Why focus on pain?

I am going to admit something, I hate the word pain.  That being said, for the rest of this entry I am going to substitute the word pain for 'P'. 

'P' is said by a new patient a minimum 10-15 times during their initial assessment.  'P' has such strong negative behavioural effect that when it is said it changes the entire doctor/patient encounter.  'P' demands focus and immediate action, and if neglected the overall treatment outcome will suffer.

From a clinician's perspective, 'P' is a symptom.  Often, from a patient's perspective 'P' is the only symptom.  This is a disconnect that needs to be addressed quickly with 'P' science education.  In a perfect world, I would love to divert the focus of all my patient interactions towards their current function and their health goals.  Unfortunately, the reason my care is often sought is because of the 'P' and the 'P' alone.  

The biggest concern with being 'P' motivated as a patient is that sometimes the 'P' will not go away. Being focused on the 'P' will only perpetuate the problem and often make it spiral out of control.  That is a topic for another time.   

The problem with being 'P' based as a clinician is that 'P' often narrows our focus prematurely.  As I mentioned above, 'P' is a symptom and symptoms are only part of the equation.  Our goal as a clinician is to find the cause of your 'P' so that we can eliminate your 'P' permanently.  To do so, we must look past symptoms and identify dysfunction and reactive compensation.  At times identifying the cause of the problem becomes difficult to explain to the patient because they may feel the 'P' in a completely different location.  Again, 'P' science education will help them understand.  

I want to reiterate, I am not saying that 'P' isn't important or should be neglected by a good clinician.  I'm saying that 'P' should be viewed for what it is, a symptom of something else.  Once we identify that something else, the 'P' will often go away.

*In case you were wondering what term I use in place of 'P' in my office, it is usually discomfort.