Strategies for describing pain to a healthcare provider

An “invisible symptom” is a symptom that is not outwardly observable to other people. Unlike visible symptoms—something like a scrape, a bruise, or a broken bone that is seen on an X-ray—invisible symptoms are things like fatigue or changes in mood. These symptoms are very real and have a very real impact on a person’s life, but they cannot be fully observed by others.

Pain is perhaps the most common invisible symptom.

Acute and chronic pain in the United States

In the United States, the prevalence of acute pain (considered temporary, short-term pain) has increased over the past three decades. Contributing factors include an increase in the availability of surgical procedures, conditions like diabetes and obesity, and people over the age of 65 (who are more likely to experience pain due to age-related health conditions or injuries). While prevalence is increasing, acute pain typically responds well to treatment.

The prevalence of chronic pain has also increased. Over 50 million people in America experience chronic pain in a given year. Chronic pain is pain that lasts for longer than 3 to 6 months (a timeframe considered the cutoff between acute and chronic) and in some cases much longer. The causes and treatment for chronic pain are more complex than the treatment for acute pain.

Describing pain to your healthcare provider

Because pain is not a symptom that is fully observable, your healthcare provider will rely on you to describe this symptom during your appointments. A common tool is the Numeric Rating Scale (NRS), which asks you to rate your pain on a scale from 0 to 10:

• 0 is no pain
• 1 to 3 is mild pain (annoying or nagging)
• 4 to 6 is moderate pain (interferes with normal activities)
• 7 to 10 is severe pain (unable to function normally)

While this scale can be helpful, it also has limitations. Different people will inherently have different ideas about what pain ranks as mild, moderate, and severe. In many cases, pain fluctuates, so a person will be trying to rank pain that they are not experiencing in that exact moment. A number also does not capture important details about the pain, like when it occurs and how long it lasts.

If you are experiencing pain, you will need to describe that pain to your healthcare provider. Sometimes, this can take some practice.

Strategies for describing pain:

• Think of pain you have experienced in the past and compare it to your current pain.
• Use metaphors and descriptive words, such as sharp, burning, aching, dull, or radiating
• Describe where the pain is located and if it spreads to other areas.
• Describe when the pain is at its most and least severe (for example, in the morning, or during a certain activity).
• Describe how long the pain lasts—is it constant? Does it come and go?
• Discuss how pain affects your normal daily tasks (things like driving, cooking, work, or exercise).
• Discuss what things make the pain worse and anything that makes it better (for example, does it get better or worse with movement or rest).
• Discuss what medications or other therapies you have used and how the pain responded. Also discuss any side effects from treatment.
• Be honest, especially if you have concerns about your symptoms or medication side effects.

Also consider keeping a pain journal, where you track your symptoms. Keeping a record can help you recognize patterns in your symptoms and may help you answer some of the questions above.