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Palliative care - managing pain

Palliative care helps people with serious illnesses feel better. One of the problems a serious illness can cause is pain. No one can look at you and know how much pain you have. Only you can feel and describe your pain.

Pain that is always or almost always present can lead to lack of sleep, depression, or anxiety. These can make it harder to do things or go places, and harder to enjoy life. Pain can be stressful for you and your family. However, with treatment, pain can be managed.

How Pain Is Measured

First, your doctor or nurse will find out what is causing the pain, how much pain you have, what it feels like, what makes it worse, what makes it better, and when you have it.

You can tell your doctor or nurse how much pain you have by measuring it on a scale from 0 (no pain) to 10 (the worst pain possible). You choose the number that describes how much pain you have now. You can do this before and after treatments, so you can tell how well the treatment works.

How Pain Is Treated

There are many treatments for pain. Which treatment is best depends on the cause and amount of your pain. Several treatments may be used at the same time for the best pain relief. They include:

  • Thinking about something else so you’re not thinking about the pain, such as playing a game or watching TV
  • Mind-body therapies such as deep breathing, relaxing, or meditation
  • Ice packs, heating pads, biofeedback, acupuncture, or massage

You can also take medicines, including:

  • Acetaminophen (Tylenol)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen (Aleve) and ibuprofen (Advil, Motrin), diclofenac
  • Narcotics or opioids, such as codeine, morphine, oxycodone, or fentanyl
  • Medicines that work on the nerves, such as gabapentin and carbamazepine

What to Do

Understand your medicines, how much to take, and when to take them. Do not take them more often.

  • Do not take less or more medicine than prescribed.
  • If you are thinking about not taking a medicine, talk to your doctor first. You may need to take a lower dose over time before you can stop safely.

If you have concerns about your pain medicine, talk to your nurse or doctor.

  • If the medicine you take does not relieve your pain, a different one may help.
  • Side effects, like drowsiness, may get better over time.
  • Other side effects, like hard dry stools, can be treated.

Few people who take narcotics to treat pain become addicted to them. If you are concerned about addiction, talk to your nurse or doctor.

When to Call the Doctor

Call your doctor if your pain is not well-controlled or if you have side effects from your pain treatments.

Update Date: 6/12/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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