for you to remember what your provider said. A buddy can step in to take notes. They can also ask questions for you.
Don’t be afraid to ask questions.
Maybe you don’t understand how a treatment works. Or why your provider isn’t ordering more tests. If you don’t ask questions, your provider might not answer them. And that may leave you feeling confused or ignored. But it won’t leave you feeling any better. Dr. Ticoras shares this example:
“It may seem to you that your physician isn’t taking your pain seriously because she doesn’t send you for an MRI right away for back pain. But it may be because insurance doesn’t usually cover an MRI for this purpose until you’ve had the pain for a certain amount of time or have tried other treatments first. That’s why it’s important to keep the lines of communication open.”
Get a second opinion, if needed.
It makes sense to give your provider some time to problem solve. That may mean a few days or weeks. It may even mean a few months. It depends on the condition. But if they don’t seem to listen when you say a treatment isn’t helping? It’s time to get a second opinion.
“It’s a good idea to get a fresh pair of eyes on the situation. Another doctor may see it from a different angle,” says Dr. Ticoras. One study found that getting a second opinion cuts the chance of misdiagnosis in half. A third opinion drove it down even further, to 16%. And, of course, getting the right diagnosis is more likely to lead you to the right solution.
If you do go the second-opinion route, Dr. Ticoras suggests that you meet with someone who is at a different hospital or medical center. They’ll be more likely to approach things with a different perspective. Then you can decide which approach works best for you.
Sources
- “Chronic Pain and High-Impact Chronic Pain among U.S. Adults, 2019.” Centers for Disease Control and Prevention. November 2020. https://www.cdc.gov/nchs/products/databriefs/db390.htm
- Zhang L, Losin EAR, Ashar YK, et al. “Gender Biases in Estimation of Others’ Pain.” The Journal of Pain. March 5, 2021; vol. 22, no. 9: pp. 1048-1059. https://www.jpain.org/article/S1526-5900(21)00035-3/fulltext
- “How Can I Describe My Pain to My Health Care Provider?” U.S. Department of Health and Human Services. National Institutes of Health. January 31, 2017. https://www.nichd.nih.gov/health/topics/pelvicpain/conditioninfo/describe
- Halasy M and Shafrin J. “When Should You Trust Your Doctor? Establishing a Theoretical Model to Evaluate the Value of Second Opinion Visits.” Mayo Clinic Proceedings. April 8, 2021; vol. 5, no. 2: pp. 502-510. https://www.mcpiqojournal.org/article/S2542-4548(21)00033-3/fulltext
