"Pain is vastly undertreated today for several reasons," says Jim Guest, executive director of the American Pain Foundation in Baltimore, Maryland. Until recently, health care professionals received little training in pain treatment. Patients hold low expectations for relief and don't want to be seen as whiners. Many doctors and patients are wary of strong painkillers, such as opiates (derived from opium) like morphine. Patients fear addiction, often needlessly. And doctors are concerned about increased scrutiny from drug regulatory agencies when prescribing stronger medications.
Despite the hesitation to talk about pain, it is epidemic: 50 million Americans have chronic pain (lasting six months or longer), and 25 million experience short-term pain from injuries or surgeries annually. Women tend to experience daily pain, miss work due to pain, and develop conditions that cause chronic pain.
Both the Joint Commission on Accreditation of Healthcare Organizations and the Department of Veterans Affairs call for pain to be treated as the "fifth vital sign" and assessed as vigilantly as blood pressure, pulse, temperature, and breathing rate.
"Doctors can't measure pain," says John Klippel, M.D., medical director of the Arthritis Foundation in Atlanta, Georgia. "Their ability to understand pain is determined by their patients' ability to describe it."
This calls for straight talk. Tell your doctor:
- When the pain started
- Where it is located
- What makes it better or worse
- Whether it radiates
- How it feels presently
- How it feels in its worst form
- How it feels in its mildest form
- How the pain rates on a scale of one to 10.
Choose words carefully to describe pain: stabbing, aching, dull, piercing, tingling, gnawing, deep, pounding, shocklike.
Share your ideas about the cause of the pain. Explain -- directly and succinctly -- the methods of relief you've tried and the results.
It's important that you explain how the pain affects your life. "An accurate explanation puts the pain into perspective for the doctor in terms of what kinds of things might be achievable through therapy, and what difference it would make in a patient's life," says Klippel.