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Dear Doctors, Here's Why It's Unhelpful When You Call My Pain 'Discomfort'

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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 often 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 can make 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 may think being straight with us will scare us, but in reality, it can do just the opposite. They may think using lighter terminology will help us not catastrophize, but this just makes me fearful that no one believes me and I won’t get the help I 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.

This blog was originally published on Life in Slow Motion.

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Originally published: October 17, 2016
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