Talking With Your Healthcare Professional
Communicating the details of your pain is vital when talking to your doctor or healthcare practitioner. Whilst the pain might be difficult to describe, it is very important that you don’t suffer in silence.
Know Your Own Pain
Joanne O’Brien, Advanced Nurse Practitioner in Pain Management at Beaumont Hospital, shares advice on how to describe and manage your pain.
It’s very important that you know how to communicate your own pain:
- Know what makes it better, what makes it worse.
- Is your pain there all the time?
- Where does your pain go? By telling a nurse or a doctor where it goes, they can then follow the nerve line that the pain might be traveling.
- Describe your pain in your own words. Is it sharp? Dull? Electric?
- How severe is your pain on a scale of 1 to 10? Does it vary?
- Know your medication, write it down.
- Have you found non-pharmacological treatments helpful? Relaxation, massage or physiotherapy?
- It’s important that you pace yourself. Do a little bit everyday, it’s much better for your pain.
“It’s really important that you don’t suffer in silence, that you seek out advice and support, and that you participate in management of your own pain.”
– Joanne O’Brien
of people with chronic pain do not discuss their pain with family and friends as they think it may annoy them
of people with chronic pain delayed discussing their pain with their doctor because they found it difficult to explain
of people with chronic pain said they feel frustrated when trying to describe their pain
Referral to a healthcare professional
Talking with your GP about chronic pain
Be prepared and give your GP as much information as possible during your visit. If you are anxious that you might forget something, write it down and bring it with you. You can also bring someone in with you.
It will be helpful if you can inform your GP of the following:
- When did the pain begin?
- Was the onset of pain gradual, sudden, result of event/trauma/accident?
- Give a description of your pain
- List the region(s) of your body that you are experiencing pain
- Does it radiate (e.g. starts and spreads to another location in your body)?
- Describe how severe the pain can be on a daily, weekly basis, does it vary?
- When are you most affected (is it worse in the morning or night)?
- How often the pain occurs, is it constant, frequent, does it come and go?
- How intense is your pain? (how would you rate it 1 – 10 with 10 being the worst)
- Is the pain affecting your ability to work, socialise or is it affecting your private/family life?
- Is the pain causing sleeplessness, poor concentration or low mood?
Your GP may also ask you to use a Pain Diary which involves recording your level of pain (on a pain scale) several times a day over the period of a week. The Pain Toolkit is a useful online tool that helps you manage your pain.
Activities that affect your pain
You will be asked to note activities or other things that seem to increase pain, and note when taking any medication the effect it has on your pain. This can be very helpful in establishing whether there is any particular pattern to the pain, or any triggers that could be avoided.
Your GP may also conduct a physical examination (which will vary depending on site and type of pain) to look for possible causes of pain and to rule out certain conditions. Once your GP has assessed your pain they may conduct further tests to try and determine the underlying cause of pain.
By describing your symptoms clearly and fully and the impact these have on your life your GP will be better positioned to make the correct diagnosis, begin treatment and/or refer you to specialist services.
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Referral to a pain specialist
Chronic pain can be difficult to diagnose and treat. If your GP thinks that you may have chronic pain then he/she should refer you to see a pain specialist.
If your GP is unwilling to do so, ask him/her to arrange for a second opinion. Please note that patients cannot make an appointment for themselves, the referral must come via a GP or other medical professional.
Be prepared for your appointment and again if you are anxious that you might forget something write it down or bring someone along with you.
Keep a pain diary (either on paper or by using an app e.g. paintracker.ie):
- Record your level of pain several times a day over a period of time
- Note activities or other things that seem to increase pain
- Note when taking any medication the effect it has on your pain
This information can be very helpful in establishing whether there is any particular pattern to the pain, or any triggers that could be avoided.
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Recognising and managing chronic pain
As part of our public event Recognising And Managing Chronic Pain, Dr Ray Doyle outlined the role of the GP in diagnosing chronic pain, including some very helpful definitions and advice.
In his talk Understanding the Causes of Chronic Pain: The Scientific Perspective, Prof David Finn explained the science of pain and stressed the importance of the IASP definition of pain:
“It conveys the fact that pain is associated with a physical aspect, and also an emotional or psychological aspect. It also suggests that there doesn’t necessarily have to be obvious tissue damage or injury present for pain to be felt. In other words, pain is what the patient says it is and that’s an important message.”
Watch all the talks from the event Recognising And Managing Chronic Pain.
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Pain management principles
The objective of pain management is mastery of your pain, putting you back in control as you go on to achieve your goals and live your life.
Pain management principles are based on a holistic approach to living with chronic pain. These include:
- Daily activity
- Daily exercise
- Daily relaxation
- Setting practical goals that are achievable for you
Talk with your doctor about what is reasonable for you, what your tolerance levels are and how you can build them up slowly over time.
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Pain management programme
A Pain Management Program (PMP) is a psychologically-based rehabilitative treatment for people with persistent pain. It is delivered in a group setting by an interdisciplinary team of experienced health care professionals working closely with patients. Some Pain Centres may run Pain Management Programs that aim to teach a group of patients with similar problems about pain, how best to cope with it and how to live a more active life.
Practical advice and techniques that improve quality of life
For the majority of people, attending a Pain Management Program reduces the disability and distress caused by persistent pain by teaching physical, psychological and practical techniques to improve quality of life.
It differs from other treatments provided in Pain Clinics in that pain relief is not the primary goal, although improvements in pain following participation in a Pain Management Program have been demonstrated.
Pain management programmes in Ireland
A referral to the Pain Management Programme at your local pain clinic can usually be done through your general practitioner.
There are public Pain Management Programmes in:
- St Vincent’s University Hospital, Dublin
- Tallaght University Hospital, Dublin
- Mater Misericordiae University Hospital
- Mercy University Hospital, Cork
In addition, St James Hospital, Dublin offers mindfulness meditation. The Galway University Hospital is also developing an online program to allow access by patients in all regions of the country.
The Irish Pain Society has a helpful video demonstrating what you can expect from a pain management programme.
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Chronic pain self-management
Self-Management fits well with clinical approaches and the sooner you start the better. It’s not easy but it is possible. A lot of people make huge improvements in the quality of their life when they thought all was lost. While there is no immediate cure for Chronic Pain, implementing strategies/techniques through self-management can help reduce your pain, improve the quality of your life and puts you, not the pain, in control.
Self Management is an approach to improving health and well-being by addressing the impact chronic pain has on life i.e. stress, anxiety, poor sleep and over-doing things. It is important to take control wherever possible through improving understanding and building skills in relaxation, stress management, pacing and challenging negative thinking.
Chronic Pain Ireland Self-Management Workshops
We have been offering self-management workshops for our members since the 1990s. These workshops are designed for people with chronic pain, helping you manage the complexities of persistent pain whilst continuing to achieve your goals and live your life.