Communication is a vital yet often overlooked skill in caring for acute or chronic pain patients. As chiropractor Dr. Michael Vianin highlights in his book Dispositionalism in Musculoskeletal Care, effective clinician-patient communication promotes greater engagement, satisfaction, and outcomes in pain management. Mastering core communication techniques allows providers to build rapport, gather insights, and empower patients as partners in their own care.
Why Communication Matters
Patients frequently cite poor communication as a top complaint about pain management. They report feeling unheard, dismissed, or misunderstood. However, research shows that positive patient-provider communication has powerful benefits:
- Increased patient satisfaction and adherence to treatment plans
- Reduced patient anxiety and improved coping
- Higher quality of life and function for chronic pain patients
- Decreased risk of malpractice complaints against providers
As Dr. Vianin notes, understanding the patient's full experience is key since “the experts in pain are the patients.” Effective communication creates a safe space for patients to share their unique pain journey.
Core Communication Skills
The following evidence-based techniques form the foundation of empathetic communication in pain management:
- Active listening- Make eye contact, avoid distractions, and focus fully on what the patient is saying without interruption. Reflect back on key points to show understanding.
- Open-ended questions- Ask open-ended questions that allow patients to elaborate instead of questions with yes/no answers.
- Validate concerns- Express empathy and acknowledge the patient's feelings about their pain. Avoid dismissing or downplaying their concerns.
- Manage expectations- Set realistic expectations about prognosis, treatment, and the clinician-patient partnership.
- Shared decision-making- Collaborate with the patient to develop a personalized treatment plan based on their goals, values, and preferences.
- Motivational interviewing- Use open-ended questions and affirmative statements to build the patient's internal motivation and self-efficacy.
- Teach-back method- Have patients explain treatment plans and instructions to ensure comprehension.
Putting It All Together
With chronic pain patients especially, taking a holistic and humanistic approach is essential, as Dr. Vianin discusses in Dispositionalism in Musculoskeletal Care. Here are some examples of how to integrate good communication into pain management:
- Start with the patient's story – Let them describe their pain history and impact openly before jumping to medical history and exams.
- Show you're listening – Use verbal and non-verbal cues like nodding, eye contact, and brief comments like “I see” or “go on.”
- Ask about function and quality of life – Understand how pain affects daily activities, mood, sleep, relationships, etc.
- Discuss treatment options collaboratively – Explain options clearly and ask about the patient's preferences and values.
- Set SMART treatment goals together – Goals should be Specific, Measurable, Achievable, Relevant, and Time-bound. Check patient comprehension.
- Validate struggles – Express empathy for challenges and frustration dealing with pain rather than dismissing it.
- Check in regularly – Follow up consistently to assess progress and evolving needs. Adjust the treatment plan if needed.
Conclusion
Effective communication is integral to patient-centered pain management, forming a therapeutic alliance that empowers patients, provides insights, and improves satisfaction and outcomes. By honing core skills like active listening, motivational interviewing, and shared decision-making, clinicians can gain the whole story from the experts in pain and collaborate on tailored treatment plans. Patient communication is an art that clinicians should continuously refine to deliver outstanding pain care.
Gain valuable insights about patient-centered communication with Dr. Michael Vianin. Get your copy of Dispositionalism in Musculoskeletal Care today!
