The Evidence on Talking to Clinicians About Pain, Without the Hype
Pain scores alone convey very little, and describing function gives a clinician something they can actually work with.
Key takeaways
- More useful than a score: what you can no longer do
- Worth recording: onset, pattern, what worsens and eases it
- Most useful single change: Describe specific activities you have lost rather than a number.
- Commonest mistake: Relying on pain scores alone.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
What it is
Communicating persistent pain in a way that leads to useful decisions. It sits within Chronic Pain. The figures below are the ones published guidance uses, rather than the ones that circulate.
The numbers, in one place
| Measure | Figure |
|---|---|
| More useful than a score | what you can no longer do |
| Worth recording | onset, pattern, what worsens and eases it |
| Shared decision making | recommended by NICE |
| The three questions | What are my options? Benefits and risks? How do I decide? |
What helps
What follows is the practical part: the things guidance actually asks of you.
- Describe specific activities you have lost rather than a number
- Bring a written summary and a list of what you have already tried
- State your goal: what you want to be able to do again
- Ask the three questions when a treatment is offered
What to avoid
What to steer clear of, and why it catches people out.
- Relying on pain scores alone
- Minimising symptoms because you have had them a long time
- Leaving without knowing what happens next
Where to go next
- Talking to Clinicians About Pain in Five Minutes
- What Talking to Clinicians About Pain Is, and Why It Matters
- Talking to Clinicians About Pain — the reference entry
- What the Guidance Really Says About Chronic Primary Pain
- Pacing Activity: Sorting the Evidence From the Noise
When to speak to a doctor
Always report new or changing pain, pain that wakes you at night, pain with fever, unexplained weight loss, or new weakness or numbness — these need assessment regardless of an existing chronic pain diagnosis. Seek emergency care for bladder or bowel changes with back pain.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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