Their pain is never just one word
Opening Pandora’s Box
Asking patients about their pain experience can feel like opening Pandora’s box. Unless you ask the right questions, it can be difficult to fully understand their pain. So how can you best explore a patient’s pain experience to maximize time with them and recommend the best treatment plan? It starts with better conversations.
Better conversations for better clinical outcomes in pain management
The Global Pain Index (GPI), 4th edition, is a comprehensive survey of over 19,000 online interviews across 19 countries. The GPI provides insights into the impact of pain on people’s daily lives, as well as how gender, age and background affect the pain experience.
The GPI shows that one-third of the world’s population are in pain every day, and one in five chronic sufferers are under 30 years old. In the US, 55% of those surveyed felt that they could not be happy while in pain, and 62% of those surveyed felt that pain affects their ability to enjoy life.
The GPI has also uncovered insights into the difficulties patients have in describing their pain. For example, 37% of sufferers agree that pain is still too much of a taboo to talk about. 73% said, “I am tough, I can handle pain.” That means individual attitudes and social pressures can alter a person’s willingness to speak about their pain.
Age also plays a role in how patients interact with HCPs and manage their pain. The GPI reveals that Generation Z is far more likely to wait before they treat their pain and is far less likely to take medication. So why do patients often delay their treatment or avoid going to HCPs altogether?
In the US, 50% of pain sufferers wait to treat their pain, while 10% do not treat their pain at all. Importantly, patients who wait to treat their pain often suffer for longer (taking five or six steps to treat their pain).
Whether a fear of dependency or a preference for natural remedies, HCPs need to be sensitive to a patient’s fears and values when having a conversation with them about pain.
While getting patients to talk about pain is encouraged, language is only one way they may give insights into their experience. Dr Zubin Austin, a professor at the Leslie Dan Faculty of Pharmacy at the University of Toronto, says, “Patients may not want to, or they may not be able to use words to actually express their current state of being. But they will communicate non-verbally through face movements, hand movements, through nonverbal cues…follow up and say things like, ‘Well, you say you’re feeling fine, but you grimaced, you winced. You're clearly not feeling fine. Can we talk more about that?’” Dr Austin highlights that if you notice these important non-verbal cues, it can alert you to the actual intensity and duration of pain. These non-verbal signals can provide insights into how patients are coping, managing, and living with their pain.
Fortunately, there are ways to maximize time with your patients, so you can gather the data needed to relieve pain efficiently. Dr Bell advises to ask open-ended questions like:
How is this treatment?
- How is it working for you?
- What kind of pain do you have?
- When is the pain worst?
- When is the pain better?
- What kind of things relieve your pain?
- What questions do you have for me?
These questions are effective in encouraging patients to start talking about their pain.
On the other hand, Dr Austin talks about questions that could be avoided when talking to patients: “In speaking to patients about their pain, it is essential to avoid a style or a specific kind of question that attempts to suggest the patient is to blame for their current state… ‘Why did you go skiing? You're too old to do things like that.’” Dr Austin summarizes: “Anything that suggests that the patient themselves is responsible for their pain breaks the relationship between the healthcare provider and the patient and is going to lead to suboptimal outcomes.”
Thus, knowing which questions to ask, and importantly which questions to avoid, can help patients feel comfortable enough to talk about their pain.
Getting patients to open up about pain has never been easy. Societal and cultural taboos affect how patients talk about pain, even with professionals. Age, gender, and background also change how patients and HCPs engage. However, by acknowledging all of these factors, and asking the right questions, HCPs can reach out and open new avenues of conversation.
Let’s not be afraid to open Pandora’s box. Neither you nor your patients can afford to keep pain locked away. With the right insight, patients don’t have to leave feeling that their pain wasn’t heard. They can leave knowing that you listened to their pain.
At Haleon, we believe in making sure that every patient gets the optimal outcome they need to manage their unique pain experience. The #ListenToPain campaign aims to equip HCPs with the knowledge and tools to better understand their patients’ pain. Using information from the Global Pain Index, we’ve established five different patient profiles, describing their relationship with and the handling of their pain. Based on a deep understanding of the human pain experience, these five profiles can help you maximize those precious minutes with patients and individualize your approach.
We’re committed to providing HCPs with new tools and techniques, sharing the latest advances and bringing innovation that will allow you to better #ListenToPain.