How You Describe Pain To Your Doctor, Makes A Difference.
Chronic pain is so difficult to diagnose. Often it is a process of trial and error, testing and continually trying to describe your pain. But how do you explain pain to your doctor, in order to help them understand how your pain is different?
Medical history — injury, treatment, procedures — can only tell a doctor so much about the pain you should be experiencing. But, with chronic pain, the pain is different…and hard to explain concisely. Yet it is incredibly important that you describe the pain as accurately and descriptively as possible.
However, if you are a patient suffering from a category known as “invisible pain" — fibromyalgia, CRPS (complex regional pain syndrome) or RSD (reflex sympathetic dystrophy), diabetic neuropathy or chronic pain after cancer treatment — sometimes trying to convey the pain location, frequency and how great the discomfort can be an overwhelming, challenging and emotionally taxing experience. It is also constant. Something you are asked over, and over, and over again, with each individual you encounter in a doctor’s office.
Medical records tell the doctor the cause of your pain, but pain is so subjective, individual and unique to each patient. One patient’s “unbearable pain” might be consider “very unpleasant stabbing” to another. It is the interpretation of the pain for each patient, that helps a physician determine how to approach treatment.
First. when explaining pain to your doctor or nurse, don’t assume they know how long you have been fighting your pain. Always put your pain into a timeline. Be direct. Say:
I’ve had this pain for [ x amount of time].
It lasts [x minutes, hours, days].
It is ignited or flared by [_____________] or lessens by [_______________] your pain, which lasts for [say how long].
Location of the body is also key. If you can, mark the areas of pain on a diagram of the body, front and back. And, defining if the pain is surface pain or deep pain can be very helpful.
Of course, there is always the pain scale. Patients are routinely asked to rate their pain on a scale of 1 to 10. One of the common pain scales applied is the McGill Pain Scale. When you answer this question, think about where your pain level falls, the majority of the time. The exception being, if you experience frequent extreme pain fluctuations. According to this scale, pain is divided into four categories and is rated as follows:
No Pain
0 – Pain-free
Manageable Pain
1 – Pain is very mild, barely noticeable. Most of the time you don't think about it.
2 – Minor pain. Annoying and may have occasional stronger twinges.
3 – Pain is noticeable and distracting, however, you can get used to it and adapt.
Moderate Pain—Disrupts normal daily living activities
4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting.
5 – Moderately strong pain. It can't be ignored for more than a few minutes, but you still can manage to work or participate in some social activities.
6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating.
Severe Pain—Disabling; debilitating, reduces daily quality of life, cannot live independently
7– Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep.
8– Intense pain. Physical activity is severely limited. Conversing requires great effort.
9– Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably.
10– Unspeakable pain. Bedridden and possibly delirious. Mobility may be compromised.
Most often, pain patients break down their pain into certain feelings or sensations. The most common are:
Sharp stabbing pain
Extreme heat or burning sensation
Extreme cold
Throbbing, “swollen,” inflamed tissue
Sensitivity to contact / touching
Itching
Numbness, tingling, pins and needles
It is here that a pain journal can be of considerable aid in exploring the types and locations of pain, with your doctor. Additionally, pain can be examined in comparative timeframes. The journal can also indicate what may help, and what may hurt, you more.
Presenting a full picture of your pain, helps your doctor more quickly devise a treatment plan and recommend possible procedures that could help alleviate your discomfort.