/ Keys to Managing your Pain
Keys to Managing your Pain

Managing your pain

  • The best method to manage your pain is to prevent it from happening or to treat it early so that it does not become severe
  • Cancer pain almost always can be eased if not removed
  • Managing your pain is part of your overall cancer treatment

Setting goals for pain relief

  • Includes both comfort and function
    • The amount of pain relief you want or need may be different for different activities (less amounts for when you have to concentrate and use physical skills for your work, less amounts when you are taking care of your children or grandchildren)
  • You and your provider need to decide when pain medicines should be changed (increased or decreased)
    • This means you have to tell your provider how you are feeling when you take and do not take the pain medicines (including the side effects you have that may be related to the drugs).
    • You need to be honest with your provider and not pretend things are better or worse than what they really are.

Satisfactory pain relief

  • This is the level of pain that may be noticeable but not bothersome, so you can do what you want and need to do throughout the day (and sleep at night).
  • Your pain level should make it easy to sleep, eat and perform other activities.

How pain may feel
AchyThrobbingDullSharp
StabbingSqueezingPressureBloating
CrampingBurningShootingNumb
GnawingExhaustingPricklyElectrical sensation
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Ways to give pain medicine
1. By mouth as a pill or something to suck on (oral) or under the tongue (sublingual) or on the gums
2. Placed on the skin (transdermal)
3. By a suppository placed in the rectum (rectal)
4. By an needle:

  • into a muscle (intramuscular, IM),
  • under the skin (subcutaneous, SC),
  • or through a vein (intravenous, IV)
  • by continuous (all the time) infusion (IV) using either a device/pump connected to an IV line)

«IV picture goes here»

5. Into the spine (intraspinal, epidural, intrathecal). «Spinal picture goes here»

  • A small needle or small flexible tube is placed into space around the spinal cord area and the pain medicine is injected
  • Can be used for short term (2 to 3 days) or long term (weeks to months) pain relief

Way to Manage Cancer Pain

Medicines for pain management

  • Non-narcotics such as Aspirin, Tylenol or Advil
  • Narcotics such as Morphine, Dilaudid or Fentanyl
  • Additional medicines (called adjuvant because they are given with the pain medicines)
    • Steroids such as prednisone (not the same as what athletes may take)
    • Antidepressants/mood elevators such as Elavil or Prozac
    • Local anesthetics such as Lidocaine

Types of pain medicines based on how often they are given

  • Short acting drugs
    • Last 2-6 hours depending on drug (such as short acting morphine)
    • Long acting drugs
      • Last 12 to 24 hours or longer (such as long acting morphine which lasts about 12 hours. There is a new oral drug that works for 24 hours and a fentanyl patch works for up to 72 hours)
    • Breakthrough medicines (given when pain medicine stops easing pain even though the next dose is not scheduled for several hours)
      • You will usually take a small dose of a short acting drug in between other doses usually of a longer acting drug.

    Non-Drug Methods to Manage Pain

    Heat:

    • Decreases pain, swelling, joint stiffness
    • Increases healing
    • Includes: baths, hot water bottles, warm moist towels
    • Use caution with heat:
      • Baths should not be not over 101 degrees
      • Heating pads should be on low with cover on the pad to avoid burning the skin;
      • do NOT lie on the heating pad
      • Do NOT use heat on skin that has recently had radiation

    Cold:

    • Decreases swelling
    • Includes: crushed ice, cold packs, cold wet cloths, gel packs
    • Use cold with caution:
      • Never put ice directly on skin; place ice bag in towel, pillowcase
      • Leave on for no more than 15 minutes at a time
      • Do not use on skin that has recently had radiation

    Relaxation/Imagery:

    • Includes a wide range of activities designed to help you relax and decrease stress, pain and anxiety
    • Decreases muscle tension, aches, pains and fatigue
    • Includes: muscle relaxation, meditation, visualization, and deep breathing
    • Relaxation is considered to be very safe with no to very few side effects

    Traditional Healing:«Traditional indina med. picture goes here »

    • Talking and working with a Traditional Indian healer
    • Spiritual ceremonies to help you and your family with your cancer pain
    • Praying together to help relieve your pain
    • Addressing spiritual, mental, emotional pains (not just physical)
    • Preparing traditional teas, juices, poultices to help relieve your pain

    Massage/Pressure:

    • Involves the rubbing and kneading of the bodys muscle and soft tissue
    • Massage can be shallow and light or firm and deep
    • Oils may be used on the skin to prevent irritation
    • Massage may decrease stress, anxiety, depression and pain

    Acupuncture: «accupuncture picture goes here»

    • Involves the use of very fine (thin) needles placed into the body over strategic points to alter body function (such as the feeling of pain)
    • Based on ancient Chinese practice that is well accepted by both western providers and traditional Indian healers
    • Most people dont feel uncomfortable when the needles are placed
    • A licensed acupuncturist should be used

    Movement:

    • Moving to another position will sometimes lessen the pain
    • Sometimes just getting up, walking or other types of movement will leesen the pain

    Hypnosis (a form of relaxation):

    • A trained hypnotherapist guides the patient into a state of hypnosis with a soothing voice and calming images
    • While under hypnosis goals such as being able to control ones pain are suggested
    • Helps to train the brain to not recognize the pain or to interpret it as something less uncomfortable

    Herbal remedies (teas, herbs):

    • Traditional herbs and teas may be helpful in decreasing pain
    • Be sure to tell your provider if you are using any traditional teas or herbs

    Prayer:

    • Suggestion that praying or being prayed for can speed recovery and help with healing
    • Prayer may be silent or spoken out loud and can be done alone, in a small group (family) or with a larger group (community, tribe)

    Creative Arts:

    • Includes such activities as drawing, painting, writing poetry, making music
    • These activities can help you express how you are feeling
    • May decrease pain by lessening stress and anxiety and providing distraction from the pain feelings

    Lifestyle changes:

    • Do not do activities that cause pain
    • Learn good body mechanics how to move, sit, lift
    • Increase rest/relaxation prior to activities
    • As possible, do muscle strengthening exercises so as not to strain muscles
    • Take pain medicines as ordered
    • Let others help you

    Other methods/procedures to manage pain

    • Cancer treatment
    • Radiation or chemotherapy to decrease size of cancer and remove cause of pain
    • Nerve blocks
    • A specially trained doctor will use a needle to place medicine near a nerve to prevent the sensation of pain

    Would you like to see some brochures Native communities made about how to deal with pain?

    «Turtle goes here»

    Stopping your pain medicine

    • Always talk with your provider before you stop taking your pain medicine
    • Never stop your pain medicine suddenly
    • Always decrease your pain medicines very gradually (your provider should tell you how to do this)

    Stopping your medicine

    • If you stop your pain medicines slowly, withdrawal symptoms will not be felt or will be very mild (should you have symptoms, tell your provider immediately)

    Important points

    • Back pain can be a symptom of the cancer pressing on your spinal cord be sure to tell your provider
    • Pain medicines need to be kept out of the reach of children
    • Never share your pain medicines with others
    • Take your pain medicines as ordered





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