Shared Decision-Making in Pain Care: Questions About What Matters to You

By the Pain Care Questions Team

What Is Shared Decision-Making in Pain Care?

Shared decision-making in pain care is a structured process where you and your clinician work together on a treatment-related choice, combining their clinical knowledge with your personal values, goals, and daily-life priorities. The Agency for Healthcare Research and Quality (AHRQ) outlines this process in five steps known as the SHARE Approach.

If you’ve heard a clinician say a decision is “up to you,” this is the framework behind that statement — and knowing how it works can help you prepare instead of feeling caught off guard.

How Does the SHARE Approach Work for Pain-Care Decisions?

AHRQ’s SHARE Approach breaks shared decision-making into five steps: Seek your participation, Help you explore and compare options, Assess your values and preferences, Reach a decision together, and Evaluate how the decision is working over time.

Each step gives you a specific role. You’re not expected to know the clinical evidence — that’s your care team’s job. You’re expected to know, and to share, what matters most to you.

Myth vs. Reality: What This Process Is and Isn’t

• Myth: “Shared decision-making means the clinician tells me what to pick.” Reality: It means you and your clinician each bring something to the conversation — their clinical knowledge and your values, priorities, and daily-life context. Neither side decides alone.
• Myth: “If I don’t have medical training, my preferences don’t really count.” Reality: AHRQ’s guidance specifically asks clinicians to learn what matters most to the patient—including things like function, sleep, work demands, or caregiving responsibilities—and to weigh that alongside the clinical evidence.
• Myth: “This process only applies to one big, one-time choice.” Reality: AHRQ describes it as an ongoing process that can happen during or between visits, including revisiting a plan later if it isn’t working or your goals change.
• Myth: “Bringing questions or preferences will slow things down.” Reality: The SHARE framework treats patient input as a normal, expected part of the visit—not an interruption.

What Are the Limits of This Evidence?

AHRQ’s SHARE Approach and a related 2025 AHRQ resource on patient-centered clinical decision support describe the structure of shared decision-making — the steps, and how digital tools can sometimes support each one. Neither source recommends specific pain treatments, ranks options against each other, or promises a particular outcome from using this approach.

The AHRQ resource also references a federally funded pilot project that built patient- and clinician-facing digital tools to support shared decision-making specifically for chronic pain management. That example shows how the SHARE steps can apply to pain care in practice — it describes a specific research project’s tools, not a treatment recommendation or a service available to the public.

Neither source addresses how to start, stop, or change any medicine or procedure. Any decision about a specific treatment, medication change, or procedure belongs in a conversation with your own clinician, based on your full medical history.

What Questions Should I Ask During a Shared Decision-Making Conversation?

Before a visit, it helps to write down short answers to a few questions. You don’t need medical language—plain, honest answers matter here.

Your goals and daily function

• What activity or task does pain interfere with most right now — work, sleep, walking, caregiving, something else?
• If your pain improved somewhat but not completely, what change would feel meaningful to you?
• Is your main goal less pain, more function, fewer side effects from treatment, or some combination?

Your tradeoffs and tolerance for risk

• Are you more concerned about a slow, gradual approach or about trying something with faster potential results but more unknowns?
• How much time, cost, or travel can you realistically commit to a given approach?
• Are there past experiences — good or bad — with treatments or procedures that should shape this conversation?

Questions to bring into the conversation

• “What are the realistic benefits and harms of each option we’re discussing?”
• “What happens if we wait, or if I choose to do nothing for now?”
• “How will we know if this plan is working, and when will we check back in?”
• “What would make you recommend we revisit or change this plan?”

What’s the Decision Path If Your Pain Plan Isn’t Working?

AHRQ’s framework treats a plan as something to monitor and adjust, not something fixed. These four situations can help you decide what to do next.

1. If you don’t understand why an option is being suggested, then ask your clinician to explain the expected benefit and the realistic downsides in plain language before agreeing to anything.
2. If your goals or daily-life priorities change after a plan is set, then say so at your next visit — AHRQ’s framework treats this as a normal reason to revisit a decision, not a failure.
3. If a plan doesn’t seem to be working after the agreed check-in point, then ask what the evaluation step looks like: what signs would tell you and your clinician it’s time to reconsider.
4. If you feel unsure or rushed during the conversation, then ask whether you can take the information home, think it over, and follow up before deciding.

How Does This Fit Into My Broader Pain-Care Preparation?

This kind of preparation works alongside other parts of getting ready for a pain-care visit, such as tracking your symptoms or understanding how a multidisciplinary care team is organized. If you’re just getting oriented to this site, our Start Here page shows how our content areas fit together. Our How We Research page and Editorial Policy explain how we select, verify, and review sources like the ones used on this page.

Frequently Asked Questions About Shared Decision-Making in Pain Care

What is shared decision-making, in plain terms?

It’s a collaborative process where you and your care team weigh your preferences, values, and goals alongside clinical evidence to reach a decision together — which can include deciding to take no action for now.

What are the five steps of the SHARE Approach?

Seek your participation, help you explore and compare options, assess your values and preferences, reach a decision together, and evaluate how it’s working over time.

Do I need medical training to take part in this process?

No. The framework specifically asks clinicians to learn what matters to you—your values, preferences, and goals—and to weigh that alongside their clinical knowledge.

Can a shared decision be changed later?

Yes. AHRQ’s framework includes an evaluation step meant to check on the plan and revisit it if it isn’t working or your goals have changed.

Does shared decision-making tell me which pain treatment to choose?

No. It’s a process framework, not a treatment recommendation. The AHRQ sources describe the steps involved and, in one pilot project, tools that supported chronic pain conversations — they don’t rank or recommend specific treatments.

Medical Information Disclaimer

This article is for general education only and is not medical advice. It does not diagnose any condition, recommend or rule out any treatment, or replace a conversation with a qualified clinician who knows your health history. Pain Care Questions is an independent educational publication; it is not a pain clinic, treatment provider, or referral service. Read our full Medical Information Disclaimer. If you are experiencing a medical emergency, contact your local emergency services immediately.

By Pain Care Questions Editorial Team. Last reviewed: September 2026. Sources: Agency for Healthcare Research and Quality (AHRQ), “The SHARE Approach” and “How Patient-Centered Clinical Decision Support Can Strengthen Shared Decision Making” (AHRQ Pub. No. 25-0058, June 2025).