10 steps to optimize your next doctor appointment to talk about chronic pain

No, it’s not just you. Chronic pain care around the globe is genuinely difficult right now.

Recent surveys show that 1 in 4 patients feel rushed or dismissed during appointments. Over 40% rate their pain care as poor. Nearly a third have waited three months or more just to see a doctor. And if you're already taking opioids, 40% of clinics won't even accept you as a new patient.

Add to that the medication access problems (over 90% of patients report delays getting prescriptions filled), the doctors who've stopped prescribing out of fear of losing their license, and the specialists who seem more focused on tapering you off medication than actually helping, and it's no wonder so many people feel abandoned by the system.

But here's what the research also shows: how you prepare for an appointment can genuinely change what you get out of it, even within a broken system.

In this article, you'll find:

• The science behind why preparation actually improves pain care outcomes

• A practical 10-step roadmap to help you get ready for your next appointment

• Specific strategies for describing pain in ways doctors can actually use

• Tips for navigating difficult conversations about medications, fears, and treatment options

• A downloadable checklist you can print and take with you

These aren't theoretical tips written lightly. They're based on my experience of what actually works when time is short, trust is fragile, and the system is stacked against you.

Why preparation matters: the science

Studies on patient activation show that when people come prepared with clear goals and organized information, they get better outcomes. Not just better satisfaction, actually better pain management, better treatment adherence, and more functional improvement.

Communication quality predicts outcomes as much as the treatment itself. When patients feel heard and understand the plan, they report better pain control even when the interventions are identical. That's not placebo, that's therapeutic alliance, and it's clinically measurable.

The biopsychosocial model of chronic pain emphasizes function over pain intensity. Research repeatedly shows that focusing on what you can do (not just how much it hurts) leads to better long-term outcomes. Rehab programs built on this principle consistently outperform those focused solely on pain reduction.

And here's the kicker: patients forget 40-80% of what doctors tell them during visits. Prioritizing your concerns and asking for clear next steps isn't just practical, it's based on memory research showing that people retain structured, simplified information far better than complex explanations delivered all at once.

None of this fixes the systemic problems. But it gives you the best chance of being heard, understood, and walking out with something useful.

Your roadmap: 10 steps to prepare for your next appointment

1. Clarify your main goal before the visit

Before you even walk in, ask yourself: what do I most need from this appointment?

Pain relief? Better sleep? Help getting back to work? Understanding what's actually wrong? Approval for a specific treatment? A second opinion on tapering?

You probably have multiple concerns. Write them all down if it helps. But then identify your top priority, the one thing that, if addressed, would make this visit worthwhile.

This isn't about limiting yourself. It's about focusing the conversation where it matters most, especially in a 15-minute window.

2. Describe pain beyond a number

"How's your pain on a scale of 1 to 10?"

It's the most common question, and the least helpful answer. A "7" doesn't tell your doctor what they actually need to know.

Your doctor needs to understand the character, pattern, and behavior of your pain. Here's a practical guide to describing it in ways that actually help:

What to describe about your pain:

Aspect	Questions to consider	Example descriptions
Quality	What does it feel like?	"Sharp and stabbing," "deep aching," "burning," "tingling and electric," "throbbing," "pressure," "tight and squeezing"
Location	Where exactly is it? Does it move?	"Lower back on the right side," "starts in my neck and radiates down my arm," "both knees," "across my shoulders"
Timing	When is it worst? When is it better?	"Worse first thing in the morning," "builds throughout the day," "flares at night," "constant but varies in intensity," "comes in waves"
Triggers	What makes it worse?	"Sitting for more than 30 minutes," "cold weather," "stress," "after exercise," "certain movements like bending"
Relievers	What makes it better, even a little?	"Heat helps temporarily," "lying down," "distraction," "gentle movement," "certain positions"
Pattern	How does it change over time?	"Good days and bad days," "constant with flares," "gradually worsening," "stable but never goes away," "unpredictable"
Impact on sleep	Does it affect your sleep? How?	"Wakes me up 3-4 times per night," "can't fall asleep because of it," "have to sleep in a recliner," "wake up stiff and in more pain"

Here is an example of a helpful description:

Instead of: "My back pain is an 8 out of 10."

Try: "I have a deep aching pain in my lower back on the right side that's there all the time, but it gets much worse after I've been sitting for more than 20 minutes. It feels like a tight squeezing sensation that sometimes shoots down my right leg. It's worst in the morning when I first get up, I'm very stiff. Heat helps a little, but only while I'm using it. It wakes me up at least twice a night when I roll over."

This description tells your doctor about quality (deep aching, tight squeezing), location (lower back right side, radiating to leg), timing (worse in morning, at night), triggers (sitting), partial relievers (heat), and impact (sleep disruption, stiffness). That's actionable information.

3. Focus on function, not just pain

Pain severity matters, but what often matters more is what pain stops you from doing.

What is "function" in chronic pain?

Function means your ability to do the activities that matter in your daily life. It's not about being pain-free. It's about what you can and can't do despite pain, and how pain changes your life.

