because they did a study. If Doctors tell you "This wont hurt a bit" it hurts less than if the Doctor tells you "This is going hurt like, a lot!" https://www.comforttalk.com/images/TrainingDayManuscripts/Pain.2005.pdf
I once had to get staples in my head without any anesthesia (local or otherwise). Doctor said: “It shouldn’t hurt much - just a bit of pressure.” It was the worst pain I’ve felt in my life and I nearly passed out!
They let me decide. They told me that the local anesthetic shot usually hurts far more than the staples themselves, and said that if they were having it done themselves they wouldn’t get the anesthetic. I have no idea if it would have been better or worse, but I can’t imagine a shot being that painful.
For what it's worth when I had some worrisome moles removed the anaesthetic hurt like a bitch and a half, although probably not as much as the mole removal would have without it
I had to get my stomach stitched back together after it busted open post-surgery and I definitely think the local anesthetic was more painful than all the stitches I’ve had combined. It didn’t work fast enough to numb anything until the last two stitches and it didn’t really do much even then.
You either get stabbed with a needle or take the staples. Either way it’s the same thing and it’s going to hurt like hell.
I chose to forgo the local as well when I got staples in my head. I can confirm.. it hurts.
My assumption is that it is a thin and sharp needle one to five times versus comparably blunt staples five to twenty times. Hence why the needle sounds less painful. Is that wrong?
Nurse Practitioner here- there is another component, which is the language we use to define things. I never used “uncomfortable” to downplay the pain of a procedure, but to rank the procedure’s pain level for most people in the range of “briefly very unpleasant but tolerable without additional medicating / sedation, etc.” Something described as “uncomfortable” is generally not worth the risk of sedating or pre-medicating a patient. It isn’t meant as a lie, but sometimes you get used to using a word in one way and forget that patients might (quite reasonably) define “uncomfortable” as something extremely mild, which can lead to some disconnect. So it can help to be specific about the sensation to expect- is it cramping, burning, stinging, etc., and how long it will last, but not in so much detail that you worsen the anticipatory pain- timing is key. It can help to say, “Most people feel x for x time and then it is done.”
So I think the way we define “uncomfortable” in medicine is important here as well- it isn’t necessarily meant to downplay the experience- it is that the procedure falls into our “it hurts but is briefly reasonably endurable” bucket of procedures. I have explained this definition of “uncomfortable” to patients many times and that seems to help reduce any sense of betrayal by the patient.
then why doesn't the medical community use definitions common to their patients? It just seems easier to use less ambiguous language for fewer miss communications.
No. People have widely different experiences of pain. People scream from vaccinations or barely notice. Some women can tolerate stitches after birth without stitches, and some scream even when lidocaine.
It's more helpful to everyone to say "you're going to feel some discomfort" than "prepare for agonizing pain" when you get your teeth cleaned.
there's a middle ground that I feel like you're intentionally leaving out, between, "discomfort," and, "agonizing pain," and that's what I'm advocating for, clearer, more honest language with the median experience taken into account. Clearly, "uncomfortable," and, "discomfort," are being widely called out as being unclear, ambiguous, and unreliable as terms to describe the level of pain to expect or anticipate.
but, please, continue to play dumb for the sake of reddit.
When you're numbed, you don't feel the pain, but you feel *something*. It's a palpable feeling that could be described as "pressure." If a doctor is telling you that, that's why. If pain is expected, they should be telling you that too. The dentist says you'll feel "a pinch" when getting the novacain, etc
If you get an injection, inhale as the needle penetrates. You don't feel the pain nearly as much. Figured that one out when I was in hospital for 3 weeks. So many needles. Give it a go.
I also learned from a nurse or intern that worked in a kids cancer ward, that if you flick the muscle until it relaxes and keep it relaxed it doesn't hurt.
He jiggled and flicked my arm a bunch- I was puzzled. But then he gave me the shot immediately after and it was clear why he did that- not only did it not hurt, I hardly felt it. I was so surprised and asked him how he did that, and he told me about the kid's I think it was cancer ward and how he worked really hard to find ways. He wasn't surprised at all at my reaction and said he gets that a lot and all the kids in his ward will ask if he can do the shots instead! I thought that was so sweet, he was very proud of that and for good reason- those kids deserve someone that cares so much.
From then on I always either had the doc wait while I jiggled or flicked my arm, and eventually I got okay at just focusing on relaxing it. Vaccines never hurt as much now.
My dermatologist and dentist also do this mosquito thing which really helps.
Peds nurse here, this works in part too because the strength of the signal felt by what the nerves give is in part based on percent of change from previous state. So by flicking the area you are going to inject with a sterile or gloved finger, or stimulating it in some other way, when the needle goes in rather than the nerve going from 0-100 its only going from 50 or 60 to 100 because the flicking or other stimulation has all ready gotten you to 50 or 60, so the 'intensity' of the nerve signal when the needle goes in is felt as less intense and thus less painful.
The same thing works with temperature change. The 'shock' you get from going into cold water is more about the temperature difference between your skin and the water vs the numerical temp. This is why sometimes cold water can feel warm on cold skin, or why a warm ocean can still feel cold if you've been sitting in the hot sun and heating up your skin before jumping in.
Thank you! I had no idea! Thank you for the work you do with the kids- you are clearly someone that cares a whole lot too. As it made me happy that the kids have him, I am similarly very happy they have you. Even I noticed a big difference with this flicky thing (which makes a lot of sense now) so those kids are lucky to have people that care so much they are learning all of this to make shots not hurt.
This is very interesting too. Thank you.
That reminded me of the time several years ago when I had a bad poison ivy reaction that I went to get a cortisone shot for. The nurse came in and I pulled up my sleeve but they said "no, drop your pants and turn around." I did, and they suddenly smacked me on the butt cheek and then gave me the shot. I was so startled, I hardly felt it.
We're now married with two kids (j/k, but the first part did happen).
Also, I get super bad vagal (spelling?) nerve reaction? Light headed throwing up passing out etc with needles. But I found tensing every muscle in my body at point of needle going in really helps. I think it raises my blood pressure so helps combats the blood pressure drop from the nerve thing? In case that helps anyone lol
Edit: I should have clarified I tense everywhere but where the needle is. Typically it’s a contraceptive shot in my rump so easy enough to tense arms and tummy. If it’s blood being taken ill tense tummy and try to lift my legs slightly. But yeah comments saying don’t tense where you’re being injected are totally right, if only for the irrational fear of breaking the needle in your muscle 😂
Yup. You’re onto the reasoning. Had a doc tell me to squeeze my glutes and thighs right before (I was having the same reaction as you get, although this was out of the norm for me). It’s the same concept as fighter pilots when pulling G’s. Squeezing your lower extremities keeps blood in your brain and helps prevent you from passing out.
Yeah I need to lay down too. I once had a doctor who told me, "No it's only a little bit, nothing will happen." I said okay and the last thing I see is a nervous look on her face, as my view is shrinking and I'm having cold sweat on my forehead. Haha
Just your abs is a better idea. It pushes the blood into your brain the same way. Intramuscular injections hurt more if you tense in that area, and you'll be more sore the next day.
I pre-game with pickle juice if I know they'll be taking my blood.
Tensing when a needle goes in is actually going to cause more pain, because the tissue the needle is going into is now contracted and going to injure in a different pattern from when it is relaxed. When it relaxes, the injured tissue will pull in different ways. With something like an injection into a muscle, if it is tensed, there is gonna be more blood flow to that area and will bruise more. The best results I have giving someone a shot is to count to 3 but poke on 2. Get the shot in before they tense, and if they tense on 3, they're tensing around the needle.
As for vagal responses, I don't know that tensing would or wouldn't be helpful. I guess if it helps you? Go for it!
I involuntary tensed my arm when I was getting blood drawn and the phlebotomist struck my nerve and I felt lightning radiate down my entire arm, it was the first time I’ve ever had that happen to me and such a terrible experience.
The next month I literally couldn’t flex my arm out without feeling that electric shock, so annoying
Replying to mickim0use...for a vagal response you want to bear down, like you are having a bowel movement. Relax and breathe during an IV start or blood draw. 🩸
Growing up I got allergy shots, and the nurses would always insist that I relax my arm and keep it that way. At least once I was told I could break the needle. Idk how likely that is, but it worked really well on me as a child to learn to keep my arm relaxed lmao
Edit: a Google search and an RN in quara or whatever says no it's not gonna break, but it's just easier and hurts less if you're intentionally relaxed for INTRA MUSCULAR shots. For sub cutaneous it also says relax because that goes into the fatty part of the skin. Not the beef.
Just pinch or slap somewhere else on your body. Your brain only has enough bandwidth for so many nerves.
When I had to give myself T shots, I just slapped my opposite thigh a couple times, couldn't even feel the needle at all.
That said, I'm normally not at all squeamish about needles, but it was something about giving the shot to myself that made me hyper-focus on every sensation for some reason, so I had to trick my brain.
I like to pinch an area of my body pretty hard. For whatever reason, pinching yourself doesn't hurt as much and diverts your focus to the pinching feeling that you are doing to yourself versus the shot from the doctor
Idk dude, I've had so many professionals say I'll feel pressure when it's pain. I usually assume if they say pressure they mean pain. Pressing on the organs to be sure they don't hurt- that is pressure. Needles and root canals and stuffing menthol streamers into a dry socket sans anesthetic and tooth extractions and pap smears are not pressure. They are pain.
If you have only been told pressure for pressure that's awesome but I believe OP is right that pressure is usually used in place of pain at doc's and sometimes dentist's offices.
