By Dr. Michael J. Cooney
(I’m honored to have this article featured on SpineUniverse.com):
An experienced chiropractor has tips to help you get the care you need at your next appointment
From our patient’s first consultation to the last treatment office visit, the success of any pain treatment we prescribe is contingent upon us (the health care provider) accurately treating the root cause of your pain.
As the patient, precisely describing your acute pain or neuropathic pain is a “high stakes” conversation.
I can read your medical history, referring doctor reports and lab results, but this is all secondary to understanding each patient’s pain mechanics.
It is absolutely essential that this is communicated to your pain management provider as accurately as possible.
or those battling “invisible pain” such as fibromyalgia, CRPS (complex regions pain syndrome), RSD (reflex sympathetic dystrophy), diabetic neuropathy or chronic pain after cancer treatment, accurately conveying the location, frequency and depth of the discomfort can be particularly challenging and emotionally taxing.
If you or a loved one are combatting short-term (acute) pain or a neuropathy (pain lasting 12 weeks or longer), I’d like to offer my own simple tools to help you accurately convey the unique characteristics of your pain so that the most effective treatment protocol can be set into motion.
You may wish to bring this article to your next doctor visit and go over each of the key pain description points I’ve outlined below.
I hope your doctor will ask you these questions, but if not, you can act as your own pain advocate and offer this information.
“Tell Me About Your Pain”
Based upon your medical records, we already know the cause of your pain (injury or disease). Our goal is to eliminate or minimize this symptom so you can resume your highest quality of life possible.
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
Where does it hurt? There is a graphic of a human figure with a back view and a front view (see above).
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.
This tool comes from the McGill Pain Questionnaire which includes other measurements, but the front and back of the unisex human figure are the most recognizable.
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.
Simply stated, think about where your pain level falls the majority of the time—unless you experience extreme pain fluctuations.
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.
“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.
Also, jot down any treatments or actions that lessen or increase your discomfort.
For example, perhaps you’ve found that hot showers or cold weather makes you feel worse, but Epsom salt baths or exercise makes the pain more manageable.
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.