Talking About Pain with Patients

CHC Top 5: Talking About Pain with Patients

By Laura Brown

Physicians, nurses, pharmacists, social workers, physical therapists and other health care professionals often interact with patients who are experiencing pain. What can make these conversations effective and satisfying? Invite participation by asking permission from patients, and by explicitly inviting patients to respond. Asking questions like, “Do you want to hear about…?” before proceeding with additional information and following up by asking, “How does that sound to you?” establishes a trusting relationship, and helps providers collect information from patients.

Using motivational interviewing techniques can get patients talking and telling their story so they can discover their circumstances and options with professional or clinical guidance. Asking open-ended questions can help identify psychosocial factors that are contributing to patient experiences of pain.

Use positive language like, “I wish I knew exactly what was behind this pain” instead of, “It’s not clear where your pain is coming from.” Avoid using negatives (e.g., “no” “not” “nothing” “never”). Affirm resilience by offering encouraging responses when patients disclose positive coping strategies. Everyone does resilient things, and it’s important to celebrate those so that people have hope and realize they can cope. Distill the information that patients have shared, and then keep listening. Distilling complex reflections during the interaction and leaving space for patients to interject facilitates accurate shared understanding. Still not sure if conversations about pain are going well? Focus on making sure that the patient is the one doing most of the talking.

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