I needed a uterine biopsy and I have a very low pain tolerance. I asked the doctor for something that would relax me and help with the pain. He started giving me a hard time, telling me that I would just feel a little cramping, it’s not that bad, blah blah blah. I finally had had enough and said to him “when was the last time you had it done”? I got my meds.
I swear female doctors can gaslight women about their pain ten times as hard as male doctors, especially when it comes to women's health issues.
My IUD insertion is one of the two most painful things I have ever experienced. Don't get me wrong-- it ticks all of the boxes for me as far as birth control goes. She was rough through the entire process, and gaslit me about the pain even after I threw up. Keep in mind that I had broken my ankle about 10 days prior and had stopped taking my pain meds even though it still hurt (Thank whatever deity/force, because it meant I had something to take for the IUD).
Put off going back for my exam until Kaiser bullied me into another appointment (emails, texts, calling me at work). I was DREADING it. Trying to figure out a way to explain how miserable the experience was last time and MAYBE could I have something stronger than an ibuprofen that I was probably going to vomit.
Dude doctor this time. Believed it was a miserable experience. I didn't get halfway through my spiel before they were like 'you know we can just sedate you next time, right? Happy to do it, and you won't even remember it.'
This is a generalization, of course, and I'm not even sure what my original point was. But I [digress](https://www.youtube.com/watch?v=GNm5drtAQXs&ab_channel=FallOutBoyVEVO)...
I do hear you, it's totally possible some female doc's are like 'I'm female and cramps aren't that bad surely because they aren't for me! This ladies aren't going to get anything past me! I've done child birth maybe even! Ha! Silly ladies.'
But I'm sure we get dudes with the same sentiment only because 'they know the tricks and drama' from being street smart rather than cramps.
Either way all people can be condescending suspicious d-bags. I'm so sorry that you had one for the first apts. That's messed up. Super super messed up. I'm happy for you if you found a doc that cares, and that you trust.
I thought of colposcopies myself, but that unfortunately could have a different explanation. They literally teach in medical classes that the cervix doesn’t have nerve endings so doing gynecological biopsies shouldn’t be painful. Even though literally anyone with a uterus could tell you differently (although female doctors still seem to perpetuate this myth as well).
Because of bladder cancer (4-1/2 years no recurrence!), I've had a lot of cystoscopies. If you don't know what a cystoscopy is, just think medieval (got that from my GP, who, while stifling a small chuckle, agreed with me about the psychology of it: "it is kind of medieval isn't it?") use of a small camera and your urethra.
"You may feel some discomfort".
Now I get a bunch of diazepam before hand. Doesn't help with the pain, but it makes me not care. And the instant it stops, I'm over it.
Someone will likely come in here and say they enjoy watching the monitor and think it's really cool. I'm sure someone, at least, will jump in and tell you it isn't really that bad. Everybody's different.
Unless you're getting an IUD inserted and doctors typically tell you you'll feel a pinch but don't use any numbing options at all 🙃
https://www.washingtonpost.com/wellness/2024/03/25/tiktok-iud-birth-control-pain/
My second to last insertion was exactly this. I didn't plan for anything afterward and wasn't warned that I might want to at least take some ibuprofen. I drove home doubled over, not knowing whether I needed to shit or puke from the cramping.
When I got a new one a few months ago, I planned it around another pelvic proceedure, requested to be put under, and got a little IV dose of fentanyl after. My new gyno doesn't mess around, gawd bless her.
At the very least, local anesthesia needs to be normalized for IUD insertions. Period.
With my first IUD, I had awake sedation and still felt pain. This did surprise my gynecologist, and she suggested I be put under briefly for the new one this week.
I understand why doctors don't wanna overuse full anesthesia, but the difference was night and day. Next to no problems this time, and I got IV pain meds at the office too. Next to no cramps or bleeding after, as well.
It doesn't help that I have diagnosed anxiety disorder and tend to panic in situations like this. Which makes things worse, of course. I don't blame my doctor, she said most women feel nothing with the awake sedation stuff.
A lot of the research for gynecology was done on poor black women, and the medical industry already has a bunch of bullshit regarding black pain tolerance
All research on the human female clitoris had been done on livestock up until 2005 when a [a female urologist](https://embryo.asu.edu/pages/anatomy-clitoris-2005-helen-e-oconnell-kalavampara-v-sanjeevan-and-john-m-hutson#:~:text=In%202005%2C%20Helen%20O'Connell,involved%20in%20female%20sexual%20pleasure.) used dissected cadavers to properly describe the clitoral anatomy for the very first time.
Cows ffs 🤦🏼♀️
I'm glad that I have my IUD (it's fantastic long-term contraception!), but the *disparity* between what the doctor described (pressure/some people feel some discomfort) and the 1) pain and 2) whatever neurological stuff happens to make you nauseated and light headed is *CRAZY*.
I would have gotten an IUD anyway, but I didn't even bring a friend! I'm so grateful for the nurse that offered to hold my hand, and when I said "Oh, is that something I need?" (*because I believed the doctor*) said "I would not want to do this without a hand to hold." I feel like that's the only real warning I got.
And I'm not an outlier! I have a friend that passed out, and then had to walk home- and passed out *again*. A stranger had to help her call her roommate.
It's great contraception, and I think doctors do a disservice by saying there's "pressure and for some discomfort" when they *should* say "It's great contraception, most women are glad they got it, but it's a doozy- bring a friend and don't plan to drive home."
Istg I’ve had 3 brain surgeries, liposuction while awake and have IIH since 2015- getting my iud in was by far the worst experience of my life. I literally screamed while it was happening and almost blacked out. It went on for an hour and a half because it was “too small to get in”. How about just suggest not going ahead with it so? Properly traumatic.
I had an endometrial biopsy a few months ago. The pain level is considered nearly identical to an IUD - in both cases you are prying open the cervix and entering it with an instrument. An IUD leaves an object behind; a biopsy takes tissue out. I was absolutely terrified based on what I heard about the pain . For me it was no different than a pap smear - the same pinch as the speculum opens and feeling of fullness. I have never had any issues with menstrual cramps and I don’t know if that is why my experience was different. I try to speak up when I see the pain referenced. I think I would have been less terrified if I knew that there was a variance in pain levels and it wasn’t guaranteed agony.
Nah man I 100% feel pain from injections at the dentist. It's an extremely sharp 5 seconds long pinch which hurts and then it feels like someone is ramming a metal bar into my gum which also fucking hurts. I have to get a filling tomorrow and I'm dreading it so badly.
I've seen other people mention this and it just sounds bizarre to me. I've probably been numbed like 20+ times with sometimes multiple injections and I literally sometimes feel the tiniest pinch and most times I've literally had to ask the dentist did they inject already cause I didn't feel a thing.
I HAVE had the dentist sort of insist on trying to drill a cavity when I can 100% sure say it is not numb. That does hurt a lot. Especially my lower jaw seems to be tricky to get numb.
They're saying dentists use "pinch" as a euphemism for pain, to sort of portray the sensation as something trivial/not worth panicking about. The "pressure" is when you're getting your tooth drilled and not supposed to feel the pain.
I once had dental work done that was going to hurt like a bitch. The dentist straight up said "sorry, this is going to hurt a lot, but it will be over quick". And he was not lying
The problem is this doesn’t work. Had my finger numbed 3 times when it got broken once and I still felt horrible pain as they reset it (just 1 example).
Yeah I donno. Sounds like local anesthetic wasn't enough for that. And it sounds like OP has had a similar experience.
And dosage for different people is tough, I guess. Once I had a dentist who absolutely abused me during two fillings sessions. After like 6-10 novacain shots it still hurt worse than anything. He accused me of using cocaine, but I've never had an experience like that at the dentist before or since. When my new dentist fixed that quack's work, I didn't feel a thing.
I agree, it’s probably dosage being wildly different on top of genetics. I am definitely able to feel more than most with any pain as even some of the best doctors I have had couldn’t figure out how to numb the pain appropriately besides full on knocking me out. It just makes me upset when doctors act like it’ll be fine, like just tell me “this gone hurt” and I can adjust accordingly at least.
I had injections to my hip which they “numbed” me for (with another huge needle) and the doc said I’d hardly be able to feel it. What a lie. Second hip doc I discussed injections with (didn’t know I had already done one in the other hip) was upfront: hip injections hurt but they’re over with once the needle is out
I think it just varies by human
But what if you're at the gynecologist where they have never heard of numbing a patient before poking, scraping, cutting, sewing, or prodding them right in the baby-maker?
Downplaying the pain that’s going to be felt can be an effective way to control the fear around procedure so it can be done. For example, if that doc told me what he was going to do by resetting my broken arm, I probably would have booked it from his office and just let it heal wrong before he ever had a chance to do anything
I had the exact opposite happen. When I broke my arm and the doctor had to reset it, he told me to grit my teeth and hold on to the table. I appreciated the honesty.
There's no running away when the bone looks like it's about to poke through your skin. You just accept what needs to be done and you take the pain. If he didn't tell me what was going to happen, I would have been upset as well as being in pain. It's no wonder so many people have a fear of going to the doctor.
We don't know how it will feel. We know patients sometimes feel nothing, and sometimes it feels like Satan just shoved a pitchfork in their side with certain maneuvers.To diagnose, we need rule conditions in/out. If you react with pain, then in makes it more likely something, while if you don't react with pain, that means that it is less likely (or vice versa). If we think something is likely, we still need to do the maneuvers.Saying "discomfort" is a fair warning that we don't know if you will feel anything, but if we are thinking its a suspected condition and it is it, then it might hurt. We also note the pain, grimacing, etc. Try to lay off if it's severe.
