Communicating your pain better
Living with chronic pain can be isolating, especially when others don’t quite get it. Whether your pain is visible, like arthritis or invisible like Complex Regional Pain Syndrome, it’s tough. The good news is, there are strategies that can help you communicate your needs, set boundaries, and make daily life a bit easier.
In Episode 27 of It’s Not In Your Head podcast, Justine and I discussed how both patients and doctors can improve their communication and understanding of chronic pain. Below, I’m breaking down the key takeaways for patients and doctors to help make this journey a little smoother.
For Patients: Managing Chronic Pain with Practical Strategies
1. Strategy: “Wanna Swap?”
If you’ve been told directly or have been made to feel your pain is in your head, you can simply ask “Wanna swap?” Then hold your silence for 2-3 seconds. This allows the other person to reflect on what you’re going through. It’s a subtle yet powerful way to make them pause and think.
2. Strategy: Keep it simple.
It’s exhausting to explain your condition every time you meet someone new. The truth is, you don’t owe anyone a detailed explanation, and they probably don’t really care anyway.
Try saying:
“I have a pain problem that just doesn’t want to go away.”
“I have a pain problem. It makes it painful to move much”
Or, “It’s like arthritis, but constant.”
This allows you to set a boundary while still giving them a context for why you are a bit slow to get going. It allows them to accommodate your needs without needing to pry. If you want to explain more, you can, but you control the conversation; no need to over-explain.
3. Strategy: “Sorry, not today, but I can…”.
It’s okay to say “No” or “Not today” when you need to, and it’s important to recognise your limits. Learning to set boundaries is an essential part of managing chronic pain.
Maybe you can’t walk 5 km today, but you can handle one. Adding “But I can….” allows you to focus on what you can do and gives yourself credit for today’s victory. It’s about recognising your capacity and working within it, not pushing through pain for the sake of perfection, or to meet others’ expectations, only to have to deal with the flare of pain after.
4. Strategy: “Use colours to tell others where you are at”
Sometimes, you are not up to saying “Not today”. Nonverbal tools like colour-coded wristbands can communicate your status quickly without needing to explain yourself every time. For the people who know you, a quick glimpse can tell them where you’re at.
Green means “I’m good,” red means “I need space,” and yellow signals a middle ground. These quick indicators let people know where you’re at without adding emotional labour.
For Doctors: How to Better Support Chronic Pain Patients
Chronic pain is complex, and it can be frustrating for both patients and doctors. But before diving into treatment, it’s important for healthcare providers to first acknowledge the patient's pain.
1. Strategy: “That sounds tough”
At a point of emotional distress in a consult, leading with empathy can create a strong therapeutic relationship. A simple “That sounds really tough. Are you happy to keep trying to work out what is happening?” can go a long way in building trust and rapport. It lets the patient know they’re heard and validated.
2. Strategy: “I don’t know but…”
Chronic pain is complex; patients have difficulty describing symptoms, choose not to tell us components, and if they have brain fog, struggle to remember what happened this morning, let alone their entire history. This makes things confusing, stories don’t fall into recognisable patterns, and it becomes frustrating.
Just because it doesn’t make sense doesn’t mean it is in the patient's head. It just means it is complex. Leading with honesty and saying “I don’t know, but this is how we start to work it out” doesn’t blame the patient, acknowledges you are not an all-knowing god and generates a plan to move forward.
3. Strategy: “What do you think is wrong?”
Nearly all patients gave a thought on what they think is wrong. Whether it is what they read in a scan result, what they have been told by others, or what Dr Google says, knowing where they start allows you to estimate how much education you need to do, to get them from what they think is wrong, to what you think is wrong.
4. Strategy: What’s your preference?
Most patients have some definite things they want, and definite things they don’t want. Creating a plan that misses everything they want, and includes everything they don’t, doesn’t result in the patient getting better.
Ask “What’s your preference? My tools include further investigation, medications, rehab, psych, diet and exercise, injections, surgery, that’s about it.” If your toolkit is only surgery, and they don’t want surgery, that is ok; they need to see someone else.
Patients quickly understand that the list of management strategies is pretty short. Asking them about their preference gives you clear guidance on the way they will be happy to go forward.
It’s then up to you to tie that into an effective plan.
Conclusion
Managing chronic pain is never easy, but with the right tools and strategies, it becomes more manageable. Whether you’re a patient setting boundaries, using nonverbal cues, or a doctor leading with empathy, the key is communication and understanding.
If you’re ready to dive deeper into these topics and hear more real, actionable advice, definitely give Episode 27 of the It’s Not In Your Head podcast a listen. Justine and I discuss even more strategies, share personal stories, and provide insights that can help make chronic pain a little easier to navigate.
https://www.iniyh.com/episodes/ask-us-anything-aua-1
Take care of yourself and remember, you’re not alone.
Dan