24 Secrets Pain Doctors Won’t Tell You

Updated: Mar. 30, 2022

Learn what pain doctors are really thinking when you visit them, and how you can better manage your symptoms.

Smiling woman doctor with stethoscope

Sure, I can give you some meds to dampen the pain

We spoke to some of the top pain specialists around the country (see the “Sources” below for more info). And they all agreed that the best doctors will talk to you about the possible causes of your pain, whether it’s your lack of activity, your stress level, a condition like arthritis, your mattress, or one of these surprising back pain causes.

woman holding compress to her neck

Heat or ice?

Use an ice pack for acute injuries, to minimize blood flow and reduce swelling and pain. Use heat to loosen muscles and stiff joints and help you feel more mobile. (Heat or ice? Here’s a guide to injury treatment.)

doctor with arms folded, with stethoscope

Any doctor can hang a shingle that says ‘I treat pain’

Look for doctors who are board-certified in pain medicine or who did a fellowship in something pain-related. (Here’s what you should know about pain management.)

woman doctor looking at x-ray

Your back and neck (and often shoulder) pain may have little or nothing to do with your abnormal MRI

Studies show that if you perform an MRI on any 100 people, you’ll find an abnormality in about 90 percent of them, even if they’re not experiencing any pain. (These are the sciatica symptoms you should know.)

pills on a prescription pad
istock/Pamela Moore

Reconsider before asking for a prescription

The latest research shows that taking opioid pain meds (like Vicodin and OxyContin) for chronic pain can change the brain, damaging its ability to feel pleasure and leading to a craving for more drugs. A few studies found that long-term use can actually lead to increased pain. There are many other options to treat pain, including non-opioid medications.

African American woman looking at a computer screen

In mild pain? Play word games or another favorite challenging puzzle

When you distract your brain, you don’t hurt as much. Another activity that helps: watching a funny TV show.

man holding his lower back

Before you praise me for curing your back pain, remember this

It may have gone away on its own. Approximately 90 percent of low-back pain subsides within 12 weeks without medical intervention.

close up of cheese plate; person's hands
istock/Eva Katalin Kondoros

If you have chronic pain, consider experimenting with dietary changes

Eliminate dairy for a few weeks, then reintroduce it and see how you feel. Do the same with wheat, red meat, shellfish, citrus, peanuts, caffeine, and alcohol, one at a time. If your pain gets worse when you add back a food, it may be contributing to your problem. Here are anti-inflammatory foods you can eat to help reduce pain.

a man's hands manipulating a person's head and neck
istock/Rich Legg

If I specialize in prescribing narcotics, giving injections, or doing surgery, that’s probably what I’m going to recommend

But there are dozens of other options to try like massage, physical therapy, chiropractic, acupuncture, spinal cord stimulators, and behavioral therapy. If you want to explore these options, work with an integrative medicine doctor to explore different natural and conventional methods of treating pain. And don’t forget nutrition, sleep, exercise and stress reduction.

close up of human spine with man in background

Think twice about having surgery, especially on your back or spine

I’m in a practice with only three doctors, and between us, we have over 1,000 patients who had back surgery who wish they never had. In a Consumer Reports survey, just 60 percent of those who had back surgery were completely or very satisfied with the results. (Here’s how one woman with a herniated disc healed through mind-body exercises.)

therapist with patient on couch
istock/Aleksandar Nakic

Pain is mental too

Your brain can make your pain feel worse. So you may want to explore psychotherapy, cognitive behavioral therapy, meditation, and even self-hypnosis. (Here’s how to trick your brain into feeling less pain.)

hand holding various prescription medications

If the doctor takes only cash (not insurance) and hands you a prescription after just a few minutes, you may be at a pill mill, not a full-service pain clinic

Most legitimate pain clinics take insurance and offer treatments beyond medication.

woman swimming in pool

Your pain may improve with the right kind of exercise

Specifically, aerobic exercise fives times a week and regular practice of yoga and t’ai chi have been shown to help. Pain will also feel worse if you don’t get a good night’s sleep. (Here are sleep doctors’ tips for deeper sleep.)

a variety of prescription pills in blister packaging

Pain medications are known for causing severe constipation

Always ask about a stool softener, or try one of these constipation home remedies.

closeup of a pill on a woman's tongue
istock/Aldo Murillo

Before you come to me, try taking Tylenol or Advil for a few days

Simple, but it may work. And in some cases, the may be just as effective as opioid painkillers. Be aware, though, that overuse can result in rebound pain, liver issues, bleeding and ulcers.

doctor handing a patient a note

Surgeons and orthopedic doctors who prescribe narcotics after surgery tend to under-dose

That’s because they’re worried about creating an addiction. If you’re still in pain after a procedure, it’s OK to ask for more. Social support can actually cut down on the need for pain meds.

man with glasses wearing a tie looking down

To many insurance companies, the treatment of pain is an elective procedure, not a medical emergency

Be prepared to fight to get your treatment covered.

woman massaging her neck

Diagnosed with spinal stenosis?

If you’ve been diagnosed with spinal stenosis, a narrowing of the spinal canal, and your doctor says you could be paralyzed if you don’t have surgery, find another doctor. Studies have shown that’s not true, and surgery should be a last resort only after you’ve tried other options.

elderly person holding wrist

Try injections for carpal tunnel

Injections for carpal tunnel syndrome have the highest success rate of any procedure. It should definitely be something you try before you resort to surgery. Here are some home remedies to try for carpal tunnel syndrome, too.

doctor passing a patient a collection bottle
istock/Kirby Hamilton

Please don’t take it personally when I ask you to take a drug test

We want to believe that you’re not addicted, but 3.3 million people in the U.S. are abusing prescription pain relievers, and we don’t want to be responsible.

man outdoors holding his knee

You may never be 100 percent pain-free

Especially if you’re experiencing chronic back or knee pain. In many cases, we consider your treatment a success if we get rid of 50 percent of your pain and help you to be more functional.

hypodermic syringe in a bottle of clear liquid

Steroid injections are now a top treatment for back pain in America

But critics say there is little evidence of any long-term benefit compared to their risks, especially for back pain that doesn’t radiate down the legs.

Asian doctor at the bedside of an African American patient

We’re incentivized to find ways to treat you

Pain doctors are paid about five to 10 times more for doing a procedure on you than for counseling you about how to prevent pain. Nerve blocks and injections are very lucrative, especially if you do them assembly-line-style all day long.

woman in workout gear with earbuds

Get out of bed!

For every day you’re lying there, you lose 1 to 3 percent of your muscle strength, and then you start to feel stiff simply because you’re not moving. Your pain will get better faster if you stay active. Make sure you avoid these things that only make pain worse.