Here are some tips from a doctor about how to describe your pain in terms a doctor can understand best.
Pain symptoms are personal, unique–and subjective. (What Joe describes as “unbearable pain” may be considered “pretty unpleasant pain” to Mike).
Over the years, I developed my own “pain diagnostic” conversation with patients to help my team and I understand what, where, when and how much pain patients are feeling.
I’ve outlined key points below:
This is key to a proper diagnosis. Don’t assume we know you’ve battled this pain for a year, a month or a decade.
Spell it out:
- I’ve had this pain for _________________.
- How frequently and how long does it last?
- What ignites (flare) or lessens your pain and for how long?
Location, Location, Location
There is a graphic of a human figure with a back view and a front view. Doctors may instruct you to mark the area/s where your pain is concentrated. They may also ask you to note a difference between pain that is on the surface and pain that is under the surface.
How Bad is Your Pain – A Measurement Tool
Most referring physicians, regardless of their medical specialty, use a simple 1 to 10 point pain scale, so I stick with this to keep everyone on the same page.
Below are the descriptions from the McGill Pain Scale:
0 – Pain-free
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.
No one presenting in a doctor’s office should ever insist they have “level 10” pain. At that point, the person would no longer be functional enough to carry on a conversation, let alone participate in an appointment.
Any pain at level 8 or above would make it very difficult to converse at all, so level 10 is impossible at a regular doctor’s appointment. Such pain is only seen in situations of medical emergency.
Even if we “feel like” we’re at level 10, we have to recognize that saying this instantly creates doubt as to our truthfulness. Saying anything greater than “10” is obviously exaggerating since 10 is the maximum you can possibly feel by definition.
Instead of trying to impress the severity of our pain to our doctors by using big numbers, we need to focus on the “functional limitations” our pain imposes on us.
This directly applies to disability evaluations as well. The more specific you can be, the more your reporting will be taken seriously (as long as the details are believable). Having a written record is also given more weight than just speaking.
Here are a few examples to give you an idea of the kind of information doctors are looking for:
- cannot drive because of pain in back/hips or too distracted by pain
- cannot eat because cannot cook or prepare food due to pain
- cannot brush teeth due to pain in arms/shoulders
- cannot sit or stand, can only lie down (spend X hours/day lying down, X hours/day upright and/or active).
- cannot care for my children (need assistance for X hours/day)
- cannot read more than 15 minutes due to pain in neck/shoulders
- cannot wash dishes or clothes due to pain when upright and using arms
Such information also helps the doctor justify medication or other treatments to their superiors or insurance companies.
“My Pain Feels Like…”
Most of the time, patients experience one or two consistent pain “feelings” but some can experience a range of sensations.
The most common pain types are:
- Sharp stabbing pain
- Extreme heat or burning sensation
- Extreme cold
- Throbbing, “swollen,” inflamed tissue
- Sensitivity to contact / touching
- Numbness, tingling, pins and needles
Create a Pain Journal
I always encourage patients or their loved ones to document a week-long pain cycle before they meet with their pain management, chiropractic or alternative medicine team.
I kept such a journal for years and it definitely helped in my disability evaluation: How to get EDS Diagnosis, Pain Treatment, SDDI
Also, jot down any treatments or actions that lessen or increase your discomfort.
If you come prepared with all this information, your time with the doctor can be better spent focusing on next steps and a treatment plan, rather than a lengthy Q & A review of the information provided here.
More importantly, addressing these issues in advance will ensure your doctor receives up-to-date, higher quality information.
As a result, your case can be assessed more quickly and a pain management plan can be put into action to start reducing or eliminating your discomfort as quickly and effectively as possible.