The Need For Better Pain Care

In my practice, I hear all too often how long a patient has gone, from doctor to doctor to doctor, looking for an answer but leaving without a diagnosis. Whether that patient goes 4 months or 5 years without an answer, it is too long. Why is it that patients struggle to find an answer, especially to symptoms of severe pain?

Is it that physicians are dismissing patient concerns? What happens in our emergency rooms, with family physicians and even at women's health specialists that it is a regular occurrence that patients are treated (and the focus is to convince) as though their pain is “normal”, “inexplicable” or “highly exaggerated”. Individuals are often told their extreme pain is in their head. This is because visible signs of injury do not always appear upon an exam.

The key is to better education of BOTH patients and doctors.

For patients, it is knowing how to describe pain and the severe pain symptoms, including keeping a pain journal to review cause and effect, time of day, and environmental factors. And, it is also learning how to assess when a doctor might be helpful, and when to ask for a specialist. Too often primary care physicians resist referring a patient to a pain specialist.

For doctors, it is learning to recognize and asses key symptoms of chronic pain conditions. And, as doctors, developing a solid network of resources and specialists to refer patients to. We cannot know and specialize in everything, nor should we. Seeing when it is time to send a patient to someone else who many know more is essential to the proper diagnosis and care of pain.

Recently I came across this story of a Canadian women struggling with getting a diagnosis for 7 years. In this instance she experienced chronic pelvic pain without a proper diagnosis for all those years.