Patients' Perspective
Patients' Unwillingness to Report Pain

People do not acknowledge nor report their pain because they don’t understand the nature of their pain, nor do they understand pain’s warning signal for underlying disease progression. As people continually refuse to acknowledge pain’s medical validity, a belief system is created that stigmatizes those who do seek pain relief. Society today believes that:^11,12

• people in pain should simply tolerate it
• people who report their pain are "bad" patients who distract their physicians from treating the underlying disease

Tolerating pain

Belief systems, whether found on medically sound facts or not, play a vital role in the inadequacies of opioid pain management today. These beliefs are thought to have spread through religious or moral convictions that people are weak in character if they need to take opioids for pain relief.¹² In fact, one study showed that 51% of pain patients felt that they should be able to tolerate the pain.

Believing that tolerating pain is a way of life, some people will refuse to seek out pain relief even though they can no longer perform everyday activities. For example, one women in a focus group reported, "I ruptured a disk in my back, but I worked around the house, and I didn’t give in to it until I couldn’t stand on my leg anymore, and I went down. And then I lost all feeling in my leg. And then I called the doctor after I was in bed for four days and couldn’t stand the pain anymore. I wasn’t going to give in to it." ¹³

Also, giving in to the pain is sometimes perceived by people as being lazy or a burden to society. One intractable pain patient who has been searching for adequate pain treatment wrote to the National Foundation for the Treatment of Pain and explained that he wasn’t a lazy person, he just needed relief. "I have been suffering [from back pain] for over 10 years. Surgery, spine taps, nerve blocks, physicians, chiropractors, trigger point injection, and Auburn Pain Clinic to name just a few...I’ve worked very hard all my life…I’m not lazy, and if you contact previous employers, they’ll tell you that I’m a hard worker. I was awarded by the military many times for my hard work, and am proud of that. The only reason I brought it up is that I have not been a burden on society."

Fear of being a bad patient and distracting the physician from the disease that causes the pain

When dealing with a severe ailment such as cancer or lower back pain, patients would rather not report the severity of their pain to their healthcare providers because they believe that in doing so, they are being "bad" or disruptive patients.⁴ Again, the belief system that patients should tolerate pain influences the idea that mentioning pain indicates weak character and a disruption to the medical process. Patients would rather suffer with their pain than disturb their healthcare providers because they believe that it’s more important for their healthcare providers to focus on the disease rather than the pain.¹¹

According to the "Barrier Questionnaire" that was distributed to over 200 pain patients:¹¹

• 46% said that good patients avoid talking about pain
• 41% thought that physicians might be annoyed by discussing pain
• 30% thought complaints of pain could distract the physician
• 68% said it was more important for the doctor to focus on the disease that is causing the pain than the pain itself