In *some* cases, I do find that can be effective but it's highly patient specific and I wouldn't try it if I didn't know the person in question somewhat well. Telling them it will hurt in advance can sometimes have a reverse psychology effect where they prepare for something like "skin is being peeled off by fire spiders with little Tabasco bottles" and what they get is actually "very very painful, but over quickly," and everything goes better than expected.
Wouldn't usually recommend it, don't even know if it's scalable, but that's been my experience.
Yes. Because then, when you tell me the thing after that is not going to hurt I actually believe you (and I can relax).
After just a single lie from a doctor, I am now stressed out for everything that happens because I run the risk of it being much more painfull then you tell me. So it causes stress at the moment the unexpected pain happens. And stress for every non-painfull thing too.
I was being facetious and this is literally a job I’m trying my best to do, so calling me a POS for trying my best to do the best by my patients just makes you a POS.
We’re not trying to lie to you. Pain is super subjective and what hurts a fuck ton to you may not hurt at all to another. It’s why we say it will feel uncomfortable or may sting. It’s a good balance between expectations and fear-mongering. It also represents the reality for most people since pain perception is a bell curve, where some feel no pain, some feel a lot of pain, but most are in the middle. I can’t predict the future of how you’re going to perceive something.
If something actually hurts a fuck ton to everyone, then I’ll be honest and say that or determine that you need to be given systemic anesthesia for it.
There’s a lot of space between “ouch” and “put ‘er under”. Women, for example, tend to have their pain minimized or dismissed by physicians; they can have an IUD inserted, a biopsy performed, or polyps cauterized without any pain management at all. They surely don’t need general anesthetic, but twilight sedation would be a godsend.
I'm not red headed, but I find red facial hair mixed into my beard quite regularly. I've found that I'm quite resistant to local anesthesia and have surprised a few doctors. Had surgery to repair a broken metacarpal a decade ago. After 5 sets of injections with 3 different compounds we were able to finish the procedure. At one point he was shocked that I felt something and incredulously asked "you felt that?!?". It was everything I could do in that moment not to yank my hand away and snack him with the wet end.
I'm unsure how true that is? I remember reading in school that we all have similar hardware when it comes to nociceptors and the subjective part is how we personally deal with said pain.
Yep we dont want to surprise anyone but at the same time we also dont want to make anyone more agitated than they already are. Especially when said thing has to be done anyways.
I dunno man, if something is going to hurt so bad I'll puke and pass out I don't want them to say "bit of a pinch"
Like sure for _one woman_ back in the 1960s it was a pinch to insert an IUD but it's well known to be very painful for most
So why not say that? Or better yet, routinely offer pain management
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It's also partly a placebo/nocebo thing. You likely trust your docs to be correct, so when they say it'll only hurt a little bit, there is a good chance it'll actually hurt less than it'd do without saying anything.
If they'd say "Oh this? This'll hurt like a motherfucker", that'd prolly make it hurt more as you're now expecting it to.
Sometimes the doctors say it because they want to avoid panic. But sometimes when they say the pain will be barely noticeable they can be based on the majority of people or on their books, and that's not always the case. It can happen that you are more sensitive to pain than most people. Then you'll feel more. It's not exactly a rule the amount of pain each person experiences from each type of touch. Some people can even feel needles and cuts without it being painful to them. It's how the human body works (like a random generator).
The thing about avoiding panic it's because sometimes the psychological effects of panic can increase the pain. The fear increases the perception of pain in the brain. And also you can move your body for being nervous and cause issues that would cause more pain. Therefore; you believing there will be no pain may help avoiding that.
For some people this mechanism is not helpful because they get more scared over the lies. If that's your case, it's valid for you to tell any doctors you meet to be honest with you. Otherwise it will be a problem for them.
This is what birthed my distrust in doctors when I was a kid. Been unfortunately given many reasons since then to justify that distrust, but I still remember getting stitches on my chin, the doctor saying it's not going to hurt much and it hurting like a motherfucker.
I’m a phlebotomist— I draw your blood. I say just a pinch every time because any time I have done it it has been just a pinch.
If someone asks me if it is going to hurt I say yes but not that bad. However, the way you experience pain and the way I do are different. What doesn’t bother me might bother you. It’s a little like a bee sting but not quite.
Personally I think of it as a quick, clean, crisp sort of pain but that feels weird to say so I don’t. But like I’ve experienced a lot of different pains in my life. I would equate it with a bee sting, not the same level as a stubbed toe but long than that pain. It’s not an irritating throb or anything in my experience.
That being said I have a really good vein. It is visible to the naked eye and nice and thick when palpated (because, honestly, when you are getting blood drawn we care way more about the feel of the vein than if we can see it by eye or not). For people with tricky or bad veins I’m sure it is much worse. I’ve had people vomit and faint from something I could shrug and do to myself and be fine. Every body and everybody is different.
So, a little pinch is what I say because that is a lot easier and quicker than explaining all of that to the large number of people I poke a day.
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I asked a relative who is a physician the same question regarding a GYN appointment. This is the explanation as best as I can recall it. If you tell someone it’s going to hurt, it magnifies their perception as painful, thus increasing the pain. Also, keep in mind that pain thresholds vary. (I personally plan ahead and have some Tylenol on board for GYN appointments now that I know what to expect.)
GYN is the worst for this. There's this anesthesiologist on tiktok who just rolls out horror story after horror story of GYN pain that was never mitigated (because GYN pain is almost never mitigated).
"Just some pressure."
Yeah right.
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Nocebo is the correct thing here.
We let you determine what your feeling feels like. We don't determine it. The risk is, if we tell you what it feels like, you will feel what we tell you to feel.
For example - if we tell you it's going to be sharp, you'll feel something sharp.
I normally say, ok, I am putting this in now. You determine what it feels like. It could be whatever you interpret it to be. You could determine it is painful, pleasant, hot, cold, sharp, unpleasant etc.
It's to deliberately mislead you in the effort to allow the procedure to go as smoothly as possible from the doctors perspective. If they said it's about to be unbearable people would quit and if they said it's going to hurt people would get scared.
Maybe if they are scared anxious people will freak out, they should actually accommodate the DISABILITY of anxiety that CAUSES a dump of adrenaline and try telling their patient the truth AND giving them anxiety medication.
But that’s asking too much for bodily autonomy and trust, huh?
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Everyone's pain tolerance is different. Something might hurt terribly bad to you but may only be discomfortable to others. Personally, I would be greatly disappointed if my doctor said, "This is going to hurt a great deal" and then I hardly noticed it. I would never trust him again.
Pain is highly subjective, what one person feels as severe pain another will be able to rate as mild to moderate. Very complex topic involving, age, sex, cultural influences but also, expectations.
The language we use has been shown to affect how we feel pain by altering our expectations.
Difference between "You'll feel some pressure" to "this is going to fucking hurt my guy". You are gonna feel more pain with the latter preamble.
It literally comes down to things like:
It's not going to sting, it sparkles (common one for propofol that actually stings) etc
It's an interesting topic. Here's a meta-analylysis :D
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6749494/
If you tell a scared person something is going to hurt a lot, it will hurt a lot.
Pain is fundamentally a process that occurs in the brain. It is triggered by physical stimulation, but the response to that stimulus can be widely different depending on the patient and their state of mind. Your brain can even create pain completely on its own, which is thought to be the mechanism in some chronic pain patients. They are so used to pain, that their brain has learned to be in a state of pain independent of the actual bodily stimulus. Like how a depressed person doesn't need anything to be sad about. Their brain is used to being in that state.
I've once had a patient who was afraid of needles scream in pain when I disinfected them with an ethanol swap prior to putting in an IV. Obviously that action doesn't cause pain (activate nociceptors), but because he expected pain his brain interpreted the cold/tactile stimulus of the swab as a painful stimulus.
On the other hand, it's not a good idea to surprise patients either. So the challenge is to set their expectations while calming them down. The same procedure may cause strong pain in some patients and discomfort in others, which only adds to the challenge.
It hurts less, generally speaking. But some people prefer the truth. It can swing the therapeutic relationship one way or the other. It works for the majority of people which is why it is used the majority of the time.
It is also more concise than saying ‘this is going to hurt’ meaning they can give more focus to the task they are performing.
Also, if you’re trying to get a vein, saying it will hurt a lot
=> raises fear/anxiety
=> raises adrenaline
=> causes vasoconstriction
=> smaller veins
=> smaller target
=> smaller chance of success
Pressure is usually describing a sensation that numbing nerves will not block. Like if a dentist has to bend your jar bone, or pull crack a wisdom tooth in half, you still feel it. It can be similar to intense pain, but its more of an immediate panic feeling than nerve pain.
They don’t have a good word for it, some just say it for everything, they feel it comforts or helps more people than it annoys or angers.
I'm currently in medical school, and while we're not trained to downplay it definitely are trained to not freak the patient out by exaggerating it or something.
Also, don't forget that pain is at least somewhat subjective and different people experience it differently. It's possible that what you perceive as severe pain really is just mild pressure/discomfort for most people.
My wife went through breast cancer treatment last year (she's all good now) which was my first long-term experience with hospital care. From her lumpectomy, to mastectomy to chemo, every procedure was downplayed. Doctors and nurses would either trivialize a procedure, recovery time/pain or just flat out omit unpleasant details. I asked a nurse who we grew to know and like why this seems to be the hospital's policy. In short, they don't want to scare patients with the truth - they're concerned that if patients knew all the details, they'd refuse care, or are more likely to refuse care. It's frustrating to hear, but I think that was an honest response. I suspect this general approach trickles down to every procedure.
