Managing Pain with Medications

Follow these guidelines to get the relief you deserve:

• Start medications at lower doses; then increase the dose if your symptoms don't lessen.
• Tackle persistent pain with continuous, round-the-clock pain relief. Use occasional, "as needed" help for breakthrough and acute pain.
• To treat limited pain with the fewest side effects, treat the underlying cause of the pain in the part of the body where the pain is located. This is possible only if the pain is confined to a small area and medications can be added or removed as needed.
• Cancer treatment such as hormones, chemotherapy, or radiation therapy can shrink the cancer and decrease the pain it is causing.
• To treat pain that's throughout your body—and get the fewest side effects—combine local and general therapies.
• Combining medications allows you to take advantage of the ways some of them can work together.
• Call your doctor or nurse to change your medication if it fails to relieve your pain after you have taken the highest dose you can.
• Try any medication for at least a few days before you call your doctor or nurse about trying another.
• If you are taking a combination of pain medications, try to change only one at a time.
• Treat side effects as they develop, and take steps to prevent the side effects you can anticipate.

In pain emergencies:

• If you are alone in the hospital and need pain help, but the nurse can't give you more medication, ask to see the doctor on call. There is always one. If the doctor is tied up, or doesn't answer within 15 minutes, and the nurse has not been helpful, demand to speak to the nursing supervisor, patient ombudsman, patient relations person, or hospital administrator.
• If you are alone at home and you have new or uncontrolled pain, call your doctor through his or her answering service or through the hospital. Ask to have a prescription called in to a pharmacy that delivers. Opioid (narcotic) prescriptions can't be called in, so you'll need to get someone to present a written prescription at the pharmacy and pick up the medication. If you can't find someone to do that, and you have new, very severe pain, go to the emergency room.
• If you're in hospice and have severe pain, call your hospice nurse.

There are other ways to control pain besides medication.

• Radiation therapy offers very effective and lasting relief from a wide range of local types of cancer pain.
• Procedures that temporarily block nerves before surgery can help reduce post-surgical pain.
• You can give yourself epidural infusions of morphine and anesthetics with a special pump. This procedure is called PCEA, or patient-controlled epidural anesthesia.
• Certain nerve-blocking techniques can help with particular points of pain for longer periods of time.
• Chemotherapy can reduce pain from advanced (metastatic) cancer.
• Complementary and alternative therapies may also help with different types of pain.