Who would think that children are better at communicating than adults? But when it comes to pain, they know exactly how to get the attention of the experts: They cry. Pain is very personal. Everyone feels it differently, and, in our society, many of us are reluctant to discuss it. We may feel it's socially unacceptable to complain (even to our caregivers) or morally admirable to suffer in silence — or some of us may avoid facing the issue because that means we'll have to find the time to deal with it. But pain is our body's way of letting us know that something is wrong, and it shouldn't be ignored. It's important to find the right way to describe pain so that you and your physician can get at the cause and take appropriate action.
Pain can be considered your body's "fifth vital sign" and should be taken as seriously as your other vital signs: temperature, blood pressure, pulse and respiratory rate. Pain is complex and can show itself in different forms. We are all familiar with acute pain — a "help needed now!" sensation triggered by the nervous system to alert you to possible injury and warn you to change your behavior. Then there is chronic pain — defined as pain that persists for longer than three months. More Americans suffer each year from chronic pain than diabetes, heart disease, and cancer combined.
Unfortunately, causes of chronic pain are often not as obvious as the instant and acute pain you experience when stub your toe or burn your finger. Chronic pain can be associated with numerous conditions, including rheumatoid arthritis, osteoarthritis, shingles, diabetes, problems with spinal discs, fibromyalgia, and cancer. But pain is not always just a symptom of another condition. Chronic pain can be linked to changes in various regions of the nervous system and can be a disease in its own right. It can also have physiological and psychological consequences of its own. And when pain starts to interfere with your personal relationships and/or your ability to engage in activities of daily living, it's time to get serious and speak up! It's not always easy to express what you're feeling, and the problems with pain get magnified when you can't fully describe the pain to your doctor.
Fortunately, there are tools to help the doctor better assess the type of pain that you are experiencing. Often your doctor will ask a number of questions about the pain, including an assessment of the pain intensity (usually using a scale of 1 to 10), along with questions about the location, duration, and character of the pain. The doctor is also likely to perform a physical examination and may order blood tests, X-rays, or other diagnostic tests to find the origin of the pain.
Some doctors may ask that you keep a pain diary so that you can bring to your appointment a record of when your pain occurs, how bad it is and how severely it's affecting your work and personal life. A pain diary will make the conversation with your doctor easier. If you start a pain diary, you may want to try recording details using this mnemonic device — LOCATES:
L — Location of the pain and whether it travels to other body parts
O — Other symptoms, such as nausea, numbness or weakness
C — Character of the pain, whether it's throbbing, sharp, dull or burning
A — Aggravating or Alleviating factors: What makes the pain better or worse?
T — Timing of the pain — how long it lasts, and is it constant or intermittent?
E — Environment where the pain occurs — while working or at home?
S — Severity of the pain
There are many questions that clinicians may ask you in order to learn more about your pain and its causes, since different types of pain may require different treatments. But if you are in pain, begin thinking even before your appointment about the best ways to describe it. And — importantly — do not be ashamed, never minimize your pain when you are talking with your doctor and do not omit any potentially related details — they may be important. Finally, if you are not getting the results you want, it may be time to find a doctor who specializes in treating chronic pain. In all cases, your relief starts with you-especially, your willingness to speak up about the pain you are feeling.