Dear Alice,

I have bad knees. My knees hurt all of the time. My left knee is the worst. I play rugby, so my knees do get a lot of wear and tear. I have been told by my current doctor that there is nothing they can do and that all I can take for the pain is Ibuprofen. I have tried physical therapy with no results. Lately, my knees have been hurting me a lot. They hurt at night, when I walk, even when I am just sitting there. Ice and heat don't help either. Sometimes I won't sleep for two or three days at a time because the pain in my knees is so nagging and uncomfortable. I want to know how I can talk to the doctor assertively telling her that I need something more for the pain. I don't want to seem like what they are doing isn't enough, but it isn't. I am a college student on campus, I walk a lot, I need to be able to walk across campus with out having my knees hurt. If you have any advice for me it would be greatly appreciated...

In Pain

Dear In Pain,

It might feel like the worst part about having aches and pains isn't the pain itself — it's getting someone to really listen to you and help you manage the pain. In fact, one study reported that fewer than half of the patients who visited their health care provider for pain relief felt that the provider truly understood the extent of their pain. One of the reasons this might occur is that, unlike a broken bone or slipped disc, the feeling of pain doesn't show up in any medical tests like blood tests or x-rays. Often, the only thing a health care provider knows about a particular pain is what her or his patient says about it. This might mean that the more specific you are in describing your pains, the more information s/he has to work with in order to help you alleviate or manage the pain.

To help describe your pain to your health care provider, some things to think about and keep track of might include the location of the pain or pains (knees, thigh, calf, and particular spots or areas in those parts), their frequency, or how often the pain occurs (all the time, only at night, once a week, every other week, only after sports, etc.) and severity (strong, weak, sharp, dull). Think about and observe what make the pain feel better or worse (resting, lying down, standing up, playing rugby, etc.). Also, jot down how the pain impacts your regular activities (couldn't walk to class, couldn't sleep, etc.).

You may find it helpful to keep track of all this information about your pain symptoms by writing it down in a journal, planner, or calendar. Having all of this information together in one spot might make it easier to speak to your health care provider about how much this pain is impacting your life; you could even show the provider your journal. If you are still nervous, you could also practice role-playing with a friend a few times before your next visit. This might help you feel more prepared and comfortable, as well as help you think of other things you might want to say during your appointment.

After you've told your provider about the pain, you can ask about different ways to relieve it, and what to do if a recommended treatment is not effective. You may ask your provider if it would be useful look into different types of physical therapy, massage, or to visit an Orthopedist (musculoskeletal system specialist). Hopefully, you and the healthcare team can work together from there to come up with a pain-relief regiment that will work for you. If you find that he or she is still not cooperative or not listening or understanding what you are saying, you might want to consider consulting with other health care providers. If you are a Columbia student, you can call x4-2284 or log on to Open Communicator to make an appointment at Primary Care Medical Services and get you stepping on the right path to freedom (from pain). Best wishes, Alice!

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