Blue Ridge Hospice - Pain Management Consults

The truth about pain
How to manage your pain
Pain Care Bill of Rights
Guidelines for managing your pain
Pain checklist

The Truth About Pain

Many people have incorrect information and concerns about treating their pain. The following questions and answers provide the truth about pain and pain management.

"If I tell the doctor about my pain he or she will think I'm a complainer."
Response: It is the doctor and nurse's job to work out the best way to control pain. To do this, they rely on you to tell them about your pain. They can't do their job unless you do yours.

"Of course I have aches and pains. I'm old."
Response: Pain is not a normal part of growing old. Pain in older adults, just like pain in any other age group, is a signal that something is wrong. You need to talk about this with a doctor or your family caregivers so the problem can be treated.

"My father is confused. What he says doesn't make sense, so I can't tell whether he's in pain or not."
Response: Even when people are confused, oftentimes they can let you know when they are in pain. It may be helpful to look for changes in mood, activity level, body language, and facial expressions.

"I'm afraid of addiction."
Response: It is very unusual for people who have pain to become addicted to pain medicines. They are taking the medicines for a good reason, to relieve their pain, not to "get high." People who have pain need to be treated, so concerns about addiction, in most cases, should not enter into the doctor's decision to prescribe these medicines.

There is a difference between addiction, which is a psychological craving for medicine, and physical dependence. People who need opioids (narcotics) for a period of time may develop a physical dependence on the medicine, with uncomfortable symptoms, such as sweating, chills, and nausea, if the medicine is stopped suddenly. This is only a temporary situation that can be prevented by slowly reducing the medicine over a few days or a few weeks.

How to Manage Your Pain

There are many treatment methods that can reduce and manage your pain. Most pain can improve with treatment that usually consists of a combination of medicine and non-medicine strategies. And the good news is that new advances in pain treatments are happening every year. It is crucial to talk to your doctor about your pain so he or she can provide the help you need to feel better. To learn more about how to talk to your doctor about your pain and guidelines to help you manage your pain and other resources, click here.

There are also healthy ways to deal with emotions people often have when they are living with pain. Living with chronic pain can take a toll on your mood, outlook, relationships and self-image. In addition to seeking medical help, it may be important to seek extra help from a psychiatrist, psychotherapist, social worker or your faith community leader if need. By getting additional emotional and spiritual support, you will learn new 'life' skills to become more effective at managing pain that can enhance your medical treatment.

Pain associated with a terminal illness or at the end of life requires special treatment and can best be treated by a palliative care or hospice provider. For more information about palliative care or hospice, click here.

Taking action to manage your pain will not only benefit you but also everyone around you. Your pain, and worrying about you, can take a toll on friends and family members as they, too, can experience worry, depression and exhaustion. Just as you need their support, they need yours so the best thing you can do for them is to take care of yourself and your pain. Remember your Pain Care Bill of Rights!

Pain Care Bill of Rights

As a Person with Pain, You Have:

The right to have your report of pain taken seriously and to be treated with dignity and respect by doctors, nurses, pharmacists and other healthcare professionals.
The right to have your pain thoroughly assessed and promptly treated.
The right to be informed by your doctor about what may be causing your pain, possible treatments, and the benefits, risks and costs of each.
The right to participate actively in decisions about how to manage your pain.
The right to have your pain reassessed regularly and your treatment adjusted if your pain has not been eased.
The right to be referred to a pain specialist if your pain persists.
The right to get clear and prompt answers to your questions, take time to make decisions, and refuse a particular type of treatment if you choose.

Source: American Pain Foundation

Guidelines for Managing Your Pain

Good pain management improves quality of life. It is important that the treatment of pain be individualized to each person according to their diagnosis, stage of disease, response to pain and treatments, and personal likes and dislikes. However, there are some general guidelines that can help anyone to better manage their pain more effectively.

Use pain medicines as prescribed.
If the prescription says to take the medicine at certain times or at certain time intervals (for example, every six hours), make sure the person you are caring for does so. Do not wait until the pain comes back to give the medicine. This will cause needless suffering. One of the important ways that pain medicine works is that it helps to prevent episodes of severe pain. In order to do this, there has to be a certain amount of medicine in the blood. This is why the doctor prescribes taking the medicine at regular intervals-to be sure that the blood level stays high enough.

Insist on good pain control.
Let your physician know if your pain treatment is not working and ask about pain clinics. If your doctor cannot control the pain, ask for a referral to a pain clinic that has a team of people (doctors, nurses, physical and occupational therapists, psychologists) that specialize in pain treatment.
Universities and large hospitals often have these types of clinics.

Help to reduce pain.
Use warm showers, baths, hot water bottles, or warm washcloths. Heat relaxes muscles; this can help reduce pain and give a sense of comfort. Do not set heating pads on high because they can burn the skin. Also, try massaging sore spots, such as neck and shoulders.
Check with your doctor about how long to apply heat since prolonged exposure to heat can cause tissue damage.

Use cool cloths. Cooling the skin and muscles can soothe pain, especially pain that comes from inflammation or swelling. For example, many people find that using a cool washcloth on their forehead reduces pain when they have a headache. Check with your doctor about how long to apply cold since prolonged exposure to cold can cause tissue damage.

Encourage relaxation.
Position yourself carefully with pillows and soft seat cushions. Breathing slowly and quietly helps the mind and body to relax and helps decrease pain.
Simple relaxation methods can be learned from books on relaxation techniques which are available at most bookstores. Relaxation audiotapes can also be purchased through most bookstores.

Provide pleasant activities.
Being active takes the mind off the pain. Distractions such as pleasant visits with friends and grandchildren should be encouraged. Watching television, reading, and listening to music may also decrease a person's awareness of pain.

Avoid stressful events when possible.
Emotional stress and anxiety increase pain. Try to minimize these types of situations.

Ask for help.
Ask for help even if it may be difficult for you to ask for help. Chances are your family and friends have asked you what they can do to help you.
Perhaps you didn't know what to say or you felt guilty admitting you needed any type of special treatment. Or they may have decided to help in ways that irritate so when people ask you how they can help, tell them. You need family and friends to help you manage your pain and move on with your life.
But they can help you only if you help them understand what your needs are and how they can be met.

If you have a question that isn't addressed above, email Caring Connections at caringinfo@nhpco.org.

Pain Checklist

Get the information you need to make informed choices about pain management and treatments.
If you are in pain, tell your doctor and caregivers. You don't have to suffer in pain.
Discuss your thoughts, concerns and choices with your family and friends.
Talk to your doctor about different treatments and therapies.
Share your pain goal with your doctor and family/friend caregivers.
Ask for help from others if your pain makes it difficult to do household chores or other tasks.
Discuss your choices often, especially when your medical condition changes.
If you are talking to a physician on behalf of someone in pain, be sure to gather information before you call or speak to the physician, including pain level, pain goal, other symptoms and what medications the care recipient is taking.
Learn about the resources that are available in your community, including your local hospice and palliative care providers. For more information about where to find a hospice or palliative care provider.
Seek out opportunities to help others who are dealing with end-of-life care issues such as volunteering with a local hospice or end of life care coalition. For more information about where to find a hospice or end of life care coalition.

For more information about how you can engage others, contact Caring Connections at (800) 658-8898 or email, consumers@nhpco.org.