I've never had luck with getting ANY doctor to give more than a cursory glance to my pain journal.

I recommend having a spouse or good friend be there to be your advocate. I usually don't have issues with not speaking up when I think the occassion warrents it, but for some reason, I have with doctors when discussing my pain issues. That could be in part that I've been told so many times, "It's all in your head" or "I hope that you aren't going to ask for narcotics" or "You just need to work harder in PT." I have no problem advocating for my mom with her many pain and health issues, but I now panic with those docs who have been less than supportive of helping me maximize my comfort and functionality. If you have someone that can go with you to advocate for you getting better control over your symptoms and your life, that might help.

Having a list of points that you want to bring up can also help. If you start by saying, "I want to make sure we cover my issues with x,y,and z, so I have a plan going forward"....at least you will be sure all your points were at least mentioned instead of spending a lot of time on one small part of the problem

I have always been lucky and my GP has never doubted the severity of the condition I have, nor the severity of my pain.

I think honesty is the best place to start. You cannot help yourself if you mask the truth or try and keep it together. You need to use the real words that describe how bad it is for you and describe things like the true effect it is having on your daily life, your activities, your mood and your relationships. If you want to cry, don't hold back - he needs to understand how it is affecting you.

It's easy to try and keep it together and you don't want folk to see you falling apart - it's only human to hide the reality from doctors - been there and done that many times. It doesn't help either in the short term or the long term.

Pictures and a pain diary can be valuable tools if your doctor responds to those things. If not you need to try and work out what will make him or her sit up and respond. You might want to think about it and rehearse the conversation or what you want to say before you go (with a friend or partner or just in your own head). Try and anticipate any blocking questions the doctor will ask to try and test whether you are overreacting - perhaps have some actual examples that illustrate what you are trying to say ready beforehand so that you can dispatch those questions by demonstrating just haw terrible the effect of the pain etc is on you.

I spent a lot of time in tears with my GP - he was as keen to explore my mood issues as well as the practical pain and other problems. The tears are sometimes still there but much less so these days. I didn't want to be honest about mood so I was angry and defensive but when I finally fell apart we finally managed to move forward a bit. After that I was less defensive, cried when I felt like crying and was totally honest about how crap everything was. He worked hard to support me - we had a few heated arguments too but he worked hard for me and has never doubted my pain. In fact, he worries that I am am sometimes too inclined to try and tough it out when that isn't helpful for chronic pain management.

Trust is important in the GP patient relationship. My GP trusts me and the accuracy and currency of my knowledge of the condition. If I ask to try something or seek a referral, I take all the info he needs to evaluate it and I explain exactly why I think it might be worth doing. I always give him and his views their place and take on board what he thinks. We agreed recently that I would just 'live with' big flare ups in pain without medicating using fast acting fentanyl products because I already find the fentanyl patches hard work in terms of their fatiguing side effects. We discussed it constructively and because I had read, sought advice from a friend who is a pharmacist and was aware of the risks, it was a conversation of equals, not him telling me what I could and couldn't have. I know that I can always go back and revisit that conversation to look for another outcome if I have new information or if what I am prepared to suffer changes.

So, truth and honesty, examples, tears, taking someone with you who can perhaps back up what you are saying about how badly the pain affects you and no holding back are my suggestions.

You did say that you have tried all the modalities yet you are looking for something more from your doctor. On the face of it that sounds like a bit of a contradiction. Have you really tried everything and the problem is that you are going to have to accept the fact that you will never be pain free? Are you struggling to accept that this is maybe as god as its going to get? Or are there actually still various things you haven't tried for pain management yet and you want to open a discussion about what you can try? Just curious to understand where you are at in the CRPS journey.

NeuroChic --- you always seem to be able to voice things perfectly!

I was thinking the same thing.

NeuroChic said she was a lurker here for awhile and a little hesitant to join in. Unless she was worried about having a flare from typing, I'm not sure what the hold up was. I'm sure glad she decided to chime in !

Well said, Neurochic......keep up the good work !

Also, I suggest making your appointment(s) later in the day if that is possible.

first things first I never expect to get pain free my goal is to lower my pain level enough so that I can function repetitively ie get back to work at least

tried everything meaning all of the usual treatments, perhaps I should have phrased that better

my frustration with the GP is a cycle that is so silly it's like a comedy sketch, he goes back to something I've tried before that's been unsuccessful without any good reason - I call him on it politely in case he's making an honest mistake and he still prescribes it and shock horror it doesn't work

I'm on a waiting list for acupuncture and the only other thing is Ketamine which I'm going to suggest at my next appointment for it's off label use for chronic pain (here in the UK anyway)

I articulate how my pain affects me extremely specifically and always tell him what my pain scores have been averaging out at (I do three a day). I don't hold back either I tell him if it's made me cry among many little things that happen on a daily basis

The real problem is they're either incompetent, don't care or even both, I'm not saying that out of frustration I'm going off all of my doctors track records - the ones that said it was all in my head were the worse ones - this was before the diagnosis they were clearly useless. The medical journals are updated every 12 months over here they obviously didn't keep updated

Anyway I've got myself a new GP and she seems really nice - the caring type of doctor you know the one I mean. We had a good chat a week ago (first visit) and I felt comfortable talking with her - she did have a misunderstanding of the disease (she believed it always died down and went away lol) but I cleared that up straight away i wish she was right!

Thanks for the replies everyone I'll let you know how I get on

I have to say that the three medical specialists, and GP in my life are women. My former GP, a male, told me my symptoms, were in my head. There are many excellent physicians, specialist. I am prejudiced at this point.