10 Things Never to Say to Your Doctor About Chronic Pain.

Editor’s Note: Dr. Radnovich treats pain patients in Boise, Idaho. His practice is well regarded nationally as a leading clinical research site for pain. He has agreed to write some columns for the National Pain Report.

radnovich

Dr. Radnovich

Most practicing physicians are not as warm and accepting as TV’s Dr. Oz. Going to a new doctor can be an intimidating or embarrassing experience. Going to a new doctor because of chronic pain can be even worse.

You’ve probably had at least one bad experience with a physician. Perhaps you were treated in a dismissive or patronizing way or, even worse, you were called  “an addict” or told that your pain is “all in your head”. (More on that in a future blog).

So how to talk with your doctor seemed like a pretty good start to a blog series. Let’s start by talking about ways to improve your interactions with your physicians.

Here are 10 things never to say to your doctor about your chronic pain.

  1. Don’t tell your doc “I hurt all over”. If you tell me this my next questions are likely to be “do your teeth hurt? Or do you toe nails hurt? Or do your eyeballs hurt? When your doctor asks you “where does it hurt” try to be specific; pick the 1 or 2 most affected areas or the areas where the pain started.
  2. Don’t overstate you pain or overly embellish the description. Years ago, while working in an ER in St. Lucia, a farmer came in complaining of pain in his rectum “like a chicken bone stuck sideways up there”. Well, as it turned out he did. But most of the time try to use simple descriptors like ‘sharp’, stabbing’, ‘dull’, or ‘achy’.
  3. Don’t suggest the pain is the result of long ago events, such as “I was in an auto accident 30 years ago” or “I fell of the swings”. Right. And who did not fall off the swings when they were kids? There are some health professionals that reach back and attempt find a ‘reason’ for the pain. In my experience, these usually mislead from the true cause of pain and result in ineffective, unnecessary treatment. A previous event or injury can be significant if you had specific, continuous pain in a specific spot since the event. Other than that, these types of explanations tend to be counterproductive.
  4. Don’t say anything related to a work injury or auto accident, even if that is truly how the pain started. Sad but true, saying that your pain is from an auto accident or work injury will likely result in the doctor thinking that you are exaggerating your problems for “secondary gain”, like trying to get a big cash settlement.
  5. Don’t ask for a specific pain drug. Nothing says ‘drug seeker and abuser’ to your doctor faster than saying the only thing that works is Percocet. You are establishing a relationship and asking the doctor for help; not asking for a specific treatment plan. It is counterproductive to pronounce what she should give to you. Especially if that is opioids. Let the doctor come up with her own treatment plan. Yes, it is frustrating and may take longer, but in the end you will establish a good relationship and may get a better care.
  6. Don’t volunteer to your doctor that you do not abuse drugs or that you are not an addict. If you blurt out such statements, she will assume that you do and that you are.
  7. Don’t tell your doctor that you have tried everything. Terrific, if you tried everything and you still have pain; why are you seeing me? Clearly I must have something you have not tried. Make a list of treatments and medications you have tried. Let the doc decide if that is truly everything and if she has anything else to offer.
  8. Don’t insist on getting a specific lab, MRI or other test. It is okay to mention other doctors’ ideas, but that may trigger a defensive response from the new doc.
  9. Don’t tell the doctor you are allergic to everything; particularly anti-inflammatories, gluten or vaccinations.
  10. Don’t say anything about a diagnosis or treatment that you found on the internet or from TV. Doubly true for anything you saw on ‘Dr. Oz’.