Communicating Back Pain Symptoms to Your Doctor

Woman stretching back at desk in office
Willie B. Thomas/E+/Getty Images

Back pain and neck pain are subjective -- there are few, if any, definitive tests that can measure and diagnose the experience. Therefore, it falls on you to communicate your back pain symptoms to your doctor. By accurately noting your symptoms, and giving your doctor a clear picture of them, you are taking an important step toward getting a diagnosis. Here are some things to note:

Pain Intensity

How bad does it hurt?

Intensity is a measure of how strong the signals of felt pain are. As a back pain sufferer, this is probably the most important part of the ordeal for you. Intensity levels fluctuate, so it is impossible to get a useful, accurate measurement of them from objective testing. Instead, doctors and other health care providers use visual assessment tools and questionnaires to help you communicate your level of pain.

Download a Pain Chart and Keep Track of Your Daily Pain

Type of Pain

The types of painful feelings you have in your back or neck are an indication of what is going on in your spine. For example, if you experience burning, stabbing or electrical sensations down one leg or arm, it may indicate an irritated nerve. If your back muscles feel stiff or tight you may have pain due to an injury, or posture problems, or both.

More Information on Types of Pain

Location of Pain

The location of your pain may or may not be related to damage or an injury in your spine. If a nerve is affected, the pain may radiate down an arm or leg, as is the case in sciatica. If you have trigger points or other myofascial pain, you might experience referred pain -- pain located in an area that is seemingly unrelated to the actual site of the problem.

Pain is often located in more than one area of the body.

A body diagram can be used to map and track the location of the pain as it changes (or doesn't) over time. The body diagram is also a tool to help you communicate your symptoms of back pain clearly and accurately to your doctor.

In an effort to identify the cause of your back pain, your doctor might use the information you provide about the location of your pain to probe for more details.

Pain Patterns

The "when" of back pain -- if it comes on suddenly or gradually, if it is present constantly or just sometimes, or if there is a particular time of day when it always shows up -- is very important information to your doctor as she or he goes through the process of determining a diagnosis. Doctors evaluate changes in pain patterns to monitor your progress and to be on the lookout for new problems. Patterns of pain also help doctors determine the best time for you to take medication.

Chronic pain has a constant presence but varies in intensity at different times and in response to different stimuli. Sometimes there are layers of pain that combine together, resulting in more than one type of pain to be felt.

The "when" of back pain may also be a subtle influence on your decision whether to seek treatment at all.

Many people go for help with their back pain only after an initiating event, but ,in reality, even if your pain has crept up on you over time, it is best to get it checked by your physician.

Interruption of Function

Pain is more than a set of unpleasant sensations. It has the power to disrupt daily activities and lifelong dreams. Back pain can impair your ability to perform work and play activities, and to do very basic things such as coughing and sneezing.

Your expectations and attitudes play a determining role as to how much disability you experience when you have back pain. The ICSI, a group that provides guidance to doctors treating back pain, asserts that a patient’s lack of involvement in their self-management activities can perpetuate their chronic pain.

They also indicate that social support and spirituality are factors affecting lifestyle adjustment to pain. Your own perception or appraisal of yourself as able to perform actions and tasks has a great deal to do with your ability to function. This is called self-efficacy. A 2007 study published in the European Journal of Pain found that higher levels of self-efficacy in patients with low back pain were associated with less disability.

During your exam, the doctor should ask questions about your functioning and how it has changed since you have been in pain. She or he should also try to determine the level of pain you experience while at rest and during activities.

Psychological Issues

Many times depression accompanies back pain, especially chronic back pain. Your doctor should ask you if you have depression, anxiety, substance abuse or other types of problems currently or in your past.

Cognitive behavioral therapy is a short-term therapy focusing on identifying and changing the thinking patterns that bring unwanted results into our lives. It has a good reputation for helping people with chronic back pain to avoid disability. A study done in 2001 at the Orebro Medical Center in Sweden showed that cognitive-behavior group therapy can lower the risk of developing longterm disability in patients with chronic back pain.



Linton, S.J., & Andersson, T. (2000). Can chronic disability be prevented? A randomized trial of a cognitive-behavior intervention and two forms of information for patients with spinal pain. Spine, 25(21).

Woby, S.R., Roach, N.K., Urmston, M., & Watson, P.J. (2007). The relation between cognitive factors and levels of pain and disability in chronic low back pain patients presenting for physiotherapy. European Journal of Pain.

Gould, H.J. III, M.D., Ph.D. (2007). Understanding Pain. Saint Paul, MN: Demos.

Melzack, R. (1975). The McGill Pain Questionnaire: major properties and scoring method. Pain, 1(3).

Melzack, R. (1987). The short-form McGill Pain Questionnaire. Pain. August 30(2).

Registered Nurses Association of Ontario (RNAO). Assessment and management of pain. Toronto (ON): Registered Nurses Association of Ontario (RNAO); 2002 Nov.

Institute for Clinical Systems Improvement (ICSI). Assessment and management of chronic pain. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2005 Nov.

Menefee, L. Katz, N. 2003 The Manual: A Clinical Companion. Newton, MA.

Continue Reading