Pitfalls in communicating with patients with chronic pain in urology—from pain games to loss of authority

Patients with chronic pain syndromes are often referred to as “difficult” patients. In addition to positive expectations of the physicians’ competence, pain patients often express understandable doubts about the appropriateness and efficiency of new treatment options and are afraid of rejection and devaluation. Hope and disappointment, idealization and devaluation alternate in a characteristic way. This article demonstrates the pitfalls of communicating with patients suffering from chronic pain and provides recommendations for improving physician–patient interaction based on acceptance, honesty and empathy.