Dear Doctors, Here’s Why It’s Unhelpful When You Relabel My Pain “Discomfort”

Dear Doctors,

You know how doctors always use the word “discomfort” to describe our pain? Instead of recognizing that we are in agony, instead of calling our pain what it is…pain…they do whatever than can to downplay the language they use to describe the severity of what we are feeling.

I have also noticed that doctors sometimes carefully describe the nature and origins of our conditions in ways that make them seem less significant than reality.

Let me give an example. For years, doctors told me my SI ligaments are stretched out. Then just this last month, my doctor started talking about the tears in my ligaments. Um, what??? My ligaments have tears in them, and for five years, no doctor ever used that word. This seems like important information for me to know.

My assumption is that this downplaying and relabeling is purposeful. Perhaps it is taught at some point in medical school, because all of my doctors do this across the board in some way or another.  I think it has something to do with not wanting patients to catastrophize. And actually, I can see how this would make sense if you have never experienced chronic pain before. But the thing is, this isn’t how it works when you actually have chronic pain.

This past week I started realizing how unhelpful it is when doctors relabel our pain as discomfort and downplay the descriptive words they use for our pain. And here is why.

When doctors downplay the severity of my pain, it gives me anxiety.

I think the mindset behind downplaying pain is that if we don’t know the extent of damage, perhaps we won’t worry about it as much. But the problem is that so often our pain feels worse than the diagnosis we have been given, and this makes us feel both crazy and fearful.

When my pain is invalidated or made out to be less than it is, I feel anxious. The pain seems worse than the diagnosis, so I become nervous that something else is going on. I can’t understand why my doctor would want to call these agonizing sensations “discomfort,” and I worry that if my doctor doesn’t believe me, then maybe he or she won’t want to help me either. Downplaying my pain actually gives me more anxiety, not less.

But, when doctors tell me the exact nature and origin of my pain, the pain doesn’t scare me as much.

When my doctor told me about the tears in my ligaments, I instantly felt a sense of relief. I felt validated. The extent of my pain made more sense. I felt less crazy and less anxious.

Why did I feel less anxious? Telling me the exact nature and origin of my pain and the reality of structural damage in my body led me to fear my pain less because there was less of a feeling of unknown.

Here is another example. I have this deep aching pain that I occasionally get right in the center of each buttock. I used to feel so nervous every time it started, because I had no idea what was causing it and because it often signaled I was at risk for a bad flare. I didn’t know what was causing the pain, leaving me once again dealing with a feeling of the unknown.

At my appointment last week, my doctor showed me on the ultrasound that there is swelling around my sacrum. She pushed down right where that specific pain is, and explained how the swelling was causing my pain.

Suddenly, the pain stopped scaring me. I knew what it was. It was amazing how my relationship to that particular pain changed the second she gave me a term to describe it – swelling around my sacrum. Now it had a name. Now it was no longer unknown.

I wish doctors would be more direct. They think being straight with us will scare us, but in reality, it does just the opposite. They think using lighter terminology will help us not catastrophize, but this just makes us fearful that no one believes us and we won’t get the help we need.

Doctors, please, please tell us what is going on, not some filtered version that you think will make us feel better, but actually just causes anxiety.

What do you think? Have you experienced the same thing?

Check out the first booklet in the Chronic Pain and the Christian Life series, But God Wouldn’t I Be More Useful to You If I Were Healthy, on Amazon.com. 

7 responses

  1. Esther, you have hit the nail on the head! I feel the same way. I have noticed at times with certain psychologists in the pain management centres they do the exact thing that you are describing. When this happens, I feel alone and sad. I understand why they do it, but I find it unhelpful. I,like yourself would like to know exactly what is happening in my body. The truth, is far less scary.

  2. I totally get this! Just last week, I went to see a new doctor who actually showed me the MRI that was done several years ago. Nobody had ever done that. I don’t know why, maybe it’s because I never asked to see it. But anyway, he showed me the slight bulge in a disk exactly where I have pain. I could see it…the reason for my pain! Yes, totally validating.

    • I’m glad you got to see it, even if it was several years later! I wish doctors realized how much these things can help us, instead of thinking it will cause anxiety if we know the details.

  3. Yes, it took me two years to convince my doctor (who was generally pretty forthright and informative with me) that something really was wrong with my knee. He kept telling me the x-rays showed nothing (duh) and I probably just strained it and need a temporary brace and some ice. I described in great detail exactly where it hurt, put my finger on the spot and kept telling him that it would randomly lock up on me and often so suddenly that I would find myself on the floor in an instant with pain shooting up and down my leg. As you say, total downplay as if I was making it up. He should have known what a high pain tolerance I have after 12 years with the same doctor and that I don’t complain that something hurts unless it REALLY hurts! It wasn’t until it gave out on me right in front of him one day and I nearly went down but for catching myself on the examining table, that he finally took notice and sent me to a knee specialist and ordered an MRI. Guess what…shocker of shockers….I was right all along! There WAS something wrong I had a lesion on the cartilage and most of it was gone in the spot I kept pointing out as the center of pain. They had me in surgery within a week. But they told me I had to stop my NSAIDs that were keeping the pain at bay about three days before the surgery. I found out just how bad it had gotten when I had no painkillers to take the edge off — Omigosh, I have never had such agonizing pain–EVER!! I couldn’t sleep the night before because of the pain. I called and begged the doctor (the knee surgeon) for something, anything I could take and they seemed to think I was just being a wuss and needed to “man up” so to speak. I tried to tell the nurses when I got to the hospital but they pretty much just nodded and ignored me. It wasn’t until they wheeled me into pre-op that that nurse who came to prep me took one look at my contorted face and said, “You’re in pain, aren’t you?” YES!! I am!! Thank you for noticing! She said she was going to get the anesthesiologist then and came back with him. He gave me a little pre-anesthesia then to take the edge off because the surgery before mine was running overtime. I was grateful that someone finally took me seriously but perplexed why everyone else acted like I was just a whiner about some mild discomfort when I am not in the habit of complaining about every little scrape and bump and bruise. Later, I found the technical name for my condition in my record and looked it up. Evidently, most people don’t experience pain with it according to the symptom list so I guess they just figured it was all a figment of my imagination or exaggeration. Crazy stuff! So next time I tell you something hurts, doc, try believing me! I don’t invent this stuff for kicks or attention. I knew something was wrong long before anyone would acknowledge it!!

  4. YES! I have always had the same exact reaction to the word “discomfort.” To me, discomfort is the like feeling you get when you eat ice cream too fast, or accidentally sip coffee that’s way too hot. In no way does it seem relevant to the experience of chronic pain– it can’t even begin to describe that world.

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