Healthcare Professionals
Pain Communication
For many people living with chronic pain, being heard and believed is an important part of receiving good care.
Communication is more than exchanging medical information. It is an opportunity to understand the person's experience, build trust, identify what matters to them, and work together toward meaningful goals.
Before people can hear what you have to say, they need to know that you have heard them.
People living with chronic pain often arrive at a healthcare appointment after years of unsuccessful treatments, conflicting explanations, repeated testing, and experiences in which they felt dismissed or misunderstood.
Taking the time to listen can help create a safer environment for people to describe what they're experiencing, ask questions, express concerns, and participate more fully in their care.
WHY LISTENING MATTERS
Listen to the Story, Not Just the Symptoms
A medical history can tell you what has happened. A person's story can help you understand what it has meant to them.
- Give the person an opportunity to describe their experience in their own words.
- Explore how pain affects sleep, mobility, work, relationships, daily activities, and quality of life.
- Ask what they believe is happening and what concerns them most.
- Ask what they've tried, what helped, what didn't, and what they learned from those experiences.
- Find out what they hope to accomplish through treatment.
“The pain is real.” Acknowledging a person's pain doesn't require assuming that every explanation they've been given is correct. Validation means recognizing that their experience is real and worthy of attention, respect, and thoughtful care.
Listen Without Interruption, Suspicion, or Judgment
People are more likely to openly discuss their concerns when they feel safe doing so. Chronic pain can be accompanied by frustration, fear, anger, anxiety, hopelessness, or uncertainty. These emotions shouldn't automatically be interpreted as resistance or lack of cooperation.
- Avoid jumping immediately to conclusions about what the person is thinking or feeling.
- Give them enough time to explain what's been happening.
- Avoid assuming that a difficult interaction means the person is difficult.
- Recognize that previous unsuccessful treatment can influence expectations and trust.
- Create an environment where questions and disagreement can be expressed safely.
Try Reflective Listening
Reflective listening means listening carefully and nonjudgmentally, then reflecting back what you believe you heard in your own words.
For example: “It sounds like the pain itself is difficult, but what has been especially frustrating is how much it has prevented you from doing the things you enjoy.”
This gives the person an opportunity to confirm what you understood — or correct it — while demonstrating that you were paying attention.
Questions That Can Open the Conversation
“Can you tell me more about what you're going through?”
“How is the pain affecting your daily life?”
“What has changed in your life because of the pain?”
“What are you most worried about?”
“What do you think is happening?”
“What have you tried so far?”
“What helped, even if only a little?”
“What are you hoping we can accomplish together?”
“What would you most like to be able to do again?”
GO BEYOND TICK-BOX COMMUNICATION
Ask, Then Listen
Open-ended questions are useful only when there's enough space for the person's answer. Avoid immediately redirecting the conversation back to a checklist.
Explore What Matters
A person's priorities, interests, abilities, and goals can help shape a treatment plan that's meaningful to them.
Check Your Understanding
Summarizing what you heard can uncover misunderstandings and gives the person an opportunity to clarify their story.
Make Room for Questions
People may hesitate to ask questions if they feel rushed, judged, or intimidated. Invite questions and make it clear that uncertainty is okay.
Recognize the Person as the Expert in Their Experience
Healthcare professionals bring knowledge of pain science, diagnosis, treatment, and rehabilitation. The person living with pain brings knowledge that can't be learned from a textbook: what the pain feels like, how it affects their life, what they fear, what they value, and what they hope to accomplish.
- Treat the person's observations as important information.
- Ask what they notice about changes in their symptoms and function.
- Avoid assuming that a reported pain level is an exaggeration simply because it seems inconsistent with examination or imaging findings.
- Use your expertise to add information and perspective, not to dismiss the person's experience.
- Work with the person rather than simply telling them what they should do.
USE COMMUNICATION TO SUPPORT CHANGE
Motivational Interviewing
Motivational interviewing can provide a useful framework for collaborative conversations about behavior change. Rather than simply telling someone what to do, the healthcare professional helps the person explore their own reasons, concerns, confidence, and goals.
This approach is particularly compatible with chronic pain care because self-management ultimately requires the person to participate actively in their own care.
The provider becomes less of a director and more of a guide: asking questions, listening carefully, recognizing ambivalence, supporting autonomy, and helping the person identify achievable next steps.
WHAT PEOPLE OFTEN WANT FROM THEIR HEALTHCARE TEAM
To Be Heard
Give people enough time and attention to explain what they're experiencing.
To Be Believed
Acknowledge that their pain is real even when testing doesn't provide a simple explanation.
To Be Respected
Treat people as partners in their care rather than passive recipients of treatment.
To Understand
Explain what's known, what's uncertain, and what the available options may be.
To Have Hope
Provide realistic optimism and a path forward rather than implying that persistent pain means permanent disability.
To Have a Voice
Include the person's goals, preferences, values, and concerns when making decisions about care.
PRACTICAL TAKEAWAYS
- Listen before explaining.
- Ask open-ended questions.
- Let the person tell their story.
- Reflect back what you heard.
- Validate the person's experience without reinforcing unnecessary fear.
- Use language that informs rather than frightens.
- Explain uncertainty honestly.
- Ask what matters most to the person.
- Make shared decision-making part of the conversation.
- End with a clear understanding of the next step.
Good communication doesn't require having all the answers. It begins with listening, understanding, respecting the person's experience, and working together toward a meaningful path forward.
All information is for educational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Use at your own risk.
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