Talking About Pain
Choose your words carefully to help your doctor treat you.
When you live with chronic pain, the only one who can know how much it hurts is you. Pain can be hard to describe because it’s both invisible and personal. In a recent Arthritis Foundation survey, more than half of the respondents said they had trouble talking about their pain. If you can’t put into words how much pain you’re in or how it affects your life, your doctor can’t prescribe the right treatment for you.
Silently enduring pain, day after day, can take a toll on your emotional health. “Pain plays a huge role in depression. Patients get very anxious if their pain isn’t going away,” says Thelma B. Wright, MD, medical director of the Pain Management Center at the University of Maryland Rehabilitation and Orthopedics Institute in Baltimore.
“If the pain is persisting, there’s no reason to try to live with it,” she says. “When you start to notice that the pain is becoming an everyday thing, you should see a doctor.” Here’s a guide to help you talk to your doctor about your pain so you can get the relief you need.
What Does the Pain Feel Like?
Is your pain burning, shooting, stabbing, dull or achy? Being as specific as possible about how it feels can help your doctor figure out what’s wrong. “If I have a patient who tells me, ‘In the morning, my back is so achy I can’t get out of bed,’ I know that’s more arthritic pain,” Dr. Wright says. “Whereas a patient who says, ‘The pain shoots down my leg,’ that’s nerve pain.”
Here are a few words you can use to describe the way your pain feels, and how your doctor might interpret them:
- Aching, dull: muscle strains, arthritis pain
- Shooting, electric, tingling, burning, pins-and-needles: nerve pain
- Sharp, stabbing: injuries such as a broken bone, muscle or ligament tear, or penetrating wound
- Throbbing: headache, abscess, gout
- Tightness: muscle spasm
Also describe exactly where you hurt – deep in your shoulder joint or in the muscles near the surface; under the kneecap or in the back of the knee; the outside of your hip or in your groin. Is the pain in only one spot, or does it travel? Does the pain remain steady, come and go, or only flare up when you move in a certain way?
How Much Does it Hurt?
In addition to getting a description of your pain, your doctor also needs to know the intensity. That’s where the pain scale comes in. Your doctor will ask you to “rate” your pain on a scale of 0 to 10 – where 0 is pain-free and 10 is unimaginable pain. The doctor can use your score to help determine how much and what type of pain medicine you need.
How Does the Pain Affect Your Life?
Have you been skipping your morning jog because of the pain? Are you missing work? Can you barely get out of bed in the morning? Does the pain leave you so drained and depressed that you don’t want to be around people? Just as important as the level of pain you feel is the impact it has on your life.
“Some patients come in the door with an eight on the pain scale, and they’re functional. Other patients walk in with a three and they’re disabled,” Dr. Wright says. “Function is huge.” Tell your doctor which activities you’ve had to adjust, and which ones you now avoid entirely because of your pain.
When Do You Hurt?
The timing of pain can help your doctor fine-tune your treatment. “If I notice that a patient has higher pain scores in the morning versus in the evening, I may tailor my medication management to that,” Dr. Wright says. Keeping a journal can help you track when in the day your pain is at its worst.
What Helps/Worsens Your Pain?
Also note in your journal what you’ve tried to relieve the pain (rest, ice, heat, over-the-counter pain medicine). Did they ease the pain, have no effect or make it more intense?
With a good description of your pain, your doctor will have a better chance of getting you the relief you need. But even when your doctor knows the cause of your pain, treatment might not be a quick fix. “It’s a trial and error process,” says Dr. Wright. “You might go through several medications before you get the best combination.”
If your pain has lasted more than three months and you haven’t gotten relief from treatments prescribed by your primary care doctor or rheumatologist, keep working to find the right arthritis medicines, but also consider seeing a pain specialist. The American Academy of Pain Medicine offers a search tool to help you find a pain specialist in your area.