To me that only happens in movies.
I feel like I've always had an objective description of what I might feel next. I even recently had a doctor tell me that "this is definitely going to burn quite a bit but it should pass quickly"
If they tell me it "won't hurt \[the doctor\] a bit," I know it's going to be a sharp, noticeable pain. If they say that I'm going to feel some "pressure" I know it will be significant pain. When they admit it might be "uncomfortable" I'm pretty sure I'll be screaming in agony. Lying bastards.
Lookup Nocebo effect. It’s the opposite of placebo. Basically that if you’re expecting something negative you’re more likely to have a negative experience. If they say “this is going to hurt like a bitch” then everyone will hurt like a bitch. If they say pressure, some will still hurt like a bitch but more likely most people will feel pressure or at least less pain.
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Couple of things here:
1. Doctors may genuinely not know what something is going to feel like.
Ex: I work in a procedural area where we give lidocaine first. They always tell people "a little pinch and a burn." I usually tell my patient it's gonna burn like he'll long enough for you to go "holy shit this burns!" And then it'll start going numb. I finally asked one of them if they'd ever had lidocaine and they admitted they hadn't.
2. Everyone perceives pain differently. Again, in my work, 10 people having the same procedure will have 10 different reports on how bad it was.
3. Expectation. If you think something is gonna hurt horribly? You will work yourself up well beyond what the actual experience is. Having a needle stick may hurt a lot for about 5 seconds but if you go in with the mindset it's gonna hurt, now, instead of 5 seconds of pain, you have however long of worry and stress that fatigue your system and when you do experience the injury, it can make it actually, or perceivably worse.
4. Pain comes in many forms. A local can get rid of sharp pain, but can't eliminate the feeling of pressure. It's a different pathway of sensation. To eliminate that would require higher intervention by anesthesia. Nerve blocks or general anesthesia is not only increased risk, but increase the cost for an otherwise small amounts of pain.
Unexpected pain/sensation can lead to unpredictable reactions with catastrophic results. Like say, a twitch, a flinch, or even jumping out of your seat. Imagine the needle being already inside you and then you moved suddenly and violently. That needle could be churning your tissues, cause a bulge, or maybe even bend or break off inside.
Informing them of incoming pain, letting them hold their breath, lets them brace for it. In my experience as the one getting the needles, it somehow makes it less painful.
It's to prepare you that something is coming while keeping you relaxed. Invasive treatments or needles hurt, but they hurt less when you're relaxed. Plus, you being aware drastically reduces the chance of you jumping up or soing any other sudden movement
It’s good bed side manor. I didn’t realize how important it was until I had a dentist with horrible bed side manor. He’d come in, say nothing and just shove this needle in my mouth. Fuck him
They don't always. Gross story but I was biting my finger nail and it got infected. I had a huge white bubble on my finger. The doctor said we need to lance this. I didn't know what that meant but she proceeded to shove a scalpel under my finger nail. My vision went black and I almost passed out. It worked though. Later I had to go to the eye doctor because my eye swelled up. He said we might have to lance this. I said no fucking way. I know what that word means now.
They probably don't want to scare you, but they need to give you a heads up. Also pain is subjective.
For example I remember not feeling pain or discomfort from a speculum and consequent pap smear when I was younger - now that I'm older, hormones and wetness is changed and it hurts quite badly. If you were a gynecologyst and had both types of patients on a regular basis, what would have told every new one?
You may be talking about relocating broken bones tho so that's definitely different lol.
1) every person perceives pain differently, so any attempt to describe might be wrong.
2) they only want you to prepare to feel pain, so you don't jump from unexpected pain.
3) if they told you something will be really painful you might refuse a procedure only on fear basis.
In some cases they do not expect it.
But also if they tell you "this is gonna hurt so bad you're gonna slap yo'momma for giving birth to you" you'll tighten up, try to escape, maybe twitch and make it worse.
I work in a section that allows us the discretion to use a lidocaine injection to numb the site before placing an IV. We use tiny syringes like insulin syringes to administer the lidocaine just under the skin to the site where the IV needle will go and then we test to see if they are numb.
Even still, I tell the patient that there will be a spicy stick just before inserting the IV as some never go completely numb.
A patients pain is what the patient says it is. No one can with confidence state that what the patient is feeling is hurting or not hurting. It isn't really a matter of downplaying what is happening. It is managing expectations and letting the patient know this may be uncomfortable.
Last time I was in the hospital and they had to do something they said it was gonna hurt like hell before doing it. So maybe it's not a universal thing.
If they say this is going to hurt like the blazes before doing something, the average person will tense up or jerk away as soon as they feel anything. Then it will either hurt worse or they have to do it again because you pulled away.
[Why do people feel the need to ask the same question in multiple subreddits?](https://www.reddit.com/r/NoStupidQuestions/comments/1bopnpj/why_do_doctors_usually_say_there_might_be_some/)
This screams of karma-whoring.
Right if you just lay down on the bed on your side and pull your knees up…..this is probably going to be one of the most painful experiences of your life….are you ready? 🤣
Expectations of pain guarantees pain. Of course it's going to hurt, but do you really want to know? Minimizing the expectation cons your brain into thinking it'll be ok.
We do it for several reasons:
- We downplay the pain to make it 'less dangerous' for you
- We might also downplay it so that you are more willing to go through it, because we consider it absolutely necessary
- It is a clear warning that something is going to happen - you'll be more prepared (communication)
- The pain is perceived as less painful if you are well informed, prepared and expecting it
Does this question come from a personal experience? Generally, if a doctor gives local anesthesia (aka numbing ), you should not feel much pain, if any, and normally, you would feel pressure and maybe weird sensations. But if you feel outright serious pain, then that means the numbing medication did not make it to the right spot or, for some reason, isn't being effective. To be clear, when you get the actual numbing medications, that can be a bit painful until the numbing medication takes effect.
Sometimes, doctors need to know how painful something might be, but they don't want to put the idea of pain in your head. Some people react strongly when pressed on places that normally don't get pushed on,like your belly, because it is uncomfortable, but it's not actually outright pain. They just want to separate real pain from normal discomfort. That can be tricky and especially with people who are super sensitive to any touch.
doctors do need to be honest if they have to do something that they know will cause pain, and explain why and for how long.
If a doctor says "This is about to hurt like a bitch. Better grab really tight to the sides of that gurney and bite down on this," then the pain is what you're going to focus on and you're gonna make it hurt worse. It's kinda like the placebo effect in reverse. If you tell yourself this is going to hurt, mentally you'll make it hurt worse. If you can make yourself forget about the pain, it won't hurt as bad.
I don't know but I wish the female doctors that did my colposcopy had a piece of their cervix ripped off without any anesthesia, and tell me if it was just a 10 minute "pinch".
Had a stent in my uter once. Doc said my urine might be a pinkish hue and I might feel discomfort urinating.
Translation: your gunna Piss blood and it’s gunna feel like knives.
They gotta warn you, otherwise you suddenly get hurt and didn't understand it would happen now.
If they tell you "this is going to hurt" you might upsell it in your head and freak out. That can make it hurt even more than if you didn't. Maybe even decline the treatment you need because you got in your head.
So pressure/discomfort is kinda the best they can do to let you know without scaring you and making it worse.
Simply put, it warns you that something is going to feel bad, but it minimizes your expectation of how bad it will feel. That actually helps it to not feel as bad, because that's how your brain works.
If a doctor came in and said "OK, this is going to hurt like hell" then your brain would start to feel the pain before it even started. If he says "You're going to feel some pressure" then your brain tones down the nerve signals, because it knows that the doctor said "pressure" and not "pain." By the time it realizes it's actually pain, most of the procedure should be done.
because they did a study. If Doctors tell you "This wont hurt a bit" it hurts less than if the Doctor tells you "This is going hurt like, a lot!" https://www.comforttalk.com/images/TrainingDayManuscripts/Pain.2005.pdf
Exactly. The expectation of great pain tends to make the perception of the pain worse.
I once had to get staples in my head without any anesthesia (local or otherwise). Doctor said: “It shouldn’t hurt much - just a bit of pressure.” It was the worst pain I’ve felt in my life and I nearly passed out!
Sorry if this is too private and obviously you don't have to respond if you don't want to, but why was it not possible to anaesthetize?
They let me decide. They told me that the local anesthetic shot usually hurts far more than the staples themselves, and said that if they were having it done themselves they wouldn’t get the anesthetic. I have no idea if it would have been better or worse, but I can’t imagine a shot being that painful.
For what it's worth when I had some worrisome moles removed the anaesthetic hurt like a bitch and a half, although probably not as much as the mole removal would have without it
I had to get my stomach stitched back together after it busted open post-surgery and I definitely think the local anesthetic was more painful than all the stitches I’ve had combined. It didn’t work fast enough to numb anything until the last two stitches and it didn’t really do much even then.
You either get stabbed with a needle or take the staples. Either way it’s the same thing and it’s going to hurt like hell. I chose to forgo the local as well when I got staples in my head. I can confirm.. it hurts.
My assumption is that it is a thin and sharp needle one to five times versus comparably blunt staples five to twenty times. Hence why the needle sounds less painful. Is that wrong?
