TALKING WITH YOUR DOCTOR ABOUT PAIN
Talking about your pain is one of the most challenging conversations you will ever. You are bound to have it with your doctor, or with friends and loved ones, and each time you do it’s going to be unpleasant. Why? Because to everyone but you your pain is invisible and as a result, people just don’t get it.
Explaining your pain to your Doctor is more than just unpleasant, it’s difficult and it’s a very high stakes conversation. If you don’t convey your experience correctly the road to cure, management or treatment can be longer than it needs to be. I don’t want to diminish the value of having the pain talk with loved ones but because of the impact it can have on your entire approach to medical care I’m going to focus on how to talk to your Doctor.
Doctors rely heavily on signs. Signs are things they can test and measure objectively, like blood tests, electrocardiograms, MRIs and blood pressure measurements. In contrast, pain is a symptom. Symptoms are subjective effects that only the patient experiences. Because they are subjective, it is not always easy for a Doctor to understand or interpret symptoms. Fortunately there is language you can use to make your subjective symptoms more objective. Let’s call this pain language “FLIC” (Frequency, Location, Intensity, Characteristics).
- Intermittent – not continuous / occasional (e.g. back pain can be a chronic condition that comes and goes intermittently)
- Sporadic – occurring irregularly or randomly (e.g. cluster headaches can be sporadic, happening at unpredictable intervals)
- Predictable – foretold on the basis of experience or scientific reason (e.g. every time it rains the pain in my neck increases in intensity)
- Flair-up – a sudden occurrence or worsening (when your intermittent or sporadic or predictable pain is suddenly present or suddenly worse than usual)
- Constant – happening all the time (e.g. the pain in my shoulder joints is always present)
- Acute recurrent – this happens in short duration but happens again and again, like migraine headaches
- Chronic progressive – pain of long duration that continues to change and evolve, like degenerative nerve pain
LOCATION:Where Is Your Pain? / The Mcgill Pain Questionnaire
Where does it hurt? Pain conversations may start just like that. There is a common graphic of a unisex human figure with a back view and a front view. Doctors may instruct you to mark on such a drawing where your pain is being experienced. Doctors may even request you to note a difference between pain that is on the surface and pain that is under the surface. This tool comes from the McGill Pain Questionnaire which includes other measurements, but the front and back of the unisex human figure is the most recognizable. If you don’t happen to have a figure to draw on remember terms like, front, back, on the surface, under the surface, deepand shallow, however it should be easy enough to find the McGill Pain Diagram online and print it out.
|original artwork jjsjr|
The Wong-Baker Faces scale was originally devised to help children express the kind of pain they were experiencing. Most of us have seen this scale before (six faces ranging from a happy face to an upset, crying face) and it is very easy to use but its limitation is that it only addresses pain intensity.The Wong-Baker Faces scale works the same way that the “1-10 Pain Scale” works, with ZERO being no pain and TEN being the worst possible pain. Take some time to think about where your pain falls on this scale. It is perfectly fine to say that your pain falls within a range of scores.
- Sharpness – a stabbing pain like an exposed nerve
- Dullness – a deep pain, maybe throbbing, like swelling from an infection
- Sensitivity to contact – does it hurt when clothes brush against it, when you poke it?
Being able to provide characteristics like this will help your Doctor understand the cause of your pain.
https://www.painedu.org/nipc-resourcenter.aspan excellent source for information, tools and the pain assessment scales mentioned in this article