Palliative Care for Pain and Treatment Side Effects

Managing Pain

Working with your doctor

It is important to be open and honest about your pain. You don't have to pretend that 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 reduces 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?
• How are you coping with your situation?

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

Using medicines

The goal of good pain management is to have the least possible pain with the fewest side effects. Because each person responds to pain medicines in a different way, it may take more than one try to find the best medicines for you.

If your pain isn't severe, nonprescription medicines may help relieve it. These include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen.

If these medicines don't help, your doctor may prescribe medicines called opioids. Opioids may be used with other medicines, such as NSAIDs or antidepressants, to treat your pain.

Talking about concerns with opioids

Many people are worried that taking opioids will lead to opioid use disorder. Moderate to severe opioid use disorder is sometimes called addiction. This isn't usually an issue in people who are near the end of life. For others, the risk is usually low. But it can be higher if you or a family member has had a substance use disorder. It can also be higher if you are living with mental illness.

Some people may worry about feeling tired or not thinking clearly when they take an opioid. But these side effects often don't last. Many people who take opioids for a long time don't 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 developing opioid use disorder, talk to your doctor.

Talk with your doctor about getting a naloxone rescue kit. It can help you if you take too much of an opioid (overdose). Ask your doctor about how to avoid an overdose and how to store your medicine safely.

Managing Treatment Side Effects

You may have side effects of treatment or other symptoms that bother you. Tell your doctor about all of your side effects and symptoms.

Your doctor may be able to give you medicines or other treatment that can help if:

• You feel like you can't breathe well.
• You don't want to eat or you feel like you are going to throw up.
• You feel tired or weak.
• You have trouble sleeping.
• You have a change in bowel habits, such as constipation or diarrhea.
• You have problems urinating.
• You have itchy skin or a dry mouth.
• You can't think clearly.

Other treatments (called complementary therapies) may also help. These include:

• Stretching, yoga, and movement to help you stay strong, flexible, and mobile.
• Healing touch or reiki to ease anxiety and improve sleep.
• Relaxation biofeedback, meditation, or guided imagery to ease stress.
• Physical therapy or light massage (not deep tissue or intense pressure) to help you relax.

Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you already use any such therapies.

These therapies aren't meant to take the place of standard medical treatment. But they may help ease symptoms. And they may improve your quality of life.