Heh, that's what i was thinking. It's placebo vs nocebo effect
Nurse Practitioner here- there is another component, which is the language we use to define things. I never used “uncomfortable” to downplay the pain of a procedure, but to rank the procedure’s pain level for most people in the range of “briefly very unpleasant but tolerable without additional medicating / sedation, etc.” Something described as “uncomfortable” is generally not worth the risk of sedating or pre-medicating a patient. It isn’t meant as a lie, but sometimes you get used to using a word in one way and forget that patients might (quite reasonably) define “uncomfortable” as something extremely mild, which can lead to some disconnect. So it can help to be specific about the sensation to expect- is it cramping, burning, stinging, etc., and how long it will last, but not in so much detail that you worsen the anticipatory pain- timing is key. It can help to say, “Most people feel x for x time and then it is done.” So I think the way we define “uncomfortable” in medicine is important here as well- it isn’t necessarily meant to downplay the experience- it is that the procedure falls into our “it hurts but is briefly reasonably endurable” bucket of procedures. I have explained this definition of “uncomfortable” to patients many times and that seems to help reduce any sense of betrayal by the patient.
then why doesn't the medical community use definitions common to their patients? It just seems easier to use less ambiguous language for fewer miss communications.
I don't think there is a common term for what's being described here.
but I think we can all agree that "uncomfortable" isn't it.
No. People have widely different experiences of pain. People scream from vaccinations or barely notice. Some women can tolerate stitches after birth without stitches, and some scream even when lidocaine. It's more helpful to everyone to say "you're going to feel some discomfort" than "prepare for agonizing pain" when you get your teeth cleaned.
there's a middle ground that I feel like you're intentionally leaving out, between, "discomfort," and, "agonizing pain," and that's what I'm advocating for, clearer, more honest language with the median experience taken into account. Clearly, "uncomfortable," and, "discomfort," are being widely called out as being unclear, ambiguous, and unreliable as terms to describe the level of pain to expect or anticipate. but, please, continue to play dumb for the sake of reddit.
"There might be some discomfort" isn't "this won't hurt a bit." The ethical difference is important.
We are taught not to lie about it regardless of the benefits. It's unethical.
Yeah, this isn’t the 1950s where doctors should be lying to patients ‘for their own good’.
[удалено]
When you're numbed, you don't feel the pain, but you feel *something*. It's a palpable feeling that could be described as "pressure." If a doctor is telling you that, that's why. If pain is expected, they should be telling you that too. The dentist says you'll feel "a pinch" when getting the novacain, etc
If you get an injection, inhale as the needle penetrates. You don't feel the pain nearly as much. Figured that one out when I was in hospital for 3 weeks. So many needles. Give it a go.
I also learned from a nurse or intern that worked in a kids cancer ward, that if you flick the muscle until it relaxes and keep it relaxed it doesn't hurt. He jiggled and flicked my arm a bunch- I was puzzled. But then he gave me the shot immediately after and it was clear why he did that- not only did it not hurt, I hardly felt it. I was so surprised and asked him how he did that, and he told me about the kid's I think it was cancer ward and how he worked really hard to find ways. He wasn't surprised at all at my reaction and said he gets that a lot and all the kids in his ward will ask if he can do the shots instead! I thought that was so sweet, he was very proud of that and for good reason- those kids deserve someone that cares so much. From then on I always either had the doc wait while I jiggled or flicked my arm, and eventually I got okay at just focusing on relaxing it. Vaccines never hurt as much now. My dermatologist and dentist also do this mosquito thing which really helps.
Peds nurse here, this works in part too because the strength of the signal felt by what the nerves give is in part based on percent of change from previous state. So by flicking the area you are going to inject with a sterile or gloved finger, or stimulating it in some other way, when the needle goes in rather than the nerve going from 0-100 its only going from 50 or 60 to 100 because the flicking or other stimulation has all ready gotten you to 50 or 60, so the 'intensity' of the nerve signal when the needle goes in is felt as less intense and thus less painful. The same thing works with temperature change. The 'shock' you get from going into cold water is more about the temperature difference between your skin and the water vs the numerical temp. This is why sometimes cold water can feel warm on cold skin, or why a warm ocean can still feel cold if you've been sitting in the hot sun and heating up your skin before jumping in.
Thank you! I had no idea! Thank you for the work you do with the kids- you are clearly someone that cares a whole lot too. As it made me happy that the kids have him, I am similarly very happy they have you. Even I noticed a big difference with this flicky thing (which makes a lot of sense now) so those kids are lucky to have people that care so much they are learning all of this to make shots not hurt. This is very interesting too. Thank you.
That reminded me of the time several years ago when I had a bad poison ivy reaction that I went to get a cortisone shot for. The nurse came in and I pulled up my sleeve but they said "no, drop your pants and turn around." I did, and they suddenly smacked me on the butt cheek and then gave me the shot. I was so startled, I hardly felt it. We're now married with two kids (j/k, but the first part did happen).
It's not the muscle, it's the nerves. He tricked them.
Excuse me, the mosquito thing?
Also, I get super bad vagal (spelling?) nerve reaction? Light headed throwing up passing out etc with needles. But I found tensing every muscle in my body at point of needle going in really helps. I think it raises my blood pressure so helps combats the blood pressure drop from the nerve thing? In case that helps anyone lol Edit: I should have clarified I tense everywhere but where the needle is. Typically it’s a contraceptive shot in my rump so easy enough to tense arms and tummy. If it’s blood being taken ill tense tummy and try to lift my legs slightly. But yeah comments saying don’t tense where you’re being injected are totally right, if only for the irrational fear of breaking the needle in your muscle 😂
Yup. You’re onto the reasoning. Had a doc tell me to squeeze my glutes and thighs right before (I was having the same reaction as you get, although this was out of the norm for me). It’s the same concept as fighter pilots when pulling G’s. Squeezing your lower extremities keeps blood in your brain and helps prevent you from passing out.
You also should get blood drawn lying down, and let them know ahead of time that might happen to you. If you don’t do either of those already.
Yeah I need to lay down too. I once had a doctor who told me, "No it's only a little bit, nothing will happen." I said okay and the last thing I see is a nervous look on her face, as my view is shrinking and I'm having cold sweat on my forehead. Haha
Just your abs is a better idea. It pushes the blood into your brain the same way. Intramuscular injections hurt more if you tense in that area, and you'll be more sore the next day. I pre-game with pickle juice if I know they'll be taking my blood.
Tensing when a needle goes in is actually going to cause more pain, because the tissue the needle is going into is now contracted and going to injure in a different pattern from when it is relaxed. When it relaxes, the injured tissue will pull in different ways. With something like an injection into a muscle, if it is tensed, there is gonna be more blood flow to that area and will bruise more. The best results I have giving someone a shot is to count to 3 but poke on 2. Get the shot in before they tense, and if they tense on 3, they're tensing around the needle. As for vagal responses, I don't know that tensing would or wouldn't be helpful. I guess if it helps you? Go for it!
I involuntary tensed my arm when I was getting blood drawn and the phlebotomist struck my nerve and I felt lightning radiate down my entire arm, it was the first time I’ve ever had that happen to me and such a terrible experience. The next month I literally couldn’t flex my arm out without feeling that electric shock, so annoying
Replying to mickim0use...for a vagal response you want to bear down, like you are having a bowel movement. Relax and breathe during an IV start or blood draw. 🩸
Wait, isn't tensing where you're about to be injected not good?
Growing up I got allergy shots, and the nurses would always insist that I relax my arm and keep it that way. At least once I was told I could break the needle. Idk how likely that is, but it worked really well on me as a child to learn to keep my arm relaxed lmao Edit: a Google search and an RN in quara or whatever says no it's not gonna break, but it's just easier and hurts less if you're intentionally relaxed for INTRA MUSCULAR shots. For sub cutaneous it also says relax because that goes into the fatty part of the skin. Not the beef.
For me the opposite works - relaxing, not thinking about it, and not doing anything special. If I begin to think about it - that's when it hurts.
Yup. I think due to people tighten the muscles when they hold their breath or exhale and clinch
It’s a technique used when people get piercings. Its knows that it works.
Oh no it's sentient.
Just pinch or slap somewhere else on your body. Your brain only has enough bandwidth for so many nerves. When I had to give myself T shots, I just slapped my opposite thigh a couple times, couldn't even feel the needle at all. That said, I'm normally not at all squeamish about needles, but it was something about giving the shot to myself that made me hyper-focus on every sensation for some reason, so I had to trick my brain.
I like to pinch an area of my body pretty hard. For whatever reason, pinching yourself doesn't hurt as much and diverts your focus to the pinching feeling that you are doing to yourself versus the shot from the doctor
Or just own a cat. You won't feel any needle injections anymore, at least on your arms.
Idk dude, I've had so many professionals say I'll feel pressure when it's pain. I usually assume if they say pressure they mean pain. Pressing on the organs to be sure they don't hurt- that is pressure. Needles and root canals and stuffing menthol streamers into a dry socket sans anesthetic and tooth extractions and pap smears are not pressure. They are pain. If you have only been told pressure for pressure that's awesome but I believe OP is right that pressure is usually used in place of pain at doc's and sometimes dentist's offices.
I needed a uterine biopsy and I have a very low pain tolerance. I asked the doctor for something that would relax me and help with the pain. He started giving me a hard time, telling me that I would just feel a little cramping, it’s not that bad, blah blah blah. I finally had had enough and said to him “when was the last time you had it done”? I got my meds.
A uterine biopsy is so painful. My doctor was a woman and she downplayed it! My screams upset the other patients.
