Pain Care

 

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.
  •  Have your pain thoroughly assessed and promptly treated.
  •  Be informed by your healthcare provider about what may be causing your pain, possible treatments and the benefits, risks, and costs of each.
  • Participate actively in decisions about how to manage your pain.
  • Have your pain reassessed regularly and your treatment adjusted if your pain has not been eased.
  • Be referred to a pain specialist if your pain persists.
  • Get clear and prompt answers to your questions, take time to make decisions, and refuse a particular type of treatment if you choose.

 

Although not always required by law, these are the rights you should expect for your pain care.

 

Know The Facts!

 

Pain is not something you “just have to live with”. Treatments are available to lessen most pain.  Left untreated, pain can worsen other health problems, slow recovery, and interfere with healing.  Get help right away.  Don’t let anyone tell you your pain is “just in your head”.

 

Pain medications rarely cause addiction. Morphine and similar pain medications, called opioids, can be highly effective for certain conditions.  Unless you have a history of substance abuse, there is little risk of addiction when these medications are properly prescribed by a doctor and taken as directed.  Physical dependence – which is not addiction – may occur and cause withdrawal symptoms if you stop taking these medications suddenly.  You’ll need to go off your medications gradually.  Sometimes a person’s body will get used to the pain medicine and require a larger dose.  This is common, and it is called tolerance.  If this happens, your doctor may increase the level of the medication or switch to another type.

 

Most side effects from opioid pain medications can be managed. Nausea, drowsiness, itching, and most other side effects caused by morphine and similar opioid medications usually last only a few days.  Constipation, the side effect that is most difficult to manage, can usually be relieved with laxatives, adequate fluid intake, and attention to diet.

 

If you act quickly when pain starts, you can often prevent it from getting worse. Take your medications when you first begin to experience pain.  If your pain does get worse, talk with your healthcare provider.  Your provider may safely prescribe higher doses or change the prescription.  Non-drug therapies can also help give you relief.

If anyone is in spiritual distress, it may be experienced as anxiety or physical pain.

 

How Do I Talk with My Healthcare Provider About My Pain?

 

Speak up! Tell your healthcare provider that you’re in pain.  It’s not a sign of weakness to talk about your pain.

Tell your healthcare provider where it hurts. Do you have pain in one place or several places?  Does the pain seem to move around?

Describe how much your pain hurts. Use a scale from 0 to 10:  zero means no pain at all and 10 means the worst pain you can imagine.  Explain when your pain is the highest, lowest, and how it is right now.

Describe what makes your pain better or worse. Is the pain always there?  Does it go away?  Does it get worse when you move in certain ways?  Do other things make it better or worse?

Describe what your pain feels like. Use specific words like sharp, stabbing, dull, aching, burning, shock-like, tingling, throbbing, deep, or pressing.

Explain how the pain affects your daily life. Can you sleep?  Work?  Exercise?  Participate in social activities?  Concentrate?  How does it affect your mood?

Tell your healthcare provider about past treatments for pain. Have you taken prescription medication or had surgery?  Tried massage?  Applied heat or cold?  Exercised?  Taken over-the-counter medications, vitamin or herbal supplements?  Explain.

Write down your questions for the doctor or nurse before an appointment. Take notes at your visit.  If possible, bring along a family member or friend for support.

 

How Can I Get the Best Results Possible?

 

Ask questions, and speak up if treatment isn’t working. Follow your pain management plan, ask questions, and speak up if you’re not getting relief.  Sometimes the plan needs to be changed.  If necessary, seek other help.  Be persistent.

Set goals. With your healthcare provider, set realistic goals for things you most want to do, such as sleeping, working, exercising, or enjoying sexual relations.  Begin with the easiest goal first.

Work with your healthcare provider to develop a pain management planThis might include a list of medications, when to take them, and possible side effects.  It may include therapies other than medication, such as meditation/prayer.  Make sure you understand the plan and carry it out fully.  If you don’t, you are less likely to get relief.  Your pain may feel worse if you are stressed, depressed, or anxious.  Anxiety may be emotional, physical, or spiritual.

Keep a pain diary. Write about your level of pain at different times, how you’re feeling, and what activities you can and cannot do.  Keep a record of medications you’re taking or any non-drug treatments.  Bring the diary to your doctor visits.

Ask your healthcare provider about non-drug, non-surgical treatments. These could include spiritual support, relaxation therapy, exercise, massage, acupuncture, application of cold and heat, behavior therapy, music, and other therapies.

