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

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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?

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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'

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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Simple, but it works.

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

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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

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Be prepared to fight to get your treatment covered.

Diagnosed with spinal stenosis?

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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

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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

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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

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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

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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

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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!

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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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