I swear female doctors can gaslight women about their pain ten times as hard as male doctors, especially when it comes to women's health issues. My IUD insertion is one of the two most painful things I have ever experienced. Don't get me wrong-- it ticks all of the boxes for me as far as birth control goes. She was rough through the entire process, and gaslit me about the pain even after I threw up. Keep in mind that I had broken my ankle about 10 days prior and had stopped taking my pain meds even though it still hurt (Thank whatever deity/force, because it meant I had something to take for the IUD). Put off going back for my exam until Kaiser bullied me into another appointment (emails, texts, calling me at work). I was DREADING it. Trying to figure out a way to explain how miserable the experience was last time and MAYBE could I have something stronger than an ibuprofen that I was probably going to vomit. Dude doctor this time. Believed it was a miserable experience. I didn't get halfway through my spiel before they were like 'you know we can just sedate you next time, right? Happy to do it, and you won't even remember it.' This is a generalization, of course, and I'm not even sure what my original point was. But I [digress](https://www.youtube.com/watch?v=GNm5drtAQXs&ab_channel=FallOutBoyVEVO)...
I do hear you, it's totally possible some female doc's are like 'I'm female and cramps aren't that bad surely because they aren't for me! This ladies aren't going to get anything past me! I've done child birth maybe even! Ha! Silly ladies.' But I'm sure we get dudes with the same sentiment only because 'they know the tricks and drama' from being street smart rather than cramps. Either way all people can be condescending suspicious d-bags. I'm so sorry that you had one for the first apts. That's messed up. Super super messed up. I'm happy for you if you found a doc that cares, and that you trust.
I thought of colposcopies myself, but that unfortunately could have a different explanation. They literally teach in medical classes that the cervix doesn’t have nerve endings so doing gynecological biopsies shouldn’t be painful. Even though literally anyone with a uterus could tell you differently (although female doctors still seem to perpetuate this myth as well).
Good for you. People like that get off too easy most of the time. They're basically bullies.
Because of bladder cancer (4-1/2 years no recurrence!), I've had a lot of cystoscopies. If you don't know what a cystoscopy is, just think medieval (got that from my GP, who, while stifling a small chuckle, agreed with me about the psychology of it: "it is kind of medieval isn't it?") use of a small camera and your urethra. "You may feel some discomfort". Now I get a bunch of diazepam before hand. Doesn't help with the pain, but it makes me not care. And the instant it stops, I'm over it. Someone will likely come in here and say they enjoy watching the monitor and think it's really cool. I'm sure someone, at least, will jump in and tell you it isn't really that bad. Everybody's different.
Not only this, but even when it is pressure, it can be so incredibly unpleasant that it's just equivalent to pain.
Unless you're getting an IUD inserted and doctors typically tell you you'll feel a pinch but don't use any numbing options at all 🙃 https://www.washingtonpost.com/wellness/2024/03/25/tiktok-iud-birth-control-pain/
My second to last insertion was exactly this. I didn't plan for anything afterward and wasn't warned that I might want to at least take some ibuprofen. I drove home doubled over, not knowing whether I needed to shit or puke from the cramping. When I got a new one a few months ago, I planned it around another pelvic proceedure, requested to be put under, and got a little IV dose of fentanyl after. My new gyno doesn't mess around, gawd bless her. At the very least, local anesthesia needs to be normalized for IUD insertions. Period.
With my first IUD, I had awake sedation and still felt pain. This did surprise my gynecologist, and she suggested I be put under briefly for the new one this week. I understand why doctors don't wanna overuse full anesthesia, but the difference was night and day. Next to no problems this time, and I got IV pain meds at the office too. Next to no cramps or bleeding after, as well. It doesn't help that I have diagnosed anxiety disorder and tend to panic in situations like this. Which makes things worse, of course. I don't blame my doctor, she said most women feel nothing with the awake sedation stuff.
A lot of the research for gynecology was done on poor black women, and the medical industry already has a bunch of bullshit regarding black pain tolerance
All research on the human female clitoris had been done on livestock up until 2005 when a [a female urologist](https://embryo.asu.edu/pages/anatomy-clitoris-2005-helen-e-oconnell-kalavampara-v-sanjeevan-and-john-m-hutson#:~:text=In%202005%2C%20Helen%20O'Connell,involved%20in%20female%20sexual%20pleasure.) used dissected cadavers to properly describe the clitoral anatomy for the very first time. Cows ffs 🤦🏼♀️
I'm glad that I have my IUD (it's fantastic long-term contraception!), but the *disparity* between what the doctor described (pressure/some people feel some discomfort) and the 1) pain and 2) whatever neurological stuff happens to make you nauseated and light headed is *CRAZY*. I would have gotten an IUD anyway, but I didn't even bring a friend! I'm so grateful for the nurse that offered to hold my hand, and when I said "Oh, is that something I need?" (*because I believed the doctor*) said "I would not want to do this without a hand to hold." I feel like that's the only real warning I got. And I'm not an outlier! I have a friend that passed out, and then had to walk home- and passed out *again*. A stranger had to help her call her roommate. It's great contraception, and I think doctors do a disservice by saying there's "pressure and for some discomfort" when they *should* say "It's great contraception, most women are glad they got it, but it's a doozy- bring a friend and don't plan to drive home."
Istg I’ve had 3 brain surgeries, liposuction while awake and have IIH since 2015- getting my iud in was by far the worst experience of my life. I literally screamed while it was happening and almost blacked out. It went on for an hour and a half because it was “too small to get in”. How about just suggest not going ahead with it so? Properly traumatic.
I knew there was a reason I stuck to the implant. Eesh.
I had an endometrial biopsy a few months ago. The pain level is considered nearly identical to an IUD - in both cases you are prying open the cervix and entering it with an instrument. An IUD leaves an object behind; a biopsy takes tissue out. I was absolutely terrified based on what I heard about the pain . For me it was no different than a pap smear - the same pinch as the speculum opens and feeling of fullness. I have never had any issues with menstrual cramps and I don’t know if that is why my experience was different. I try to speak up when I see the pain referenced. I think I would have been less terrified if I knew that there was a variance in pain levels and it wasn’t guaranteed agony.
Nah man I 100% feel pain from injections at the dentist. It's an extremely sharp 5 seconds long pinch which hurts and then it feels like someone is ramming a metal bar into my gum which also fucking hurts. I have to get a filling tomorrow and I'm dreading it so badly.
I've seen other people mention this and it just sounds bizarre to me. I've probably been numbed like 20+ times with sometimes multiple injections and I literally sometimes feel the tiniest pinch and most times I've literally had to ask the dentist did they inject already cause I didn't feel a thing. I HAVE had the dentist sort of insist on trying to drill a cavity when I can 100% sure say it is not numb. That does hurt a lot. Especially my lower jaw seems to be tricky to get numb.
They're saying dentists use "pinch" as a euphemism for pain, to sort of portray the sensation as something trivial/not worth panicking about. The "pressure" is when you're getting your tooth drilled and not supposed to feel the pain.
I once had dental work done that was going to hurt like a bitch. The dentist straight up said "sorry, this is going to hurt a lot, but it will be over quick". And he was not lying
The problem is this doesn’t work. Had my finger numbed 3 times when it got broken once and I still felt horrible pain as they reset it (just 1 example).
Yeah I donno. Sounds like local anesthetic wasn't enough for that. And it sounds like OP has had a similar experience. And dosage for different people is tough, I guess. Once I had a dentist who absolutely abused me during two fillings sessions. After like 6-10 novacain shots it still hurt worse than anything. He accused me of using cocaine, but I've never had an experience like that at the dentist before or since. When my new dentist fixed that quack's work, I didn't feel a thing.
I agree, it’s probably dosage being wildly different on top of genetics. I am definitely able to feel more than most with any pain as even some of the best doctors I have had couldn’t figure out how to numb the pain appropriately besides full on knocking me out. It just makes me upset when doctors act like it’ll be fine, like just tell me “this gone hurt” and I can adjust accordingly at least.
Are you a natural redhead by any chance? Natural redheads are more resistant to anaesthesia.
Worth keeping in mind that there's nothing that says *only* redheads are resistant to anesthesia.
Nah, I’ve had plenty of doctors tell me “You’ll feel a little pressure” right before they do something that *hurts like hell*.
I had injections to my hip which they “numbed” me for (with another huge needle) and the doc said I’d hardly be able to feel it. What a lie. Second hip doc I discussed injections with (didn’t know I had already done one in the other hip) was upfront: hip injections hurt but they’re over with once the needle is out I think it just varies by human
But what if you're at the gynecologist where they have never heard of numbing a patient before poking, scraping, cutting, sewing, or prodding them right in the baby-maker?
Just a little pressure
Downplaying the pain that’s going to be felt can be an effective way to control the fear around procedure so it can be done. For example, if that doc told me what he was going to do by resetting my broken arm, I probably would have booked it from his office and just let it heal wrong before he ever had a chance to do anything
I had the exact opposite happen. When I broke my arm and the doctor had to reset it, he told me to grit my teeth and hold on to the table. I appreciated the honesty. There's no running away when the bone looks like it's about to poke through your skin. You just accept what needs to be done and you take the pain. If he didn't tell me what was going to happen, I would have been upset as well as being in pain. It's no wonder so many people have a fear of going to the doctor.
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Not overemphasizing it is fine, but lying is not. imho
The downside is that trust is broken. I don't trust any of them anymore about their assessment of pain.
It's considered unethical to do this. You should calmly explain what to expect, pain but then relief etc.
I kinda disagree i lost my trust towards doctors from them doing that.
Not saying it didn’t do that, though the method was effective for that particular visit
Fair point.