Doctors assess function because it's concrete, measurable, and directly tied to quality of life. Two people with the same pain intensity can have completely different functional levels. One might still work full-time and exercise regularly. Another might be unable to leave the house. Function tells us which interventions are working and what realistic goals look like.

Categories of function to think about:

Category	Examples of activities to consider
Basic self-care	• Bathing, dressing, grooming • Getting in and out of bed • Using the toilet • Preparing simple meals • Taking medications
Household activities	• Cleaning, laundry, dishes • Grocery shopping • Yard work or basic maintenance • Caring for pets • Managing finances or paperwork
Work and productivity	• Working full-time, part-time, or not at all • Taking sick days or leaving early • Performing specific job tasks • Concentration and focus • Commuting
Social and recreational	• Spending time with family or friends • Attending events (movies, dinners, gatherings) • Hobbies you used to enjoy • Exercise or physical activities • Travel
Sleep and rest	• Falling asleep • Staying asleep • Waking refreshed • Needing naps
Mobility and movement	• Walking distances (to the mailbox, around the block, through a store) • Climbing stairs • Standing for periods (cooking, waiting in line) • Sitting for periods (meals, meetings, driving) • Bending, reaching, lifting

Example of focusing on function:

Instead of: "My knee pain is really bad, like an 8."

Try: "My knee pain is preventing me from walking my dog, which I used to do every morning. I can only make it about two blocks before I have to turn back. I also can't stand long enough to cook dinner anymore, I have to sit down every few minutes. And I've stopped going to my book club because sitting in those chairs for an hour is too painful."

This tells your doctor exactly what's at stake: social isolation (no dog walks, no book club), loss of independence (can't cook), declining physical activity. Those are treatment targets.

Research on chronic pain outcomes shows that functional goals (like "I want to be able to walk my dog again") lead to better long-term improvement than pain intensity goals (like "I want to get my pain down to a 3").

4. Be honest about what helps and what doesn't

If something isn't working, say so.

If you stopped a medication because of side effects, explain why. If physical therapy helped a little but not enough, mention both parts. If you're afraid to try something your doctor suggested, name that fear.

Your doctor needs the truth, not a filtered version that you think they want to hear.

This includes being honest about things you've tried on your own: CBD, medical marijuana, over-the-counter supplements, curcuma, even things you're not proud of. The stigma is real, but withholding information makes it harder for your doctor to help you safely.

5. Bring a simple timeline

You don't need a detailed 10-page medical history, but a basic timeline helps, especially if you're seeing a new doctor or if it's been a while.

Jot down:

• When did the pain start?

• Were there major changes or flares?

• What treatments have you tried and when?

• What triggered you to make this appointment now?

A few quick notes on your phone or a scrap of paper can save precious minutes and prevent important details from slipping through the cracks when you're put on the spot.

6. Mention sleep, mood, stress, and energy

These aren't separate from chronic pain. They're part of it.

Poor sleep makes pain worse. Chronic pain drains energy and affects mood. Stress amplifies everything. Depression and anxiety are common in chronic pain, not because you're weak, but because pain changes brain chemistry and nervous system regulation.

Bringing these up isn't complaining or going off-topic. It's giving your doctor the full picture so they can help you more effectively because those need to be addressed to improve your pain.

If your doctor dismisses these as unrelated, gently push back: "I understand, but research shows these factors directly affect pain outcomes. I think they're relevant to my treatment."

7. Share fears or expectations openly

Are you worried the pain means something serious is being missed?

Afraid of becoming dependent on medication? Concerned about side effects? Worried you won't be believed? Frustrated that imaging came back normal but you're still in pain?

These fears are real and they affect how you engage with treatment.

Naming them out loud can shift the conversation in helpful ways. It also gives your doctor a chance to address misconceptions or offer reassurance where it's warranted.

If you're being tapered off a medication and you're scared, say that. If you've read horror stories online about a treatment, mention it. Your doctor can't address fears they don't know about.

8. Prioritize your concerns

If you walk in with a list of ten things, you probably won't get through all of them. And that's okay.

Start with your top two priorities. The issues that are affecting your life the most right now.

You can say something like: "I have a few concerns, but the two biggest ones are X and Y. Can we focus on those today?"

This respects your doctor's time constraints while making sure you get progress on what matters most. You can always schedule a follow-up for other issues.

9. Ask for clarity, not perfection

You might not get a definitive diagnosis. You might not get a cure. Very likely won’t get a miracle. You know that, chronic pain is complicated, and sometimes uncertainty is honest.

But I encourage you to still ask for clarity:

• "What do we think is happening?"

• "What's the plan for right now?"

• "What should I focus on between now and the next visit?"

• "What are we ruling out?"

• "What would make you concerned enough to investigate further?"

Clear answers to simple questions help you move forward, even when uncertainty remains.

If your doctor says "it's just chronic pain," ask them to explain what that means in terms of mechanisms, treatment options, and prognosis. "Just chronic pain" isn't an explanation.

10. Leave with a clear next step (this is key ❤️)

Before you walk out, make sure you know what happens next.

• When's the follow-up?

• What should you try at home?

• What symptoms should prompt you to call sooner?

