How palliative care can help with pain and treatment side effects

Managing pain

Managing pain is not easy. But it is essential to your quality of life. For example, pain can make you feel tired or depressed. It can also make it hard for your body to heal.

You deserve to have your pain controlled. Almost always, pain can be controlled with the right medicines in the right amounts. The goal of good pain management is to have the least possible pain with the fewest side effects.

Palliative care providers are specially trained to treat pain. They know about all the medicines to control various types of pain. Because each person responds differently to pain medicines, it may take a while to find the best medicines for you.

It is important to be open and honest about your pain. You do not have to pretend you are strong or able to handle pain. Telling your doctor exactly how you feel is one of the most important parts of controlling pain. Your doctor may ask you:

• Where do you feel pain?
• What does it feel like? Sharp? Dull? Throbbing? Burning? Steady?
• How strong is the pain?
• How long does the pain last?
• What lessens the pain? What makes it worse?
• What medicines do you take, and how much do they help?
• Which pain medicines have worked for you before? Which have not helped?

Your palliative care doctor or nurse may ask you to rate your pain on a scale of 0 to 10. Zero means no pain. Ten means the pain is as bad as it can be.

Myths about pain medicines

You may be concerned about becoming addicted to your pain medicine. It is common to confuse dependence on pain medicines with addiction to pain medicines. But there is an important difference between dependence and addiction.

Dependence means your body starts to expect and rely on certain medicines after you have been taking them for a while. If you suddenly stop taking these medicines, you may feel bad for a time (withdrawal). But just because your body is dependent on a medicine does not mean that you are addicted to it. Addiction means that you crave a medicine even when your body doesn't need it. People who are addicted to medicine want the medicine so they can feel “high."

Most people with chronic pain take enough pain medicine to control their pain but not so much that they feel "high." Used correctly, pain medicine helps you function better but does not really change your behavior. You are addicted only if you have lost control over the medicine, start to take more medicine than you need, or do things to harm yourself or others.

If you do not have a history of substance abuse, you are probably not in danger of becoming addicted to pain medicines. In fact, many people take them for a long time with no problems or bad side effects.

While taking pain medicines, you may worry about feeling tired or not thinking clearly. But these side effects often do not last. Many people who take pain medicines for a long time do not have problems thinking clearly. After you and your doctor find the right amount of medicine for you, you may be able to drive, work, and do other activities.

If you are worried about side effects or about getting addicted to pain medicine, talk to your doctor. He or she can talk to you about your concerns and the best medicines for you.

Complementary medicine for pain

You may want to try complementary medicine for your pain. These treatments include:

• Heat or cold therapy to relieve painful areas of the body.
• Stretching, yoga, and exercises to help maintain strength, flexibility, and mobility.
• Behavioral treatments, such as relaxation, biofeedback, meditation, or guided imagery.
• Healing touch and massage.
• Education and emotional support. Your doctor can refer you to the social services department of your local cancer treatment center or hospital.
• Complementary therapies, such as acupuncture, aromatherapy, prayer, and humor therapy.

Side effects

Palliative care can help with side effects from treatment. Sometimes side effects bother you more than anything else. Tell your palliative care provider about all of your side effects. He or she may be able to give you medicines to help if:

• You feel like you cannot breathe well.
• You do not want to eat or you feel like you are going to throw up.
• You feel tired or weak.
• You have problems sleeping.
• You cannot have a bowel movement (constipation) or you have problems urinating.
• You have itchy skin or a dry mouth.
• Your mind is changing or you cannot think clearly.
• Your muscles are twitching or jerking.