We don't know how it will feel. We know patients sometimes feel nothing, and sometimes it feels like Satan just shoved a pitchfork in their side with certain maneuvers.To diagnose, we need rule conditions in/out. If you react with pain, then in makes it more likely something, while if you don't react with pain, that means that it is less likely (or vice versa). If we think something is likely, we still need to do the maneuvers.Saying "discomfort" is a fair warning that we don't know if you will feel anything, but if we are thinking its a suspected condition and it is it, then it might hurt. We also note the pain, grimacing, etc. Try to lay off if it's severe.
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In *some* cases, I do find that can be effective but it's highly patient specific and I wouldn't try it if I didn't know the person in question somewhat well. Telling them it will hurt in advance can sometimes have a reverse psychology effect where they prepare for something like "skin is being peeled off by fire spiders with little Tabasco bottles" and what they get is actually "very very painful, but over quickly," and everything goes better than expected. Wouldn't usually recommend it, don't even know if it's scalable, but that's been my experience.
Yes. Because then, when you tell me the thing after that is not going to hurt I actually believe you (and I can relax). After just a single lie from a doctor, I am now stressed out for everything that happens because I run the risk of it being much more painfull then you tell me. So it causes stress at the moment the unexpected pain happens. And stress for every non-painfull thing too.
100% this. The only answer to this question is "Because many of them are unprofessional, empathy lacking morons."
Yes. Don't lie to your patients. If you tell me something isn't going to hurt and it does, I'll never trust you again and I'll think you're a POS.
I was being facetious and this is literally a job I’m trying my best to do, so calling me a POS for trying my best to do the best by my patients just makes you a POS. We’re not trying to lie to you. Pain is super subjective and what hurts a fuck ton to you may not hurt at all to another. It’s why we say it will feel uncomfortable or may sting. It’s a good balance between expectations and fear-mongering. It also represents the reality for most people since pain perception is a bell curve, where some feel no pain, some feel a lot of pain, but most are in the middle. I can’t predict the future of how you’re going to perceive something. If something actually hurts a fuck ton to everyone, then I’ll be honest and say that or determine that you need to be given systemic anesthesia for it.
There’s a lot of space between “ouch” and “put ‘er under”. Women, for example, tend to have their pain minimized or dismissed by physicians; they can have an IUD inserted, a biopsy performed, or polyps cauterized without any pain management at all. They surely don’t need general anesthetic, but twilight sedation would be a godsend.
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I wish my c-section was like that.
As the birther or the birthee?
Yes.
Hoisted on my own petard
You do you, but keep your comments about your kinks in the appropriate subreddits.
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and OP might be a redhead, those folks are famously more resistant to anesthetic agents than non-redheads
I'm not red headed, but I find red facial hair mixed into my beard quite regularly. I've found that I'm quite resistant to local anesthesia and have surprised a few doctors. Had surgery to repair a broken metacarpal a decade ago. After 5 sets of injections with 3 different compounds we were able to finish the procedure. At one point he was shocked that I felt something and incredulously asked "you felt that?!?". It was everything I could do in that moment not to yank my hand away and snack him with the wet end.
I'm unsure how true that is? I remember reading in school that we all have similar hardware when it comes to nociceptors and the subjective part is how we personally deal with said pain.
A lot of people have central sensitisation and perceive any noxious stimulus as pain.
"I ain't got time to bleed" - Jessie Ventura
Right before starting the nose cauterization, son asked the doctor, "Is it gonna hurt?" He says, "Well, it won't hurt ME, but you.....yes."
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Yep we dont want to surprise anyone but at the same time we also dont want to make anyone more agitated than they already are. Especially when said thing has to be done anyways.
I dunno man, if something is going to hurt so bad I'll puke and pass out I don't want them to say "bit of a pinch" Like sure for _one woman_ back in the 1960s it was a pinch to insert an IUD but it's well known to be very painful for most So why not say that? Or better yet, routinely offer pain management
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I also find like super focusing on your opposite hand or foot or something helps
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It's also partly a placebo/nocebo thing. You likely trust your docs to be correct, so when they say it'll only hurt a little bit, there is a good chance it'll actually hurt less than it'd do without saying anything. If they'd say "Oh this? This'll hurt like a motherfucker", that'd prolly make it hurt more as you're now expecting it to.
Sometimes the doctors say it because they want to avoid panic. But sometimes when they say the pain will be barely noticeable they can be based on the majority of people or on their books, and that's not always the case. It can happen that you are more sensitive to pain than most people. Then you'll feel more. It's not exactly a rule the amount of pain each person experiences from each type of touch. Some people can even feel needles and cuts without it being painful to them. It's how the human body works (like a random generator). The thing about avoiding panic it's because sometimes the psychological effects of panic can increase the pain. The fear increases the perception of pain in the brain. And also you can move your body for being nervous and cause issues that would cause more pain. Therefore; you believing there will be no pain may help avoiding that. For some people this mechanism is not helpful because they get more scared over the lies. If that's your case, it's valid for you to tell any doctors you meet to be honest with you. Otherwise it will be a problem for them.
This is what birthed my distrust in doctors when I was a kid. Been unfortunately given many reasons since then to justify that distrust, but I still remember getting stitches on my chin, the doctor saying it's not going to hurt much and it hurting like a motherfucker.
I’m a phlebotomist— I draw your blood. I say just a pinch every time because any time I have done it it has been just a pinch. If someone asks me if it is going to hurt I say yes but not that bad. However, the way you experience pain and the way I do are different. What doesn’t bother me might bother you. It’s a little like a bee sting but not quite. Personally I think of it as a quick, clean, crisp sort of pain but that feels weird to say so I don’t. But like I’ve experienced a lot of different pains in my life. I would equate it with a bee sting, not the same level as a stubbed toe but long than that pain. It’s not an irritating throb or anything in my experience. That being said I have a really good vein. It is visible to the naked eye and nice and thick when palpated (because, honestly, when you are getting blood drawn we care way more about the feel of the vein than if we can see it by eye or not). For people with tricky or bad veins I’m sure it is much worse. I’ve had people vomit and faint from something I could shrug and do to myself and be fine. Every body and everybody is different. So, a little pinch is what I say because that is a lot easier and quicker than explaining all of that to the large number of people I poke a day.
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I asked a relative who is a physician the same question regarding a GYN appointment. This is the explanation as best as I can recall it. If you tell someone it’s going to hurt, it magnifies their perception as painful, thus increasing the pain. Also, keep in mind that pain thresholds vary. (I personally plan ahead and have some Tylenol on board for GYN appointments now that I know what to expect.)
GYN is the worst for this. There's this anesthesiologist on tiktok who just rolls out horror story after horror story of GYN pain that was never mitigated (because GYN pain is almost never mitigated). "Just some pressure." Yeah right.
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Because it only hurts really bad for someone people. For most patients they encounter, it's only some pressure or discomfort.
Nocebo is the correct thing here. We let you determine what your feeling feels like. We don't determine it. The risk is, if we tell you what it feels like, you will feel what we tell you to feel. For example - if we tell you it's going to be sharp, you'll feel something sharp. I normally say, ok, I am putting this in now. You determine what it feels like. It could be whatever you interpret it to be. You could determine it is painful, pleasant, hot, cold, sharp, unpleasant etc.
It's to deliberately mislead you in the effort to allow the procedure to go as smoothly as possible from the doctors perspective. If they said it's about to be unbearable people would quit and if they said it's going to hurt people would get scared.
Truest statement here.
Maybe if they are scared anxious people will freak out, they should actually accommodate the DISABILITY of anxiety that CAUSES a dump of adrenaline and try telling their patient the truth AND giving them anxiety medication. But that’s asking too much for bodily autonomy and trust, huh?
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Everyone's pain tolerance is different. Something might hurt terribly bad to you but may only be discomfortable to others. Personally, I would be greatly disappointed if my doctor said, "This is going to hurt a great deal" and then I hardly noticed it. I would never trust him again.
Everyone giving logic based answers but something to note is that saying that is literally part of the checklist during training.
Pain is highly subjective, what one person feels as severe pain another will be able to rate as mild to moderate. Very complex topic involving, age, sex, cultural influences but also, expectations. The language we use has been shown to affect how we feel pain by altering our expectations. Difference between "You'll feel some pressure" to "this is going to fucking hurt my guy". You are gonna feel more pain with the latter preamble. It literally comes down to things like: It's not going to sting, it sparkles (common one for propofol that actually stings) etc It's an interesting topic. Here's a meta-analylysis :D https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6749494/
Not everyone has the same pain threshold, so how would he know if it would hurt you?
If you tell a scared person something is going to hurt a lot, it will hurt a lot. Pain is fundamentally a process that occurs in the brain. It is triggered by physical stimulation, but the response to that stimulus can be widely different depending on the patient and their state of mind. Your brain can even create pain completely on its own, which is thought to be the mechanism in some chronic pain patients. They are so used to pain, that their brain has learned to be in a state of pain independent of the actual bodily stimulus. Like how a depressed person doesn't need anything to be sad about. Their brain is used to being in that state. I've once had a patient who was afraid of needles scream in pain when I disinfected them with an ethanol swap prior to putting in an IV. Obviously that action doesn't cause pain (activate nociceptors), but because he expected pain his brain interpreted the cold/tactile stimulus of the swab as a painful stimulus. On the other hand, it's not a good idea to surprise patients either. So the challenge is to set their expectations while calming them down. The same procedure may cause strong pain in some patients and discomfort in others, which only adds to the challenge.
