Describing your pain


“Listen to your patient, he is telling you the diagnosis.”

These are the words of Sir William Osler, a renowned Canadian physician, who is often regarded as the “Father of modern medicine.”

In 2014, we often believe that it is our vast technology and slew of medical tests available that give us all the answers to our health concerns.

However, what’s most important to getting the answers we desire is quality healthcare professionals who are ready to listen to your signs and symptoms. It is the detective work of the professional’s history intake and what you tell them that will guide which tests and assessments are needed to confirm their suspicions.

Therefore, the accuracy of how you describe the what, where and when you are feeling or experiencing is key to giving the professional the clues they need. Often patients have problems describing all of these elements, but it is often the “what” that is most challenging. Let’s use the example of pain, since most ailments or complaints have a pain component. In medicine, we use the term “pain” as an umbrella term to describe many different types of unpleasant sensations.

The type or character of “pain” you are experiencing provides very important information. Examples of different types include: sharp, stabbing, dull, achy, throbbing, pins/needles and burning; to name a few. The reason why the character is so important to accurately describe is that it will help to narrow down what anatomical site might be causing the pain. For example, a pins/needles sensation might be more suggestive of neurological conditions versus a dull ache which often happens with muscular issues.

The “where” and “when” are also extremely important points to help with determining a diagnosis. Specifying where on your body you are experiencing the “pain” is essential, for obvious reasons, but the more specific the “where” is, the better. For example, if you are experiencing leg pain, it is necessary for you to be specific about where on the leg. Is it a straight line down the back of the leg to above the knee or is it a large area on the back of the leg to just below the knee.

Temporal occurrence or when the “pain” occurs also helps to piece the diagnostic picture together. Perhaps, it is constant with no change or it comes and goes and feels better at certain times. Maybe different activities aggravate or relieve the issue. Both the “where” and “when” provide the clues needed for a healthcare professional to distinguish between different diagnostic impressions.

The take home message here is, be specific and accurate about what you are feeling! Clinical acumen is the ability for a healthcare professional to make good judgement and decisions based on the information they are provided about a patient complaint. Therefore, the answers to our health concerns are twofold. We need quality healthcare professionals with strong clinical acumen and patients providing the most accurate and specific information.

Dr. Luigi Nalli is a licensed Chiropractor with a special interest in pain management. He is a graduate of both the University of Toronto and the Canadian Memorial Chiropractic College and has further certifications from McMaster University. He is also the Clinical Director of Humber Family Chiropractic, Rehabilitation & Wellness, a multidisciplinary clinic with dozens of healthcare professionals dedicated to using their clinical acumen for the best patient care and wellness. The centre?s main office is located directly across from William Osler?s Etobicoke General Hospital and is open 7 days a week. To contact Dr. Nalli or book an appointment at the clinic please call 416-744-7900 or email