24 Secrets Pain Doctors Won’t Tell You

Learn what pain doctors are really thinking when you visit them, and how you can better manage your symptoms.

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Sure, I can give you some meds to dampen the pain

Sure, I can give you some meds to dampen the painistock/kupicoo
But the best doctors will talk to you about the cause of your pain, whether it’s your lack of activity, your stress level, a condition like arthritis, your mattress, or one of these surprising back pain causes.

Heat or ice?

Heat or ice?istock/1Tatomm
Use an ice pack for acute injuries, to minimize blood flow and reduce swelling and pain. Use heat to loosen muscles and stiff joints and help you feel more mobile.

Any doctor can hang a shingle that says 'I treat pain'

Any doctor can hang a shingle that says 'I treat pain'istock/BrianAJackson
Look for doctors who are board-certified in pain medicine or who did a fellowship in something pain-related.

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Your back and neck (and often shoulder) pain likely have little or nothing to do with your abnormal MRI

Your back and neck (and often shoulder) pain likely have little or nothing to do with your abnormal MRIistock/ilbusca
Studies show that if you perform an MRI on any 100 people, you’ll find an abnormality in about 90 percent of them, even if they’re not experiencing any pain.

Reconsider before asking for a prescription

Reconsider before asking for a prescriptionistock/Pamela Moore
The latest research shows that taking opioid pain meds (like Vicodin and OxyContin) for chronic pain can change the brain, damaging its ability to feel pleasure and leading to a craving for more drugs. A few studies found that long-term use can actually lead to increased back or neck pain.

In mild pain? Play word games or another favorite challenging puzzle

In mild pain? Play word games or another favorite challenging puzzle istock/PeopleImages
When you distract your brain, you don’t hurt as much. Another activity that helps: watching a funny TV show. Or click through these RD.com jokes.

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Before you praise me for curing your back pain, remember this

Before you praise me for curing your back pain, remember this istock/g-stockstudio
It may have gone away on its own. Approximately 90 percent of low-back pain subsides within 12 weeks without medical intervention.

If you have chronic pain, consider experimenting with dietary changes

If you have chronic pain, consider experimenting with dietary changesistock/Eva Katalin Kondoros
Eliminate dairy for a few weeks, then reintroduce it and see how you feel. Do the same with wheat, red meat, shellfish, citrus, peanuts, caffeine, and alcohol, one at a time. If your pain gets worse when you add back a food, it may be contributing to your problem.

If I specialize in prescribing narcotics, giving injections, or doing surgery, that’s probably what I’m going to recommend

If I specialize in prescribing narcotics, giving injections, or doing surgery, that’s probably what I’m going to recommendistock/Rich Legg
But there are dozens of other effective options like massage, physical therapy, chiropractic, acupuncture, spinal cord stimulators, and behavioral therapy. Here's what your massage therapist can tell about your body.

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Think twice about having surgery, especially on your back or spine

Think twice about having surgery, especially on your back or spineistock/AJ_Watt
I’m in a practice with only three doctors, and between us, we have over 1,000 patients who had back surgery who wish they never had. In a Consumer Reports survey, just 60 percent of those who had back surgery were completely or very satisfied with the results.

Pain is mental too

Pain is mental tooistock/Aleksandar Nakic
So you may want to explore psychotherapy, cognitive behavioral therapy, meditation, and even self-hypnosis. Here's how you mentally make your own pain feel worse.

If the doctor takes only cash (not insurance) and hands you a prescription after just a few minutes, you may be at a pill mill, not a full-service pain clinic

If the doctor takes only cash (not insurance) and hands you a prescription after just a few minutes, you may be at a pill mill, not a full-service pain clinicistock/megaflopp
Most legitimate pain clinics take insurance and offer treatments beyond medication.

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Your pain will improve with the right kind of exercise

Your pain will improve with the right kind of exerciseistock/Tomwang112
And it will probably feel worse if you won’t get a good night’s sleep. Here are sleep doctors' tips for better rest.

Pain medications are known for causing severe constipation

Pain medications are known for causing severe constipationistock/sprng23
Always ask about a stool softener, or try one of these constipation home remedies.

Before you come to me, try taking Tylenol or Advil for a few days

Before you come to me, try taking Tylenol or Advil for a few daysistock/Aldo Murillo
Simple, but it works.

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Surgeons and orthopedic doctors who prescribe narcotics after surgery tend to under-dose

Surgeons and orthopedic doctors who prescribe narcotics after surgery tend to under-dose istock/BernardaSv
That's because they’re worried about creating an addiction. If you’re still in pain after a procedure, it’s OK to ask for more.

To many insurance companies, the treatment of pain is an elective procedure, not a medical emergency

To many insurance companies, the treatment of pain is an elective procedure, not a medical emergencyistock/mediaphotos
Be prepared to fight to get your treatment covered.

Diagnosed with spinal stenosis?

Diagnosed with spinal stenosis?istock/STUDIO GRAND
If you’ve been diagnosed with spinal stenosis, a narrowing of the spinal canal, and your doctor says you could be paralyzed if you don’t have surgery, find another doctor. Studies have shown that’s not true, and surgery should be a last resort only after you’ve tried other options.

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Try injections for carpal tunnel

Try injections for carpal tunnelistock/JPC-PROD
Injections for carpal tunnel syndrome have the highest success rate of any procedure I do, hands down. It should definitely be something you try before you resort to surgery. Here's how to keep your hands pain-free at work.

Please don’t take it personally when I ask you to take a drug test

Please don’t take it personally when I ask you to take a drug testistock/Kirby Hamilton
We want to believe that you’re not addicted, but research shows 18 to 41 percent of patients who take narcotic pain relievers are abusing them, and I don’t want to be responsible.

Chances are, you’re never going to be 100 percent pain-free

Chances are, you’re never going to be 100 percent pain-freeistock/m-gucci
Especially if you’re experiencing chronic back or knee pain. In many cases, we consider your treatment a success if we get rid of 50 percent of your pain and help you to be more functional. These proven knee pain remedies really work.

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Steroid injections are now a top treatment for back pain in America

Steroid injections are now a top treatment for back pain in Americaistock/andrewsafonov
But critics say there is little evidence of any long-term benefit compared to their risks, especially for back pain that doesn’t radiate down the legs.

We're incentivized to find ways to treat you

We're incentivized to find ways to treat youistock/monkeybusinessimages
Pain doctors are paid about five to 10 times more for doing a procedure on you than for counseling you about how to prevent pain. Nerve blocks and injections are very lucrative, especially if you do them assembly-line-style all day long.

Get out of bed!

Get out of bed! istock/Geber86
For every day you’re lying there, you lose 1 to 3 percent of your muscle strength, and then you start to feel stiff simply because you’re not moving. Your pain will get better faster if you stay active. Sources: David Greene, MD, CEO of the Florida Pain Network; Adam Perlman, MD, executive director of Duke Integrative Medicine at Duke University in Durham, North Carolina; Norman Marcus, MD, a pain medicine specialist at NYU Langone and author of End Back Pain Forever; Scott E. Glaser, MD, co-founder and president of the Pain Specialists of Greater Chicago; Joe Carlon, CEO of Arizona Pain Specialists and Boost Medical in Scottsdale, Arizona; and Marty Makary, MD, MPH, author of Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care.

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4 thoughts on “24 Secrets Pain Doctors Won’t Tell You

  1. Well thats good news for guys, I don’t know many women that dont take vicoden or something like that So good news is its not always us, it could be the meds

    1. Mine kept leading to a blank page but if I hit the back button on my phone after hitting the next arrow each time it corrected this.

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