One of the most infuriating things you could ever hear as a pretty beaten up injured worker in PAIN is, “I don’t know what’s wrong with you, maybe it’s all in your head…maybe it’s the way you react to pain…” or something alone the lines.
Today I am in really bad pain, writes a severly injured worker. The kind of pain that almost borders on panic…if this gets even a tad bit worse I might just go to the emergency department.
My first reaction was to go to my medicine bin (yes, it’s a bin) and dig through to see if I had any left over pain medications from previous hospital stays. I usually have stuff left over because I never take my pain meds unless I REALLY need them. The only thing I came up with was tramadol…I guess that has to do. I take that and get my heating pad and a cup of warm tea and lay in agony trying not to throw up debating, do I call my doctor?
The next thought that always runs through my mind is will he believe me? That’s not a fear anyone should have. But a fear I have never gotten over after doctors for many years would suggest that it was “all in my head”.
I am trying to make a long story as short as possible but there is so much that goes into why I feel this way. Basically from the time I had my back fused 3 years ago I was told it was all in my head. Or some other variation of that.
To them I had a spinal fusion, my pain was gone.. I should be fine now.
In doctors defense I know they can’t really do anything if they have nothing to go on. And I know sometimes our bodies are funny and it’s not easy to find the problem. But that doesn’t mean there isn’t one. I feel like sometimes it’s black and white to a doctor. If they can’t see it then it’s not there. And if you are repeatedly showing up claiming you are having certain problems yet they can’t find a cause they start to doubt your credibilty.
When doctors don’t believe your pain
So what can you do, if you think your doctor doesn’t believe your pain, and believes it is “all in your head”?
From our own injured experiences we have created a list of things you could consider doing to make your doctor believe your pain is damn real – but please feel free to add more suggestions:
- Tell your (or the) doctor your whole story, chronologically. Bring along your relevant medical records, including imaging, and even your own journal, in particular your daily pain level score
Many doctors, and especially busy ones such as those in the emergency departments sometimes hear what they want to hear, instead of what you are actually saying. So it’s important that you’re able to tell them the whole story about your pain, when it started, what it feels like, what makes it worse, what brings (some) relief. If the doctor interrupts you politely asks you continue to tell your story so they get the picture. However try to keep your story short and succinct, don’t go on about unrelated events.
- Consider the specialty of the doctor you are seeing
A general practitioner may not know very much about a certain type of pain (i.e. chronic pain or nerve pain). Consider consulting with a pain specialist and a specialist in the field of your injury (i.e. a neurosurgeon for a back injury, an upper limb surgeon for a shoulder injury)
- Always ask for the doctor’s reason(s) behind his/her opinion (that your pain is in your head/psychological/non-organic)
If a doctor tells you they believes your (severe) pain is in your head, ask why s/he thinks that. In doing so, they may just admit they simply don’t know how to help you. Ask for a referral (i.e. to a pain specialist).
- Always remember that YOU are the expert on your own body
If you are in (severe) pain, then something is bound to be wrong in your body. Whether or not you have an ‘oversensitiveness’ to pain is irrelevant, as it is also a malfunctioning (of the nervous system), and for which a pain specialist can help you (i.e. CRPS/RSD). It is not OK to have your pain (and you) dismissed by some doctor who, indeed, does not have your best interests at heart. Or by one that has a too big ego and believes you are a problem (for example a surgeon – typical!). Find another one who will listen and who will help you. After all, the doctor works for YOU.
- If, for some reason, you absolutely have to keep seeing the doctor who thinks it’s all in your head (as is often the case when on workcover, sadly), ask for a referral to a psychiatrist (or a psychologist) for an evaluation.
The psych will assess you (and your pain) and write to that doctor, helping set things straight! False perceptions about ‘exaggerating’, ‘malingering’ or even ‘faking’ you pain, or alleging that it’s all ‘in your head’ by that doctor will quickly disappear… after all that doctor is not a psychiatrist or psychologist, but a GP or a surgeon or whatever. Some of us here have done it, really!
- The way in which you communicate your pain is also very important!
For example, does your body language and tone of voice convey the importance of your visit? And of your pain? Only by believing in your own pain and knowing that you need help can you effectively explain it and communicate its importance to a doctor. If you need to, practice what you are going to say before your appointment. It can also be very helpful to bring someone (close) with you who can explain what they see on a day to day basis (i.e. sleepless nights, crankiness, going quiet, not seeking medical or other attention, not doing anything outside restrictions etc).
If your doctor is rude, trivialises or dismisses your concerns, or tries to make you feel bad for asking for help, try the above tips, or else FIRE HIM if you can and find a new doctor who will listen.