My article originally published December 30, 2019 in National Pain Report.
Chronic pain appointments can be difficult for both doctors and patients.
For patients, doctor visits can be intimidating and create anxiety. We want validation of our pain, empathy, answers, and support.
For doctors, chronic pain patients can be more challenging to treat than other patients. We can be demanding of their time, attention, and patience.
While they genuinely want to help, doctors often have limited training (typically only 11 hours of pain education in medical school); limited time (typically only 15-20 minutes per appointment); limited options due to government, health system, and insurance guidelines; and limited internal resources to treat chronic pain patients.
So how do you make the most of your appointment time and get the best treatment when you visit the doctor?
Below are 23 suggestions to help maximize the patient-doctor experience (thanks to the many ideas provided by members of the Chronic Pain Champions – No Whining Allowed Facebook support group):
Before the appointment
At the appointment
To get the best treatment from your doctor, be prepared, calm, engaged, insightful, and open to self-care. It’s harder for doctors to treat patients who are negative or expect the doctor to fix all their problems.
I hope you find these tips helpful.
Did you know?
As part of the week-long Mayo Clinic fibromyalgia program I attended in 2016, I met with a pharmacist to review the lengthy list of prescription medicines, over-the-counter medicines, and supplements I was taking at the time. My medicine cabinet looked like a GNC store.
I was instructed to bring the actual bottles with me to the appointment, so I packed the bottles into a gym bag (yes, I was taking a lot of medicines and supplements) and went to see her.
I was surprised as she read each bottle, making comments and recommendations about each pill – including product quality, labeling issues, ingredient safety, and dosing.
When the appointment ended, my medicine and supplement list was much shorter with her recommending stopping most of the supplements and my gym bag much lighter – throwing away the pills I was going to stop taking.
Unlike prescription or over-the-counter drugs, which must be approved by the Federal Drug Agency (FDA) before they can be marketed, the FDA doesn’t review supplements for safety and effectiveness before they are sold.
We don’t know where the products are made, how they are made, what is in them, and if the dosage is appropriate.
Safety is left up to the manufacturers and distributors of the supplements.
You assume all risks when using supplements. While some may be valuable, many aren’t.
Chronic pain can make it easy to feel overwhelmed, reduce our activity levels, and become isolated. Goals help restore a sense of order, build self-efficacy and sense of control, improve mood, and provide direction by helping with planning daily activities.
One of the tools we learned at the Mayo Clinic Pain Rehabilitation Center was goal setting to help us plan our days and keep us on track. We set goals each day. They didn't have to be massive, but they had to be SMART - specific, measurable, achievable, relevant, and time-bound.
Some SMART goal examples:
Did you notice none of the goal examples included pain reduction?
Our focus should be on reducing stress, improving our quality of life and increasing functional ability and activity, not pain reduction. Focusing on pain reduction is an easy trap to fall into - leading to frustration and depression. Just as the homepage of my website says - we can live well, despite the pain.
While it's natural to celebrate big goals, be sure to celebrate milestones along the way, as well as smaller victories. These celebrations keep us motivated along the way and help instill confidence.
Pain is the body’s alarm system. It’s designed to protect us from danger just like a home security system or a smoke detector. It’s the body’s normal response to acute tissue damage or injury and heals in normally 3-6 months.
But what happens when pain doesn’t go away?
Once pain persists beyond the normal healing time, it becomes chronic - losing its warning function and becomes its own disease/condition. It’s an abnormal response (with or without obvious pathology).
Although all pain hurts, not all pain indicates damage. We know what to expect from our pain by the very nature of it being chronic or ongoing. It’s not like getting burnt, twisting an ankle, or getting stung by a bee that needs protection until the injury has heals. Of course, any unexpected new pain should be investigated.
Pain, stress, and tension are closely related. Muscles tighten and put pressure on nerves resulting in even more pain.
It’s possible to activate your body’s natural relaxation response to help reduce the tension using mind-body tools like:
FIND MORE TOOLS AND APPS
Tom Bowen is a chronic pain patient who turned into an advocate, educator, and collaborator.