How To Talk to Your Doctor About Pain

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 they need your input.

“While most people think pain is all the same, there are actually several different types of pain,” explains pain management specialist Robert Bolash, MD. “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:

1. A list of medical diagnoses, recent surgeries or procedures.
2. 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,” Dr. Bolash says. “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.”
3. A list of treatments you’ve tried and why you stopped them. Perhaps there was a side effect, or they simply didn’t work.

How to describe your pain

Unfortunately, there isn’t an effective measuring stick for pain, Dr. Bolash says. It can be challenging for doctors to gauge the level of pain people feel and whether treatments are effective.

To evaluate your pain, your doctor might ask you to rate your pain on a scale from 1 to 10, or request imaging studies such as an MRI or CAT scan. While these tools may be helpful, they often don’t tell the whole story. So your doctor will also rely heavily on your responses to questions about your pain, including:

• Where does it hurt?
• When does it hurt?
• What makes it feel better or worse?
• How does your pain affect your daily functioning?
• What does it feel like?

This last point — describing what your pain feels like — doesn’t come naturally to most people, Dr. Bolash says. But being able to effectively communicate what you’re feeling can help your doctor better tailor treatments.

Here are some words that might help:

More pointers for your pain appointment

Dr. Bolash also recommends these tips for a productive appointment:

• Come with questions. Before your appointment, jot down some important points, questions or concerns you want to cover with your doctor. You and your doctor will have a lot to cover, so taking this extra step can help ensure that nothing is overlooked.
• Bring a second set of ears. Some people find it helpful to bring a friend or family member along. If you’re seeing a pain specialist virtually, ask if the telehealth platform you’re using allows for family members to join in your appointment.
• Keep a pain journal. Your doctor will want to know how much your pain is limiting your life. Before your appointment, make note of how your pain affects your mood and your ability to walk, sleep and enjoy activities. “We measure the success of treatment based on the things that patients are able to do as a result of therapy and progress toward their goals,” Dr. Bolash says.
• Be open to solutions. There could be factors contributing to your pain that you might not typically think about. For example, certain aspects of brain health such as managing mood or stress are known to diminish the intensity of pain, Dr. Bolash says. “A pain psychologist may be a recommended part of treatment for select patients.”