Effectively managing chronic pain goes beyond medication and therapy—it’s fundamentally about the relationship between individuals living with pain and their providers.
In too many cases, this relationship is fractured. In U.S. Pain Foundation’s 2022 “A Chronic Pain Crisis” survey, which included insights from 2,275 people with chronic pain, 63% of respondents said they felt stigmatized by their providers. And 71% of surveyed caregivers said provider attitudes are the top barrier to care.
A collaborative, open, and respectful patient-provider partnership can significantly improve health outcomes, helping you and your providers jointly work toward better results and improved quality of life.
The Foundation of Pain Care
A collaborative approach forms the foundation of effective pain management, says Antje Barreveld, MD, medical director of Pain Management Services at Newton-Wellesley Hospital, president-elect of the American Academy of Pain Medicine, and associate professor of anesthesiology at Tufts University School of Medicine.
“I see a good relationship with my patients as one where we are collaborative and we work together to understand each other’s perspective,” Barreveld shares.
Your providers should take the time to truly listen to what you have to say—if they don’t, you have the right to request a referral or new provider.
Attentive care on the part of the provider is a key aspect of a productive patient-provider relationship, says Teresa Reyburn-Orne, CPNP-AC, a pediatric pain management nurse practitioner, president of the American Society for Pain Management Nursing, and associate director of pain services and senior instructor of pediatric anesthesia at University of Colorado Anschutz Medical Campus.
“One hundred percent, the most helpful intervention I do as a pain practitioner is sit down in a chair and listen,” Reyburn-Orne explains.
This simple act of listening can make a significant difference in understanding and addressing a patient’s needs.
Patient Tips for Improved Communication
Preparation is key to making the most of your health care appointments. Before each visit, reflect on your top priorities and goals. Consider keeping a pain diary to track symptoms and triggers, and prepare a list of your current medications and their effects. This information can provide your health care team with valuable insights.
When discussing your pain, be as clear and specific as possible about your symptoms and how they affect your daily life. Don’t hesitate to express your concerns and fears—your emotional well-being is an integral part of your overall health.
If something isn’t clear, ask for clarification. Your understanding of your treatment plan is crucial for its success.
Honesty is vital, even when it comes to sensitive issues.
“The number-one reason why people do not seek care for substance use disorder is stigma,” Barreveld shares. “There’s a great fear of abandonment and being judged, but it’s crucial for patients to be open about their struggles so they can get the care they need.”
When children experience chronic pain, the dynamics become even more complex.
“For pediatric patients, we don’t just treat the child, we’re treating a whole family,” explains Reyburn-Orne. “A lot of times, the parents are communicating for the child, sometimes when they shouldn’t be.”
It’s crucial to let the child describe their own pain experience, as this not only provides more accurate information but also empowers the child to take an active role in their care.
The Consequences of Dismissive Care
Despite best efforts to build trust and effectively communicate, there may be times when you feel dismissed or mistreated by the providers helping to manage your pain.
“We’re all human, and it’s important to approach disagreements or concerns with empathy and understanding, taking a deep breath, and trying to communicate effectively,” Barreveld advises.
The first time this happens, share your concerns and feelings with your provider, and see if you are able to communicate in a different way or find a solution that makes you feel heard. If you consistently feel dismissed, though, it may be time to seek a second opinion or request a different provider.
Certain demographics are also more likely to routinely face discrimination in health care.
“There’s excellent science and data that shows [members of the medical profession] discriminate very readily toward people of color, toward women, toward other underserved pain populations, toward patients with addiction,” Barreveld says. “Much of what I try to do is to chip away at those biases and stigma.”
If you feel you’re experiencing discrimination, Barreveld advises against an accusatory approach but emphasizes that “calling things out and being honest is important.”
The emotional toll of past negative experiences with health care providers can create challenges in the doctor-patient relationship, including medical trauma and PTSD. When something as fundamental as life-altering pain is dismissed as a lie, or the person experiencing that pain is told it’s all in their head, it leaves an emotional scar. It may also make these individuals hesitate to seek out needed care in the future. Patients who have experienced dismissive or inadequate care in the past may find that building a new relationship with a provider requires extra trust and understanding.
This is true no matter the patient’s age. “Unfortunately, just like adults, children suffer when medical providers don’t understand what they’re describing,” explains Reyburn-Orne. She notes that some doctors assume children describing chronic pain are just trying to get out of homework or another activity.
Being open about past negative medical experiences while maintaining a willingness to move forward with a new practitioner can help build a foundation for a more positive relationship.
The Impact of Collaboration
The future of pain management lies in comprehensive, interdisciplinary approaches.
“The embracing of integrative therapies by the larger pain community has been really great,” Reyburn-Orne notes. “Many now consider an interdisciplinary pain management plan as essential, and they used to be thought of as optional.”
Trust and effective communication are key. Don’t hesitate to ask about complementary therapies that might enhance your treatment plan, or to request additional communication between the different providers making up your care team.
“I do think that the future of medicine is collaborative,” Barreveld says. “It includes not just the health care providers, physicians, the patients, but also our insurers, as well as our policymakers.”
Effective pain management is a team effort. By thoroughly preparing for your appointments, communicating openly, and advocating for comprehensive care, you can play an active and crucial role in your treatment journey. With patience, persistence, and the right partnership with your health care providers, you can work toward better pain management and an improved quality of life.
-Janet Jay
To learn more about the U.S. Pain Foundation’s Pain Awareness Month initiative, click here.
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