We need to talk about pain

What do snowflakes, fingerprints and the concept of pain have in common? Superficially, this incredibly random list has very few (if any) similarities, but there’s one key thing that binds it together: each snowflake, finger print and experience of pain is totally unique. You’d think that describing physical discomfort would be easy, but because it’s so restricted to our individual and completely personal experiences it’s actually recognised as one of the most difficult forms of linguistic communication.i


Realistically, living with a chronic condition like PsA it’s likely that you’ll feel pain in lots of different ways at different times of day / month / year – from swelling in your heels to discomfort in and around your finger joints. Experiencing pain with such regularity can make it all too easy to accept the discomfort as a fact of life, but it’s crucial to be as open with medical professionals as possible in order to ensure that they’re giving you the best possible treatment and advice.


So if pain is one of the hardest things to articulate,i how on earth should you approach these conversations with your physician? The good news is that lots of medical professionals undergo training to help them understand the linguistics of communication around symptoms, but there are a number of ways in which you may be able to give them a head start:

  • Using metaphors is a common ways to talk about pain. Because we’re sub-consciously aware that the pain event is totally unique, we search for ways to help other people relate to it. Channelled properly, this is an incredibly useful tool, but take the time to really think about the description you’re using to best help your physician identify the potential issue.
  • Keeping a pain diary for 1-2 weeks before meeting with your specialist can help identify triggers for flare-ups and discomfort. Recording the type of pain you experience, where it is and any activities you’d been doing that have triggered the pain will help your doctor in spotting any immediate causes.
  • Charting regular pain episodes can also help to identify the intensity of pain experienced. Measuring your pain on a scale of 1-10 (e.g. yesterday the pain in my knees was a 5 and today it’s an 8) will give a direct point of reference for your pain flares and may further help identify triggers.
  •  Pain isn’t just something that impacts the body, but it has a psychological impact too.ii Keep a diary log to track the emotional impact that the pain has on your daily life. This can help your specialist identify any additional support that you may need – such as yoga or mindfulness, or even counselling – and establish a supportive pain management plan.
  • Because pain is so subjective, there are various to describe it – is it a burning, tingling, aching or throbbing pain? Make a list at the start of your pain diary, recording all the words you’d potentially associate with pain, to help you quickly and accurately identify the issues you’re experiencing and start to notice patterns.

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i Ehlich, K. Theor Med Bioeth (1985) 6: 177. doi:10.1007/BF00489662. Available at: https://link.springer.com/article/10.1007/BF00489662
ii https://www.ncbi.nlm.nih.gov/pubmed/21752179

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