Pain is like
warning lights on your car's dashboard. It alerts you to something that needs investigation. Pain serves an important function. It's your body's way of saying, "Pay attention."We all avoid pain. You wouldn't knowingly slam your thumb in car door or touch a hot stove. It's human nature to avoid situations that cause pain, and we do what we can to rid ourselves of pain as soon as possible -- such as taking an aspirin for a minor headache.
When your pain is severe enough, or worrisome enough -- or lasts long enough -- you find yourself in your doctor's office. Then, ideally, you and your doctor figure out what's causing pain and fix underlying cause. The most satisfying encounters for both you and your doctor occur when pain points to a clear diagnosis; you're treated and disease is cured. A good example is a cough and pain in chest when taking a deep breath leading to diagnosis of pneumonia that is cured with antibiotics. But not all pain is solved that easily.
Each of us tolerates pain differently -- even pain from same cause. Surprisingly, patient who would complain most bitterly when we injected a local anesthetic that tended to burn a little was not frail 80-year-old grandmother, it was strapping 25-year-old body builder who said he "wasn't afraid of nothin." Those are also patients most likely to faint when blood was taken.
As a surgeon, I did many "lumps and bumps" operations. Depending on patient's tolerance for pain, I could perform procedure in my office or in operating room, where, among other things, sedation was available. It usually was clear whether a procedure could be done in office or required support of operating room staff.
Then there were judgment calls. It could go either way. If I looked at top of a patient's head and saw orange or red, patient would go to operating room. My experience supports thinking that redheads are more sensitive to pain.
How do you get pain to move from "pay attention"' to "problem fixed?"
Your doctor needs help from you when your "pain light" flashes on. There is no way your doctor can measure your pain. Sure we can check your heart rate, which tends to beat faster if you're in pain, or your blood pressure, which also rises. Clues like a fever or a high white blood cell count that can point to cause of pain; they don't measure your experience of pain.
Only you know what your pain feels like.
Sometimes cause of pain can be identified before doctor even sees you. The broken bone on an X-ray, abnormal blood thyroid level or malignant prostate cells on a pathology slide speak for themselves. Sometimes tests will show what is not causing pain: a normal EKG usually means that your chest pain is not from a heart attack, and a normal breast exam, mammogram and breast ultrasound suggest that breast pain is not caused by breast cancer.
No test can exclude a medical condition with 100 percent certainty. Or in medical lingo, tests can have "false negatives" -- meaning you have condition even though test says you don't. This is another reason you want your doctor to perform a complete evaluation, and not just make a diagnosis over telephone.
