Logging Your Pain

Several weeks ago, I noticed that my right thumb was bothering me.  Nothing major, but a bit of a nuisance.  My first thought was that I may be developing some arthritis due to the fact that I use my hands all day long in my practice.

On Wednesday, I got home from work and took the Christmas tree down, finally.  As I sprawled out on the floor and worked to unscrew the base from the trunk of the tree, it hit me as to why my thumb has been bothering me.  It was just an overuse issue, not arthritis (thankfully).  It happened that our tree this year required a bit more attention than usual as it wouldn't seem to stay upright.  Therefore, it necessitated more adjustments than typical.  Had I just taken a moment to think back to when my pain began, I would have figured it out.  I should have known better.

When taking a history in the clinic, I ask patients to describe many things about their painful condition.  When does it hurt?  What is the intensity?  Are there certain positions that bring out your pain?  What makes it feel better?  Was there a specific event that precipitated your pain?  These are just a few examples of the information I'm seeking in order to help piece together the puzzle.  They will help me find the root cause of the issue, and ultimately design a proper treatment plan.

This history taking may seem obvious and easy, but I can assure you that it isn't always.  Most folks are too consumed with everyday life to note exactly when their pain began (I'm not talking about traumatic events here, such as a car accident, which are obvious).  But because the nature of insidious onset pain can provide your health care provider with very valuable information, it's important to identify causation as thoroughly as possible.

One simple suggestion that I would offer is to keep a pain log.  For several days, jot down when you notice your pain.  What activities are you doing to exacerbate it?  What positions?  What's the intensity?  When you put in in writing, you'll be better able to notice patterns.  And as I mentioned, it's these patterns that will help you and your health care provider figure out the best plan to ultimately resolve your condition.

The next time you're in pain, think about the possible causes.  When you can't think of a thing, keep thinking.  Pain doesn't crop up for no reason.  You may find yourself surprised that the cause, while not initially evident, is more obvious than you thought.