Learn to Listen
The two most important activities to recommend when treating chronic pain patients also can be the most difficult: Sleeping and exercise. For people experiencing unrelenting discomfort, both can feel impossible, according to Dan Clauw, MD, professor of anesthesiology at the University of Michigan in Ann Arbor, Michigan.
“If you stop moving, your pain is going to get worse and worse and worse,” Dr. Clauw said. “But you have to be careful about how you talk about it. For example, don’t use the word ‘exercise’ when you’re talking to a chronic pain patient, use the word ‘activity.’ ”
As people become more active, they begin sleeping better, he said.
Most importantly, Dr. Clauw said, clinicians must demonstrate empathy and listening skills. Patients with chronic pain often are used to being dismissed and have become isolated in their personal lives.
“There is a lack of properly trained providers who can listen rather than do procedures,” Dr. Clauw said. “What happens is people just constrict their lives over the course of having pain, and they fall into this shell of themselves. They need their doctors to hear them.”
For primary care doctors seeking more information on pain management, online resources can be helpful, said Robert L. Rich Jr, MD, former chair of the American Academy of Family Physicians Commission on Health of the Public and Science.
“One suggestion I’d begin with is to look at pain guidelines, not just from the CDC and AAFP but also from local medical boards,” Dr. Rich said, adding that California and Washington State have done extensive work on chronic pain. “I am seeing more of a movement again toward teaching the management of chronic pain, but we still need more training.”
A version of this article appeared on Medscape.com.