Talking to the Doctor About Your Pain

It can be hard to talk to your doctor about pain; for many of us, going to the doctor’s office is stressful in and of itself. Explaining something as personal and subjective as pain can be challenging, and you want to make sure you do what you can to get the best possible treatment. There are some specific strategies recommended (and pitfalls to be avoided) by doctors and pain patients alike:

Be organized when you go to the doctor to talk about your pain. It’s a good idea to write down (or even type up, and bring an extra copy for the doctor’s file) all of your questions as well as what you want to say about your pain. This way, you don’t forget something and remember it when you get home, and you give the doctor the best chance of understanding what you are actually going through.

Be specific when describing your pain. Avoid saying that your whole back hurts; describe the places where the pain originates, or is most intense. Describe the quality of the pain (eg. searing, throbbing, dull ache, tingling, etc). If the pain moves, explain where it usually starts and which parts of your back hurt the most. When did the pain start? Does it spread from your back to other parts of your body? If the pain is worse at certain times of day or after certain activities, explain those, as well as anything that makes your back hurt less.

Do not over-exaggerate your pain. You will undermine yourself with the doctor if you do this. You will be asked to rate your back pain on a scale of 1 - 10, 10 being the worst pain you can imagine. If you’re not writhing on the floor screaming at the doctor’s office, they are likely to doubt you if you say 10, and under no circumstances should you describe your pain as any number above 10. This will cause the doctor to think that you are being dramatic, and they may underestimate your pain as a result, the opposite of the intended effect.

Explain how living with pain has affected your life. The most powerful demonstration of your pain you can provide is to illustrate how your life has changed since the back pain started. What did you used to be able to do that you no longer can? For example, did you used to sit at your desk all day for work, and now the pain prevents you from sitting for more than an hour? Did you used to referee soccer on the weekends, but now the pain becomes unbearable after 15 minutes on the field? Are you able to sleep, sit, walk? Be realistic and specific.

Ask questions and be engaged in the discussion. The doctor, of course, is the medical expert, but you are the expert on you and on what you are trying achieve by seeing the doctor. If you don’t understand why a course of treatment is being prescribed, ask for clarification and explain your discomfort to the doctor. People who participate in their own treatment tend to see better results that people who just expect the doctor to immediately know how to fix them.

If you’ve been in severe pain for a while, you’ve probably tried a lot of the “over-the-counter” remedies that are available to you without a doctor’s prescription: OTC pain medication, heat packs, ice packs, maybe you’ve even tried a back brace. If none of that is helping, you can start to feel a little bit desperate for relief. It’s important, however, to be strategic when you begin a conversation with your doctor about prescription pain medication. Doctors tend to be cautious about prescribing this type of medication, because it is highly regulated, and accidentally prescribing to drug addicts can result in a physician losing their license. While you are looking for the most comprehensive and effective treatment for your pain, you can benefit from keeping the doctor’s concerns in mind. Try following the steps below:

Let the doctor lead the conversation about course of treatment. Requesting a specific procedure or self-diagnosing can make the doctor defensive. Remember, doctors are only human; they’re just as subject to ego and insecurity as the rest of us. You’re better off exercising some patience while the doctor develops and revises a treatment strategy based on their medical expertise. Ask questions, raise any concerns you have, but don’t request specific new medications or treatments. This can be frustrating at first, but in the long run it should keep the doctor on your side and lead to a higher quality of care.

Building on the above, asking for pain meds outright will send up a red flag for the doctor - they probably don’t really know you well as a person, and - as you have no doubt experienced by now - pain is hard to prove. Requesting a specific opioid medication will come across as drug-seeking behavior. Be open to trying other forms of treatment suggested by the doctor before taking pain medication, as it is a last resort treatment.

Don’t offer the information that you are not a drug user or addict in an attempt to allay suspicion, as this can have the opposite effect: the doctor may assume you actually are.

Above all, don’t give up on finding a solution to make your pain more manageable. If, after multiple visits where you thoroughly document your issues, your doctor is not effectively trying to help you find relief, you may want to consider building a new relationship with a different physician, and possibly seeking the care of a pain specialist. Stay positive and believe in yourself, and make sure you have a team of providers who believe in you too.

Combining these steps and strategies should provide a good foundation for talking to your doctor about your pain; be patient, stay positive, and keep an open mind. There is definitely a path to greater comfort and reduced pain in your life.