Takeaway
Take the time to listen and validate your patients’ pain experiences. Learning how the pain affects their daily activities may more precisely direct therapy.
Lifelong Learning in Clinical Excellence | August 22, 2025 | 2 min read
By Eellan Sivanesan, MD, Johns Hopkins Medicine
“I’m tired of explaining myself!”
During an inpatient consult early in my career as a pain physician, I met a patient who had lived with severe back and leg pain for over a decade. Multiple surgeries, dozens of medications, countless imaging studies—yet the pain persisted. What struck me wasn’t just her discomfort, but her fatigue from having to “prove” her pain to every new healthcare professional she met. She told me, “I just want someone to believe me and help me figure out what’s next.”
That conversation has stayed with me. It reminded me that you don’t need to be a pain specialist to make a difference for someone living with chronic pain.
Listen first
In my practice, I’ve found that chronic pain often comes with a long and complex medical history. Patients have usually seen multiple clinicians, tried numerous treatments, and endured well-meaning but sometimes conflicting advice. Taking time—just a few extra minutes—to let them tell their story uninterrupted can be therapeutic in itself. You don’t have to have all the answers right away. Listening shows you care and are invested in understanding their experience.
Acknowledge and validate
Validation isn’t about agreeing with every interpretation of a symptom—it’s about recognizing the real impact pain has on someone’s life. A simple statement like, “I can see this pain is affecting your daily activities and quality of life,” can help dismantle the feeling of being dismissed or misunderstood.
Collaborate across disciplines
Managing chronic pain often requires a team approach—primary care, physical therapy, behavioral health, interventional pain, and sometimes surgical colleagues. As a non-pain specialist, you can help patients navigate referrals, explain what each specialist does, and coordinate communication. This guidance reduces the burden on patients, who may otherwise feel like they’re managing a small healthcare system on their own.
Address the whole person
Chronic pain is rarely just about the physical sensation. Sleep, mood, mobility, relationships, and employment can all be affected. Asking a patient, “How is your pain affecting your day-to-day life?” opens the door to addressing the broader impact—and points to interventions beyond medications.
Offer hope without overpromising
Hope matters. Chronic pain may not be “cured,” but it can often be managed more effectively with the right combination of treatments and support. Framing the journey as one of improvement and adaptation, rather than a binary cure-or-no-cure, can help patients stay engaged in their care.
Practical tips for all healthcare professionals:
1. Give space for the story.
Let patients share their experience without interruption.
2. Validate their reality.
Acknowledge that the pain and its impact are real.
3. Connect the dots.
Help coordinate among different specialties.
4. See the whole picture.
Ask about sleep, mood, and function—not just pain scores.
5. Encourage small wins.
Celebrate progress, even if it’s incremental.
Chronic pain care isn’t the sole responsibility of pain specialists—it’s a shared responsibility across healthcare. A few extra moments to listen, validate, and coordinate can have an outsized impact on a patient’s quality of life.
Read more about Dr. Sivanesan.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.