Healthcare Professionals
Person-Centered Chronic Pain Care
Person-centered care starts with recognizing that the person living with chronic pain is more than a diagnosis, a pain score, or a body part.
Chronic pain is a biopsychosocial experience. Biological, psychological, and social factors can interact to influence how pain is experienced, how it affects daily life, and how a person responds to treatment.
The goal isn't simply to treat pain. It's to understand the person experiencing it.
A person may seek care because of pain, but the greatest burden may come from what the pain is doing to their life: anxiety, isolation, sleep disruption, reduced mobility, difficulty working, loss of meaningful activities, or concerns about what the pain means.
Understanding those effects can help healthcare professionals develop a more complete picture and identify opportunities to support recovery, function, confidence, and quality of life.
THREE FOUNDATIONS OF PERSON-CENTERED CARE
Recognize Our Humanity
Treat the person, not just the pain.
People living with chronic pain are people first — not pain numbers, appointment times, body parts, symptoms, or medical diagnoses.
- No single contributor determines the pain experience. Chronic pain can involve biological, psychological, and social factors.
- A pain score can't fully capture what a person is experiencing or how pain is affecting their life.
- Explore how pain is affecting sleep, mobility, daily activities, relationships, work, and the things that matter most to the person.
- Look beyond pain intensity to identify psychosocial factors that may be contributing to distress or disability.
- Help the person identify what's important to them and turn those priorities into meaningful goals.
Consider the whole experience. Anxiety, fear, isolation, helplessness, hopelessness, catastrophizing, all-or-nothing thinking, unrealistic expectations, and fear avoidance may all influence how a person experiences and responds to persistent pain.
Prioritize Listening Over Speaking
Listen to the person's story.
The person sitting across from you wants to be heard and believed. The pain is real. Taking time to understand their story can create a safer environment for discussing concerns, expectations, fears, and goals.
- Give the person time to tell their story without interruption, suspicion, or judgment.
- Go beyond tick-box communication. Create an environment where people feel comfortable asking questions and discussing what they're experiencing.
- Repeat or summarize their story to confirm that you understood it correctly — and to show that you heard them.
- Remember that while healthcare professionals may be experts in pain science and treatment, the person is the expert on their own experience.
- Use open-ended, guiding, and reflective questions to understand the person's experience, concerns, and goals.
Questions That Can Open the Conversation
“Can you tell me more about what you're going through?”
“How is the pain limiting what you do?”
“Are there times when the pain is better or worse?”
“What are you most worried about?”
“Do you worry that something potentially dangerous is happening in your body?”
“What things do you think might improve your experience?”
“What are your goals, including your expectations for treatment?”
Choose Your Words With Compassion
Language can inform — or unintentionally create fear.
The words healthcare professionals use, how they're said, and even body posture can influence how a person understands their pain and what they believe they can safely do.
- Avoid language that may unintentionally create fear, anxiety, or a sense that the person's body is damaged beyond repair.
- Be thoughtful with phrases such as “bone on bone,” “wear and tear,” or “degenerative disease.”
- Avoid dismissive statements such as “you look normal,” “you'll be fine,” or “the pain is in your head.”
- Avoid language that suggests there's nothing more a person can do or that their condition is hopeless.
- Limit unnecessary clinical jargon. Use clear, straightforward language that people can understand.
- Stories and metaphors can sometimes make complex pain concepts easier to understand.
LANGUAGE MATTERS
Put Clinical Findings Into Context
The goal isn't to avoid discussing clinical findings. It's to put them into context and explain them in a way that informs rather than unnecessarily frightens.
Language to Use Carefully
- “Bone on bone”
- “Wear and tear”
- “Degenerative disease”
- “You're the worst case I've ever seen”
- “There's nothing more I can do”
- “The pain is all in your head”
A More Helpful Approach
- Explain findings in plain language.
- Put imaging and examination findings into context.
- Explain what findings mean — and what they don't mean.
- Discuss what the person can safely do.
- Emphasize function, confidence, and meaningful goals.
- Offer realistic hope and a path forward.
SHARED DECISION-MAKING
Treat the Person as an Equal Partner
Person-centered care means treating the person as an equal partner in decisions about their healthcare.
Shared decision-making can include:
- Respecting the person's autonomy and preferences.
- Exploring simpler or safer treatment options when appropriate.
- Clearly explaining potential benefits, risks, and uncertainties.
- Discussing what may happen if the person chooses not to proceed with a particular treatment.
- Connecting treatment decisions to the person's goals and what matters most to them.
LOOK BEYOND THE PAIN SCORE
Pain Intensity Is Only One Part of the Experience
Pain intensity is only one part of the chronic pain experience. Understanding how pain affects a person's thoughts, feelings, behavior, relationships, sleep, mobility, and daily activities can provide a more useful picture of the challenges they face.
Depending on the clinical setting, validated tools such as the PEG Scale, Central Sensitization Inventory, Pain Catastrophizing Scale, and other appropriate measures may help explore specific aspects of the person's experience.
RESEARCH & PROFESSIONAL RESOURCES
Motivational Interviewing
An evidence-based communication approach that can support collaborative conversations and behavior change.
READ THE RESEARCH →Positive Language in Pain Consultations
Resources from the ACI Pain Management Network on communication in pain care.
EXPLORE RESOURCE →Communicating About Chronic Pain
VA guidance for clinicians communicating with people living with chronic pain.
VIEW VA RESOURCE →Psychologically Informed Practice
Research examining communication and psychologically informed approaches to clinical care.
EXPLORE RESEARCH →Patient-Centered Consultations
Research examining patient-centered communication and psychologically informed approaches to clinical consultations.
EXPLORE RESEARCH →Language in Musculoskeletal Rehabilitation
Professional research examining communication strategies used in chronic pain rehabilitation.
EXPLORE RESEARCH →Person-centered chronic pain care begins by seeing the person behind the pain — listening to their story, understanding what matters to them, communicating with compassion, 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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