We have had so many chronic pain patients who come to us and say “No one really understands how much pain I’m in, even my doctor doesn’t take me seriously.”
It is so frustrating when the people you count on most to help you aren’t there for you.
And it’s beyond humiliating and demoralizing when they hint that you’re dishonest, a drug addict, or that it’s all in your head, rather than recognizing that you have a medical problem that deserves serious attention and HELP.
Patients have asked me over the years why some doctors don’t take chronic pain seriously, and here are some of the scenarios I believe are most common:
- They think patients are malingering — exaggerating or inventing pain for financial reasons
- They flatly deny the patient’s own experience, as if it literally did not happen
- They believe the person is neurotic or depressed or otherwise emotionally unstable
- They believe the person isn’t doing everything they could to help themselves
- They think the patient just wants narcotic drugs
- They literally don’t speak your language (for example, Spanish)
- They just can’t relate to your experience
- They don’t understand how pain and your upbringing, experiences and culture interact (for example, many women are taught to be quiet about pain and just fight through it — so when they seek medical help for pain, they’re truly desperate)
When this happens, I think it’s probably due to any of several reasons:
- Fear of failure
Sometimes, doctors are often simply afraid that they can’t help you. That’s not a conversation any physician wants to have — after all, we’re wired to help our patients no matter what — so some may keep trying even though chronic pain isn’t really their expertise.
The opioid epidemic is putting doctors even more on the defensive, especially because many of them really aren’t trained in non-drug pain relief therapies. They’re very cautious about prescribing dangerous drugs, which is good — but they’re not sure what else can be done, either.
This happens a lot. The doctor is familiar with someone who has mild chronic pain — and they simply can’t understand why your case is any different. They don’t understand that, just as people can have different stages of cancer, they can have different levels of chronic pain, from mild to absolutely flat-on-your-back severe pain that lasts and lasts and lasts. They may not realize that what helps one person may make someone else’s chronic pain even worse. And they often don’t realize just how many different things someone with chronic pain has tried, without lasting success.
- A bias for action
Many doctors like being able to quickly help patients. If they can’t quickly help — often the case with fibromyalgia, sciatica, chronic back pain and chronic headaches like migraine — they quickly lose interest in that patient because treating them isn’t rewarding for them, emotionally or financially.
- Too time-intensive
Many of them are forced to work in a practice that tightly limits their time with each patient. That makes it really hard for them to help patients with complex pain.
- Different communication styles
Especially female patients and male doctors. I’m not judging, just reporting based on what we’ve heard from patients as well as colleagues over the years. Some doctors hear reports of pain as “just another woman complaining about things,” or think “women always cry,” especially if they’re hearing more about feelings than they are about pain specifics.
- Lack of knowledge
For example, recent studies have found that at a physiological and neurological level, women actually experience pain differently from men. Fibromyalgia, TMJ and autoimmune disorders are all much more common in women than in men. But many doctors aren’t aware of this fact.
- Gender bias
I hate to say it, but I hear it all the time: some male doctors tend to view women in general as ditzy or overly emotional, and no doubt this affects how seriously they take their reports of health problems, especially something like chronic pain that’s harder to measure and observe. And there are other examples of differences in how pain in women is treated. For example, emergency rooms take longer to treat pain in women, and are less likely to use the strongest pain meds for women (more on the undertreatment of pain in women). Not to say that all male doctors treat women this way — I’m confident that ours don’t, for example. However, you should always feel comfortable that you are being heard.
Most providers see thousands of patients in a year. So of course they probably do see a few people reporting chronic pain who are also malingerers, drug-seekers, depressed, attention-seeking, and so forth. A doctor with a “glass half empty” personality may generalize from the few to the many, even though the vast majority of the people they see are actually legitimate chronic pain sufferers who need real help.
- Stigmatized diagnoses
Many doctors stigmatize certain diagnoses associated with chronic pain, like fibromyalgia, chronic fatigue syndrome (myalgic encephalomyelitis), and irritable bowel syndrome. They don’t take them seriously as medical problems and view them as problems of willpower or laziness, nothing more.
Chronic Pain Deserves Treatment
Nearly everyone with chronic pain can be helped, even though we all know it can’t always be eliminated completely. Don’t let a few bad apples make you give up.
Here’s a quick overview of what you should expect when you visit a chronic pain specialist.
Many doctors will take your pain seriously. You can count on them to partner with you to find help. I know at our practice, every single one of our providers (male and female) — from pain management physicians to physical therapists to chiropractors, acupuncturists and medical massage therapists -– is there for our patients.
In fact, that’s why we always say: First, we listen. Then we decide, together, on the best treatment plan for you.