Let’s Talk Pain

You finally decided to call your doctor about that pain in your neck – no, I’m not talking about your boss – but you’re worried she won’t understand how bad it is getting. That’s why you’ve put off this appointment.

There are ways to talk to your physician that will help both of you understand the problem and find solutions. All too often, though, the inability to talk about pain can lead to inadequate treatment and under-compensation from insurance companies that rely on doctors’ records

One of the most important ways to make your conversation effective is to be prepared and be specific. To do that before you go to the appointment, write down what you know about your injury or pain. There are a number of websites that offer lists of questions, including this simple, yet direct one.

You may even want to do a “pain diary.” And don’t be afraid to take notes with you or to make a list of questions for the doctor. You’re paying for the care, not the other way around.

Write down details such as “My neck pain is on the right side and seems to start just below my ear. When it is the worst, it runs down my arm and makes it tingle.”

Is it worse when you sleep, exercise, sit, stand, etc. Is it constant or intermittent? Is there anything that makes it feel better – or worse? Does it affect your daily activities like driving, lifting your grandkids, walking? What, if any, medications are you taking and how often? Do they relieve the pain or not?

You’ll probably be asked, “What’s your pain level on a scale of zero to 10 with 10 being the kind of pain that would send you to the emergency room or the worst pain you’ve ever felt (think kidney stone)?”

Because pain doesn’t show on medical imaging and doctors need some common language base, this scale has become the standard in the medical industry. All too often, though, individuals don’t understand the levels, are afraid to be truthful because they’ll feel like a wimp if they say eight or nine, or think they’re tougher than they are. Essentially the numbers zero through three mean mild pain; four through seven is moderate; and over seven is severe. You may think five is average, but your physician interprets that to mean you need more medication, according to a recent study done at the University of Rochester. When it comes to the scale, diary tracking your pain for a few days or a week before your appointment can be very helpful. Add specific and descriptive words to the numbers: “I feel pain is at five and it is a (pick a word) stabbing, cutting, throbbing, shooting, searing, dull, burning, gripping, tingling sensation.”

You should also know that there are some things your doctor doesn’t want to hear about your pain, according to Dr. Richard Radnovich, D.O., who details “10 Things Never to Say to Your Doctor about Chronic Pain.”

At the top is, “Don’t tell your doc, ‘I hurt all over.’ If you say this, the next questions are likely to be ‘Do your teeth hurt? Or do your toenails hurt?” His point: Be specific.

In any event, see a doctor as soon as you feel pain so that pain is documented. Down the road, that early information may provide important evidence as to what caused it.