If you’re a patient in a hospital or other facility and you’re in pain, speak up. Ask a healthcare provider for help.  If you don’t get help right away, ask again.  If you don’t get help, speak to a social worker or patient advocate.

Pace yourself. Once you experience some degree of control over your pain, don’t overdo it.  Your body may be out of condition.  Take time to gradually build up to normal activity.

How Should My Pain Be Treated?

First, understand that your pain should be treated.  Left untreated, pain can be harmful to your body. Pain treatments vary for different conditions.  Ask your healthcare provider to tell you about treatment options that can help manage the pain that comes with your particular condition.  In addition, find out about ways to reduce stress and cope effectively with your pain.

 

Most often, people with moderate to severe chronic pain (pain that persists over time) get the very best results with a combination of therapies that address the physical, functional, and emotional, and spiritual aspects of pain.

 

Pain Medications:

Medications, called analgesics, are valuable tools for reducing pain.  Pain medications work best if taken before the pain becomes severe.  You should take these medications when you begin to feel uncomfortable.  Once pain becomes severe, it takes more time and more medication to bring it under control.

 

All medications, both over-the-counter and prescription can have side effects.  That’s why it’s important to take medications as directed and let your healthcare provider know about all of the medications you are taking.

Other Pain Medications:

Some medications that were developed to treat other conditions (such as anti-depressants, anti-inflammatory steroids, and anticonvulsants) can be helpful for treating pain.  They are often given in combination with other analgesics.  Discuss any questions you have about these drugs with your healthcare provider and your pharmacist.

Topical medicines (applied to skin), like creams that contain analgesics (numbing medicine) or capsaicin (made from hot peppers), may relieve pain on the surface level.

Non-Invasive, Non-Drug Therapies:

There are many non-drug therapies for relieving pain.  They can be used alone or in combination with drug therapies.  Consult with your physician regarding the following:

Thermal treatments, such as applying heat, (heating pad) and/or cold (ice pack), can reduce pain by allowing “non-pain” sensations to overload the nervous system.

Professional therapeutic massage is a method of manipulating the soft tissues of the body to relieve pain, spasms, release tension, and restore function.

Physical therapy, which can help improve function and quality of life, often includes:  manual therapy techniques; exercises to improve strength and balance; use of physical agents such as ultrasound or electrical stimulation; and functional training.

Chiropractic is a system of adjusting segments of the spine to remove nerve interference.  Chiropractors may also use other therapies, such as lifestyle and nutrition counseling.

Psychological counseling/cognitive therapy offers people powerful skills to help them manage their pain and stress.

Mind/body techniques are based on the idea that the mind and body work together as a unit.  Mind/body techniques can relieve pain by reducing stress (which helps the immune system).  Mind/body techniques include biofeedback, hypnosis, yoga, guided imagery, prayer and meditation, and music and humor therapy.  These therapies help disengage consciousness.

Acupuncture is one of the oldest therapies know to mankind and involves the insertion of very fine metal needles into the skin at specially designated points of the body.  Acupuncture is thought to work by altering the body’s energy flow and allowing the body to regain its balance and heal itself.

Invasive Pain Therapies:

These are methods recommended for chronic or combined pain problems.  Healthcare providers with special training in pain management can evaluate whether these methods could improve your pain relief and give you information about what you can expect.  These pain therapies include: Analgesia catheters and infusion pumps / Injection therapies / Chemical, thermal, or surgical ablation / Spinal cord stimulators (SCS) or dorsal column stimulators (DCS) / Radiation.

Guidelines for Taking Medications

 

Tell your healthcare provider about all the medications you are taking – both prescription and over-the-counter.  Include vitamins and herbal supplements. Medications and herbs can interact with each other and cause side effects or complications.  In some cases, some combinations of medications can either reduce or increase the effects of other needed medications.  For more information, see the National Council on Patient Information and Education (NCPIE) website at www.medbewise.org

Talk to your healthcare provider about any food or medication allergies you may have.  This information can help determine your treatment.

 

Take all medications as directed.  Even common, over-the-counter medications can have side effects – particularly if not taken as directed.

 

Talk to your pharmacist about your medications and how different foods might interfere with how they work.

 

Caution:  Alcohol, in combination with many pain medications, can be very dangerous.  If you drink, even socially, let your healthcare provider know.

 

PAIN DIARY

Date Time Location of pain Pain intensity Scale Rating(0-10) Medicine that I took Relief Rating(0-10) What I was doing when I felt Pain