• Are there any red flags to watch for?

• Who do you contact if something changes?

A concrete next step, even a small one, keeps momentum going and prevents the feeling of being stuck or abandoned.

If the plan is "try this for three months and we'll reassess," make sure you understand what "this" is, what "reassess" means, and what would trigger a change in approach before three months.

Why this matters: what I see in my practice

The patients who come in prepared, who've thought through their main goal, who can describe their pain in functional terms, who've organized their timeline, get fundamentally different care. Not because I favor them or anything, but because they give me what I need to actually help them and be efficient in my treatment plan.

When someone walks in and says "my pain is a 9 and nothing works," I'm starting from scratch. I have to spend most of our limited time gathering basic (sometimes random) information, and it’s definitely more difficult to get to a meaningful problem-solving plan.

When someone walks in and says "my main goal today is to figure out why my pain is worse at night, because it's destroying my sleep and I can't function at work. I've tried adjusting when I take my medication and using a heating pad, which helps a little, but I'm still waking up three or four times. What else can we try?" That's a completely different conversation. We can skip the detective work and go straight to solutions.

Here is what I think : the difference isn't about being a "good patient" or performing for your doctor. It's about making the most of a system that doesn't give us enough time. When you do the organizing work ahead of time, we can spend our appointment doing what actually helps you instead of trying to figure out what's going on.

I also see this in how patients respond to uncertainty. Chronic pain often doesn't have clean answers. Imaging is normal, but pain is real. We try treatments that work for most people, and they don't work for you. We adjust and adjust and sometimes still don't get it right.

The patients who've prepared tend to handle this uncertainty better. Not because they're more resilient, but because they've already thought through their priorities and expectations. They know what questions to ask. They can distinguish between "my doctor doesn't know what's wrong" (which might be honest) and "my doctor doesn't care" (which is different and needs addressing).

This article shouldn't be necessary. In an ideal system, we'd have enough time to do this work together. You wouldn't need to prepare like you're going into battle. But we don't have that system, and waiting for it to change means you suffer longer.

So yes, it's unfair that this falls on you. But it also genuinely works. The patients I see who use this approach get better care, feel more heard, and leave with clearer plans. Not because the system is fixed, but because they've learned to work within it more effectively.

That's not resignation. It's strategy. And in chronic pain care, strategy matters.

Download your pre-appointment checklist

Print this checklist and fill it out before your next appointment. Bring it with you or keep it on your phone.

I will see you next week where I will write this article, but for doctors!! Thanks again for reading, share around you if this is helpful.

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References & Further Reading

Patient Activation and Preparation

• Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure: conceptualizing and measuring activation in patients and consumers. Health Services Research. 2004;39(4):1005-26.

• Yao F, Zheng M, Wang X, et al. Patient activation level and its associated factors in adults with chronic pain: a cross-sectional survey. Medicine. 2021;100(19):e25970.

• Campbell CI, Altschuler A, Weisner C, et al. A patient activation intervention in primary care for patients with chronic pain on long term opioid therapy: results from a randomized control trial. BMC Health Services Research.2024;24(1):112.

Communication Quality and Therapeutic Alliance

• Ferreira PH, Ferreira ML, Maher CG, et al. The therapeutic alliance between clinicians and patients predicts outcome in chronic low back pain. Physical Therapy. 2013;93(4):470-78.

• Pinto RZ, Ferreira ML, Oliveira VC, et al. Patient-centred communication is associated with positive therapeutic alliance: a systematic review. Journal of Physiotherapy. 2012;58(2):77-87.

• Lakke SE, Meerman S. Does working alliance have an influence on pain and physical functioning in patients with chronic musculoskeletal pain: a systematic review. Journal of Compassionate Health Care. 2016;3(1):1-10.

The Biopsychosocial Model of Chronic Pain

• Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological Bulletin. 2007;133(4):581-624.

• Edwards RR, Dworkin RH, Sullivan MD, Turk DC, Wasan AD. The role of psychosocial processes in the development and maintenance of chronic pain. The Journal of Pain. 2016;17(9 Suppl):T70-T92.

• Gatchel RJ, McGeary DD, McGeary CA, Lippe B. The biopsychosocial model of the assessment, prevention, and treatment of chronic pain. US Neurology. 2016;12(2):98-104.

Patient Memory and Information Retention

• Kessels RP. Patients' memory for medical information. Journal of the Royal Society of Medicine. 2003;96(5):219-22.

• Laws MB, Lee Y, Rogers WH, et al. Factors associated with patient recall of key information in ambulatory specialty care visits: results of an innovative methodology. PLOS One. 2018;13(2):e0191940.

Current Challenges in Chronic Pain Care

• Campbell CI, Altschuler A, Weisner C, et al. Problems accessing pain care, and the adverse outcomes among adults with chronic pain: a cross-sectional survey study. Pain Management. 2025;15(2):81-91.

• Pain News Network. Pain patients feel abandoned by U.S. healthcare system. January 13, 2024.

• MDVIP/Ipsos Survey. Patient frustration surges: Americans struggle with broken healthcare system. February 27, 2024.