See Doctor: Here's How it Is With My Neuropathy

Today's post from spineuniverse.com (see link below) is written by an experienced chiropractor and he summarises one of the main problems in doctor-patient communication perfectly (especially in relation to neuropathic pain). That problem is helping the doctor identify your pain by being able to describe it. Now if you've had neuropathy for some time, you'll appreciate how difficult that is. Neuropathic pain is very specific that's true - few other diseases carry the same sort of symptoms) but describing how that pain and discomfort affects you, can be a nightmare that leaves you floundering for words. This article provides some very useful tips as to how to approach an appointment with your doctor or neurologist. If you read it carefully, you'll see that it also helps you to put everything into perspective and gives you a framework which will help both you and your doctor understand how neuropathy is affecting you. This can be very helpful for the doctor in that he or she will be able to direct your treatment and medication much better instead of guessing, based on some vague symptoms. Well worth a read - a useful article.

How to Explain Your Pain to a Doctor
Submitted by Dr. Michael J. Cooney, D.C. on April 15th, 2016

An experienced chiropractor has tips to help you get the care you need at your next appointment

For more than three decades, I’ve been treating patients with acute and chronic pain from around the corner here in Rutherford, New Jersey to as far away as Australia and South Africa.

From our patient’s first consultation to the last treatment office visit, the success of any pain treatment we prescribe is contingent upon us (the health care provider) accurately treating the root cause of your pain.

As the patient, precisely describing your acute pain or neuropathic pain is a “high stakes” conversation. I can read your medical history, referring doctor reports and lab results, but this is all secondary to understanding each patient’s pain mechanics. It is absolutely essential that this is communicated to your pain management provider as accurately as possible.

For those battling “invisible pain" such as fibromyalgia, CRPS (complex regions pain syndrome), RSD (reflex sympathetic dystrophy), diabetic neuropathy or chronic pain after cancer treatment, accurately conveying the location, frequency and depth of the discomfort can be particularly challenging and emotionally taxing.

If you or a loved one are combatting short-term (acute) pain or a neuropathy (pain lasting 12 weeks or longer), I’d like to offer my own simple tools to help you accurately convey the unique characteristics of your pain so that the most effective treatment protocol can be set into motion.

You may wish to bring this article to your next doctor visit and go over each of the key pain description points I’ve outlined below.

I hope your doctor will ask you these questions, but if not, you can act as your own pain advocate and offer this information.

“Tell Me About Your Pain”
Based upon your medical records, we already know the cause of your pain (injury or disease). Our goal is to eliminate or minimize this symptom so you can resume your highest quality of life possible.

Pain symptoms are personal, unique--and subjective. (What Joe describes as “unbearable pain” may be considered “pretty unpleasant pain” to Mike). Over the years, I developed my own “pain diagnostic” conversation with patients to help my team and I understand what, where, when and how much pain patients are feeling.

I’ve outlined key points below:

Timing Matters
This is key to a proper diagnosis. Don’t assume we know you’ve battled this pain for a year, a month or a decade.

Spell it out:
I’ve had this pain for _________________.
How frequently and how long does it last?
What ignites (flare) or lessens your pain and for how long?

Location, Location, Location

 

Where does it hurt? There is a graphic of a human figure with a back view and a front view (see above).

Doctors may instruct you to mark the area/s where your pain is concentrated. They may also ask you to note a difference between pain that is on the surface and pain that is under the surface.

This tool comes from the McGill Pain Questionnaire which includes other measurements, but the front and back of the unisex human figure are the most recognizable.

How Bad is Your Pain - A Measurement Tool

 
Most referring physicians, regardless of their medical specialty, use a simple 1 to 10 point pain scale, so I stick with this to keep everyone on the same page.

Simply stated, think about where your pain level falls the majority of the time—unless you experience extreme pain fluctuations.

No Pain

0 – Pain-free

Manageable Pain

1 – Pain is very mild, barely noticeable. Most of the time you don't think about it.

2 – Minor pain. Annoying and may have occasional stronger twinges.

3 – Pain is noticeable and distracting, however, you can get used to it and adapt.

Moderate Pain—Disrupts normal daily living activities

4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting.

5 – Moderately strong pain. It can't be ignored for more than a few minutes, but you still can manage to work or participate in some social activities.

6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating.

Severe Pain—Disabling; debilitating, reduces daily quality of life, cannot live independently

7– Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep.

8– Intense pain. Physical activity is severely limited. Conversing requires great effort.

9– Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably.

10– Unspeakable pain. Bedridden and possibly delirious. Mobility may be compromised.

“My Pain Feels Like…”

Most of the time, patients experience one or two consistent pain “feelings” but some can experience a range of sensations.

The most common pain types are:
Sharp stabbing pain
Extreme heat or burning sensation
Extreme cold
Throbbing, “swollen,” inflamed tissue
Sensitivity to contact / touching
Itching
Numbness, tingling, pins and needles

Create a Pain Journal

 

I always encourage patients or their loved ones to document a week-long pain cycle before they meet with their pain management, chiropractic or alternative medicine team.

Also, jot down any treatments or actions that lessen or increase your discomfort.

For example, perhaps you've found that hot showers or cold weather makes you feel worse, but Epsom salt baths or exercise makes the pain more manageable.

If you come prepared with all this information, your time with the doctor can be better spent focusing on next steps and a treatment plan, rather than a lengthy Q & A review of the information provided here.

More importantly, addressing these issues in advance will ensure your doctor receives up-to-date, higher quality information.

As a result, your case can be assessed more quickly and a pain management plan can be put into action to start reducing or eliminating your discomfort as quickly and effectively as possible.

https://www.spineuniverse.com/blogs/cooney/how-explain-your-pain-doctor