As many of you know, I am a physiatrist.  I help patients with disabilities.  Pain can be profoundly disabling and many physiatrists specialize in treating pain. 

Pain is tricky.  It is a perception, a sensation.  I cannot accurately measure how much pain someone is in; they have to tell me.  I cannot see through a patient’s eyes, or hear sounds the way they do, nor can I feel their pain.  We have to rely on words and understanding one another to really identify pain.

I ask about pain, and I KNOW that the questions can be frustrating. “I understand that it is painful, but what KIND of pain?”  That question bothers me as much as it bothers my patients.  I spend lots of time explaining what I mean and defending that silly question, because the information can be helpful.  Sore muscles feel different than pinched nerves, but both hurt.  Getting hit with a hammer feels different than getting stabbed with a knife, but both hurt.

Because pain is a particular sensation, and can only be experienced by the patient, we rely on that persons perception of pain.  The trick is that people sense all sorts of things differently.  Some people prefer chocolate to strawberry ice cream – their perception of one is superior.  Some people like different music or fabric or aromas.  Perception varies.  Pain is no different. 

Pain is in your head.  So is your sight, sound, flavor, texture.  Understanding that everyone’s perceptions are different is essential for good communication between me and my patients.  The only way to achieve that is to take the time and patiently work through all aspects of their experience with pain.  To find out what this is like – try to explain to someone what chocolate tastes like, or what cotton feels like, or what smoke smells like. 

Dr Jason