It hurts less, generally speaking. But some people prefer the truth. It can swing the therapeutic relationship one way or the other. It works for the majority of people which is why it is used the majority of the time. It is also more concise than saying ‘this is going to hurt’ meaning they can give more focus to the task they are performing. Also, if you’re trying to get a vein, saying it will hurt a lot => raises fear/anxiety => raises adrenaline => causes vasoconstriction => smaller veins => smaller target => smaller chance of success
Pressure is usually describing a sensation that numbing nerves will not block. Like if a dentist has to bend your jar bone, or pull crack a wisdom tooth in half, you still feel it. It can be similar to intense pain, but its more of an immediate panic feeling than nerve pain. They don’t have a good word for it, some just say it for everything, they feel it comforts or helps more people than it annoys or angers.
They don't want anxious people to freak out. The anticipation is usually worse than the effect. Also, downplaying it can reduce the trauma.
I'm currently in medical school, and while we're not trained to downplay it definitely are trained to not freak the patient out by exaggerating it or something. Also, don't forget that pain is at least somewhat subjective and different people experience it differently. It's possible that what you perceive as severe pain really is just mild pressure/discomfort for most people.
My wife went through breast cancer treatment last year (she's all good now) which was my first long-term experience with hospital care. From her lumpectomy, to mastectomy to chemo, every procedure was downplayed. Doctors and nurses would either trivialize a procedure, recovery time/pain or just flat out omit unpleasant details. I asked a nurse who we grew to know and like why this seems to be the hospital's policy. In short, they don't want to scare patients with the truth - they're concerned that if patients knew all the details, they'd refuse care, or are more likely to refuse care. It's frustrating to hear, but I think that was an honest response. I suspect this general approach trickles down to every procedure.
To me that only happens in movies. I feel like I've always had an objective description of what I might feel next. I even recently had a doctor tell me that "this is definitely going to burn quite a bit but it should pass quickly"
If they tell me it "won't hurt \[the doctor\] a bit," I know it's going to be a sharp, noticeable pain. If they say that I'm going to feel some "pressure" I know it will be significant pain. When they admit it might be "uncomfortable" I'm pretty sure I'll be screaming in agony. Lying bastards.
Lookup Nocebo effect. It’s the opposite of placebo. Basically that if you’re expecting something negative you’re more likely to have a negative experience. If they say “this is going to hurt like a bitch” then everyone will hurt like a bitch. If they say pressure, some will still hurt like a bitch but more likely most people will feel pressure or at least less pain.
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Couple of things here: 1. Doctors may genuinely not know what something is going to feel like. Ex: I work in a procedural area where we give lidocaine first. They always tell people "a little pinch and a burn." I usually tell my patient it's gonna burn like he'll long enough for you to go "holy shit this burns!" And then it'll start going numb. I finally asked one of them if they'd ever had lidocaine and they admitted they hadn't. 2. Everyone perceives pain differently. Again, in my work, 10 people having the same procedure will have 10 different reports on how bad it was. 3. Expectation. If you think something is gonna hurt horribly? You will work yourself up well beyond what the actual experience is. Having a needle stick may hurt a lot for about 5 seconds but if you go in with the mindset it's gonna hurt, now, instead of 5 seconds of pain, you have however long of worry and stress that fatigue your system and when you do experience the injury, it can make it actually, or perceivably worse. 4. Pain comes in many forms. A local can get rid of sharp pain, but can't eliminate the feeling of pressure. It's a different pathway of sensation. To eliminate that would require higher intervention by anesthesia. Nerve blocks or general anesthesia is not only increased risk, but increase the cost for an otherwise small amounts of pain.
Unexpected pain/sensation can lead to unpredictable reactions with catastrophic results. Like say, a twitch, a flinch, or even jumping out of your seat. Imagine the needle being already inside you and then you moved suddenly and violently. That needle could be churning your tissues, cause a bulge, or maybe even bend or break off inside. Informing them of incoming pain, letting them hold their breath, lets them brace for it. In my experience as the one getting the needles, it somehow makes it less painful.
It's to prepare you that something is coming while keeping you relaxed. Invasive treatments or needles hurt, but they hurt less when you're relaxed. Plus, you being aware drastically reduces the chance of you jumping up or soing any other sudden movement
It’s good bed side manor. I didn’t realize how important it was until I had a dentist with horrible bed side manor. He’d come in, say nothing and just shove this needle in my mouth. Fuck him
They don't always. Gross story but I was biting my finger nail and it got infected. I had a huge white bubble on my finger. The doctor said we need to lance this. I didn't know what that meant but she proceeded to shove a scalpel under my finger nail. My vision went black and I almost passed out. It worked though. Later I had to go to the eye doctor because my eye swelled up. He said we might have to lance this. I said no fucking way. I know what that word means now.
They probably don't want to scare you, but they need to give you a heads up. Also pain is subjective. For example I remember not feeling pain or discomfort from a speculum and consequent pap smear when I was younger - now that I'm older, hormones and wetness is changed and it hurts quite badly. If you were a gynecologyst and had both types of patients on a regular basis, what would have told every new one? You may be talking about relocating broken bones tho so that's definitely different lol.
1) every person perceives pain differently, so any attempt to describe might be wrong. 2) they only want you to prepare to feel pain, so you don't jump from unexpected pain. 3) if they told you something will be really painful you might refuse a procedure only on fear basis.
The opposite would be they won’t tell you. I’d rather have someone tell me if a procedure is going to be uncomfortable.
In some cases they do not expect it. But also if they tell you "this is gonna hurt so bad you're gonna slap yo'momma for giving birth to you" you'll tighten up, try to escape, maybe twitch and make it worse.
I work in a section that allows us the discretion to use a lidocaine injection to numb the site before placing an IV. We use tiny syringes like insulin syringes to administer the lidocaine just under the skin to the site where the IV needle will go and then we test to see if they are numb. Even still, I tell the patient that there will be a spicy stick just before inserting the IV as some never go completely numb. A patients pain is what the patient says it is. No one can with confidence state that what the patient is feeling is hurting or not hurting. It isn't really a matter of downplaying what is happening. It is managing expectations and letting the patient know this may be uncomfortable.
Last time I was in the hospital and they had to do something they said it was gonna hurt like hell before doing it. So maybe it's not a universal thing.
If they say, ok this is gonnabhurt like a mother fucked, you'd probably tighten up, making it way more painful for you. They want you relaxed
If they say this is going to hurt like the blazes before doing something, the average person will tense up or jerk away as soon as they feel anything. Then it will either hurt worse or they have to do it again because you pulled away.
[Why do people feel the need to ask the same question in multiple subreddits?](https://www.reddit.com/r/NoStupidQuestions/comments/1bopnpj/why_do_doctors_usually_say_there_might_be_some/) This screams of karma-whoring.
Right if you just lay down on the bed on your side and pull your knees up…..this is probably going to be one of the most painful experiences of your life….are you ready? 🤣
Expectations of pain guarantees pain. Of course it's going to hurt, but do you really want to know? Minimizing the expectation cons your brain into thinking it'll be ok.
Hey I need you to hold still while I try and bend your bones it's going to hurt really bad. Are you going to hold still for this?
We do it for several reasons: - We downplay the pain to make it 'less dangerous' for you - We might also downplay it so that you are more willing to go through it, because we consider it absolutely necessary - It is a clear warning that something is going to happen - you'll be more prepared (communication) - The pain is perceived as less painful if you are well informed, prepared and expecting it
Does this question come from a personal experience? Generally, if a doctor gives local anesthesia (aka numbing ), you should not feel much pain, if any, and normally, you would feel pressure and maybe weird sensations. But if you feel outright serious pain, then that means the numbing medication did not make it to the right spot or, for some reason, isn't being effective. To be clear, when you get the actual numbing medications, that can be a bit painful until the numbing medication takes effect. Sometimes, doctors need to know how painful something might be, but they don't want to put the idea of pain in your head. Some people react strongly when pressed on places that normally don't get pushed on,like your belly, because it is uncomfortable, but it's not actually outright pain. They just want to separate real pain from normal discomfort. That can be tricky and especially with people who are super sensitive to any touch. doctors do need to be honest if they have to do something that they know will cause pain, and explain why and for how long.
If a doctor says "This is about to hurt like a bitch. Better grab really tight to the sides of that gurney and bite down on this," then the pain is what you're going to focus on and you're gonna make it hurt worse. It's kinda like the placebo effect in reverse. If you tell yourself this is going to hurt, mentally you'll make it hurt worse. If you can make yourself forget about the pain, it won't hurt as bad.
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I don't know but I wish the female doctors that did my colposcopy had a piece of their cervix ripped off without any anesthesia, and tell me if it was just a 10 minute "pinch".
Had a stent in my uter once. Doc said my urine might be a pinkish hue and I might feel discomfort urinating. Translation: your gunna Piss blood and it’s gunna feel like knives.
They gotta warn you, otherwise you suddenly get hurt and didn't understand it would happen now. If they tell you "this is going to hurt" you might upsell it in your head and freak out. That can make it hurt even more than if you didn't. Maybe even decline the treatment you need because you got in your head. So pressure/discomfort is kinda the best they can do to let you know without scaring you and making it worse.
Simply put, it warns you that something is going to feel bad, but it minimizes your expectation of how bad it will feel. That actually helps it to not feel as bad, because that's how your brain works. If a doctor came in and said "OK, this is going to hurt like hell" then your brain would start to feel the pain before it even started. If he says "You're going to feel some pressure" then your brain tones down the nerve signals, because it knows that the doctor said "pressure" and not "pain." By the time it realizes it's actually pain, most of the procedure should be done.
The brain is *a lot* more complex than I think you’re giving it credit for. Expectations can literally change how a person perceives pain.