How to talk to your doctor about chronic pain

Think about how to describe your pain

Because pain is individual, it can be hard to describe. But the more information you can give your doctor, the easier it will be for them to understand. Fortunately, you don’t have to use fancy medical terms.

Gynaecologist, Associate Professor Pav Nanayakkara at the Jean Hailes Clinic says using these sorts of descriptors and categories can help the conversation:

• Type – is there cramping, burning, sharp, stabbing, aching, throbbing or shooting pain, or pressure?
• Timing – is the pain constant or does it come and go?
• Location – can you point to the site of the pain; does it spread?

Dr Judith Hammond, a women’s health GP at the Jean Hailes Clinic, says that sometimes, rating pain from 0 to 10 can also help.

“What I normally say to people is 0 is no pain, one is barely noticeable – but if I distracted you, you’d probably forget you had it – and 10 is a broken bone or a … vaginal delivery.” But, she adds, this scale doesn’t work for everyone. “Culturally, pain does not always go on a one to 10 scale … and the concept of pain is very different.”

If the scale doesn’t work for you, pain management specialist Dr Megan Eddy suggests painting a picture with words. “I remember this woman saying ‘I have a big ball sitting low in my pelvis and it’s made of glass and it will shatter and the shards go down my legs’.”

Dr Eddy adds: “What I say to a patient is ‘Make me feel your pain’ and that can sometimes help them describe it.”

Consider keeping a pain dairy

If you have pain that comes and goes, Dr Eddy says keeping a pain diary may help reveal a pattern. You may discover, for example, that pain is connected to your menstrual cycle if you have periods.

A diary can also help when you have a change in treatment and want to know if the new treatment is working, adds Dr Eddy.

Keep a pain diary with a digital app, phone notes or pen and paper – whatever suits you.

For a GP appointment, Dr Hammond recommends keeping your diary simple. “[Capturing the] morning, afternoon and night [and whether the pain is] mild, moderate or severe can provide enormous information very quickly,” she says. Also jot down what helps or worsens the pain – think certain foods, medicines, going to the toilet, sex, tiredness or periods.

How long you keep a diary depends on your situation. Dr Hammond says: “A week would be helpful, but ideally watching it over a couple of months.” But don’t delay your appointment. If your pain is making life unbearable, seek help quickly.

Learn about conditions that often involve pain, including adenomyosis, endometriosis, fibroids, migraine and vulvodynia.

Book a longer appointment

Chronic pain is complex, so book in as much time as you can to talk about it.

“Be aware that it might take a few appointments to even get to a management plan, depending on who you’re seeing and what’s going on,” says Dr Eddy.

Dr Hammond agrees: “If you’ve been having pain for months or years, that’s not a quick answer.”

If time or money is a barrier, Dr Hammond has a tip: dedicate the whole appointment to your pain and leave other health issues for another visit.

Explain how pain impacts your life

How pain impacts your overall functioning is what Dr Eddy is most interested in when she meets a patient. “Because that’s often what we’re working on – reducing the impact of pain,” she says.

Try to tell your doctor how pain impacts different parts of your life, such as:

• sleep
• intimacy
• mood
• mobility
• toileting
• work/study.

You may like to take notes before your appointment.

Remember, you deserve to feel supported

Feeling validated matters, says Associate Professor Nanayakkara. “Just because you may have been dismissed in the past, doesn’t mean that you don’t deserve proper assessment and support.”

Dr Eddy prefers to know about a patient’s negative health care experiences if they feel comfortable sharing – “so I am aware of what has been difficult before and avoid making their experiences even worse”.

If you are still uneasy about your care, Associate Professor Nanayakkara says: “You are always allowed to get a second opinion.”

Read Kate May’s story about living with chronic migraine.