Dr. Allan Horowitz, published newspaper article, Richmond Hill Liberal, Copyright March 28, 1990
Dear readers:
For the past few weeks I have been educating my patients in the fine art-science of medical terminology. The final installment in this series will teach you how to describe pain to your doctor, dentist, chiropractor or witch doctor.
Telling us that you have a pain in your leg doesn’t tell us as much as you have a tingling” feeling in your leg. If it is a tingle, don’t tell us it is a pain.
“Pain” puts certain images in our minds and we look for things to fulfill our thoughts about what is really causing your pain.
If the more accurate description of “tingling” is used, it tells us something else and we begin to look for other things.
While it is true that a thorough examination should distinguish between a “tingle” and a “pain,” sometimes things do not always work out that way.
In the last few weeks, I described how a simple thing like a broken bone could be misdiagnosed if proper terminology is not used. A good examination shouldn’t have to do with a patient’s good communication skills, but in a rushed, busy emergency ward, or a busy clinic, using the proper terminology might really help.
Headaches can be described as: pounding, pressure, squeezing, vise-like, knocking, lightheadedness.
Neck pain is either sharp, dull, stabbing, grabbing, knife-like, aching, gnawing, or just plain nauseating. If it really isn’t a pain, it might be a tingle, shock-like, pins and needles or maybe it isn’t really sore, but just stiff or tight.
Back pain is usually described as a tight band running across the lower back. It may be burning, aching, stabbing, sharp, dull, throbbing, or again, just tight and stiff.
Maybe the pain is only there when you move, or maybe it is only there when you rest. Let us know. It helps.
When you first injured your knee did you hear a snap, pop, or crack? Is there now a sharp pain, or is it a dull aching pain? Is it dull most of the time, but does it get sharp when you move in certain directions? Does the knee lock in one position? When it unlocks, does it do so with a cracking noise? Does it hurt when it unlocks? Does your knee hurt when you run? Is there a “searing pain” behind your kneecap? Does it hurt more running up or down hills? Does it hurt more when you run or after the run? (It hurts me most just thinking of running!)
Most people think that any pain down the leg is called ”sciatica.” Patients will come to me claiming that they have sciatica and have had it for 15 years.
Some pain down the leg is sciatica, but not all of it. How you describe it to us is very important.
Pain shooting down the back of the leg, a cramping sensation in the buttocks, thigh, or calf (or all three), along with numbness, tingling, pins and needles may all represent a true case of sciatica, which means that the sciatic nerve is inflamed.
This is the nerve which travels down the leg, after it leaves the lower back and goes through the buttock.
If you have a pulled hamstring muscle (the muscle at the back of the thigh, running from the buttock to the knee) you might have symptoms similar to sciatica.
You run to the hospital and exclaim that you have a pain running down the back of your leg. The doctor looks at you and sees that you are 50 pounds overweight. He asks if you have ever had lower back pain and you mention that you have (who hasn’t?). He asks you to bend forward from the waist and it increases your pain. He raises you leg while you are lying on your back and again you have increased pain. He declares that you have sciatica, gives you some anti-inflammatory pills and sends you home to rest.
Wrong wrong wrong! This is one example of how a proper explanation of your pain will help him to make a proper diagnosis.If you knew enough to tell him, or if he knew enough to ask if you had pain into your calf, if it was a cramping pain or a stabbing pain. Was it made worse when you sit? Does it actually hurt to touch it and to poke it? When you pull your foot up does it make it worse, down the calf and behind the knee? Is it burning, or is there any numbness associated with it? These are all questions that can help differentiate the source of this person’s pain.
Help your chiropractor, your doctor, and yes even your dentist. Describe your pain properly and help them help you.