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Chronic Pain: Speaking Your Doctor’s Language
“The personal experience of pain is often difficult to describe, and the words we choose to describe pain rarely capture its personal impact, whether it is sudden and limited or persists over time.” – excerpt from Relieving Pain in America
Unlike acute pain, which is temporary, chronic pain is persistent, with pain continuing for weeks, months or even years. The definition of chronic pain is very broad, but it is generally defined as any pain lasting more than 12 weeks.
Chronic pain is usually caused by an initial injury, such as a back sprain. It’s believed nerve damage from that injury makes pain more intense and long lasting. In these cases, treating the underlying injury may not resolve the chronic pain. In other cases, people experience chronic pain without a prior injury due to underlying health conditions such as fibromyalgia or multiple sclerosis.
“No matter the cause, suffering from chronic pain can affect a person’s thoughts, memory, concentration, sleep and their ability to work and maintain relationships with friends and family,” says LIUNA General Secretary-Treasurer and LHSFNA Labor Co-Chairman Armand E. Sabitoni. “If you or someone you know is dealing with chronic pain, you might notice increased irritability, anger, anxiety or depression. Discussing these issues with your doctor can be difficult, but it’s a conversation worth having.”
A recent study by the CDC revealed that 50 million Americans (about 20 percent of U.S. adults) suffer from chronic pain, which was defined as “pain on most days or every day in the past six months.” Nearly 20 million people said the pain limited their ability to work or carry out their daily lives. In Canada, a recent survey found that one in three Canadians lives with moderate to severe pain as an ongoing part of their lives. One in six lives with constant pain, while one in five experience pain daily.
Communicating with Your Doctor
It’s critical to have good communication with your doctor when addressing chronic pain, especially when the causes are not known or visible. Keeping a journal may help you be more descriptive, accurate and increase your recall, since pain may vary each day.
To speak the same language as your doctor, become more familiar with common pain scales. This can help you communicate this very personal experience in the most objective way. Examples of pain scales include the following:
This pain scale is the most common. A person rates their pain on a scale of 0 to 10 or 0 to 5. Zero means “no pain” and 5 or 10 means “the worst possible pain.”
This pain scales gives people a simple way to rate their pain intensity using a verbal or visual descriptor. Some examples include the words “mild,” “discomforting,” “distressing,” “horrible” and “excruciating.”
This pain scale shows a line printed on a piece of paper with anchors at either end. At one end is “no pain” and at the other end is “the worst imaginable pain.”
Talking to Your Doctor about Pain
Be descriptive about your pain: include location, timing and intensity. Try to answer the following questions for your doctor:
- How long has the pain been an issue?
- Is it new or has it happened before?
Where is it located? Is it in more than one area? If so, which spot is most bothersome? Does it move from one place to another?
- Is the pain sharp and stabbing, dull and aching, burning or does it feel like an electric shock?
- Is there any numbness, tingling or new weakness in the pain area?
- How does the pain interfere with doing normal activities? What activities or conditions make the pain worse?
- What have you tried to relieve the pain?
- What medicines are you taking? Is medicine being taken at set times or just when you need it?
- Are you allergic or sensitive to any pain medicine?
The more you understand about the treatment prescribed, the better you will be able to advocate for yourself or your loved one, so don’t hesitate to ask questions. Here are some suggested questions to ask your doctor:
- What are all the options available for treating this pain?
- What are the benefits and risks of each treatment?
What are the possible side effects?
- What are the costs of each treatment? Will my insurance pay for it?
- How long will it take for the treatment to work?
- What should I do if the treatment doesn’t work?
- Besides taking medicine, what else can be done to manage the pain?
- What support is there for the emotional pain caused by this physical pain?
The psychological impacts of living with chronic pain can be as debilitating as the pain itself. The longer pain exists, the more likely it is to affect a person’s mental health and overall well-being. This is what makes chronic pain such a complex condition, and why it’s so important to seek treatment if you find yourself in pain.
[Jamie Becker is the LHSFNA’s Director of Health Promotion.]