Getting Treatment for Your Pain

Bring your pain diary or report to your doctor. Depending upon what stage of treatment you're in, this might be your surgeon or oncologist.

If that person does not listen, or you are unsatisfied with the response, then look further. Your primary care doctor may be able to help.

If you feel your doctor is not taking your pain seriously enough or simply can't find a solution, find a doctor who will. You may also want to ask your doctor to refer you to a pain management center at a hospital near you.

Talk about your pain with adult family members and others who care about you. Don't stay silent because you want to protect them. They'll be more concerned if you don't tell them what you're feeling.

Doctor-patient communication

Reporting or describing pain is not complaining! Don't hesitate to talk about your pain because you're afraid of bothering the doctor or seeming like a whiner.

Sometimes you might forget to discuss your pain with the doctor because you're more focused on talking about treatment or recovery. That's especially true if you're not hurting while in the doctor's office. Come to your medical appointments with a list of topics to discuss, and include pain on that list.

You and your doctor must fully understand each other. Be clear about what you say and what you hear. Sometimes, you both may use words that mean different things to the other person.

Indicate which side effects you are willing to tolerate and which ones you find unacceptable. For instance, all morphine and codeine-like products (narcotics, or opioids—pronounced OH-pee-oydz) cause lethargy (sleepiness and low energy). One patient may say, "I'll accept a little sleepiness if I can get complete pain relief." Someone else may insist on a clear mind above all, with pain relief being less important. In the first few days of taking a new opioid or increasing the dose of an opioid, you may feel sleepy. Most people adjust to this feeling and feel fine in two or three days.

Continuous communication is essential to sustained pain relief. It will take some trial and error to find the right pain medications and get them working well for you. The nature of your pain might change, and this may require a change in your treatment. Tell your doctor and nurse if:

• the pain medication isn't working
• you have side effects such as nausea, constipation, or excessive sweating
• you develop trouble breathing, a rash, or itching. These may be signs that you are allergic to a medication, and you may need to stop taking it immediately

Remember:

• Nearly all pain is treatable.
• It's not heroic to suffer. If you hurt, speak up!
• Keep a pain diary.
• Communicate with your doctor AND nurse.
• If your pain is not being treated successfully, ask for a referral to a pain management specialist.
• If you're on around-the-clock opioids you'll probably need to take regular doses of laxative to prevent constipation.
• If you take your medications as directed, your pain can be controlled with opioids without any significant risk of addiction or tolerance. You will not become immune to the benefit of opioids. If you have more pain, your dose can be increased without any preset upper limits.

The team approach

Many hospitals now have special pain management centers. Here, teams of doctors and other specialists identify and assess pain, and then design individualized treatment plans. Most centers help the patient gain an improved sense of control over pain.

Pain management centers generally bring together a group of experts from different fields to provide a comprehensive pain relief plan. The specialists include pain specialists, internal and physical medicine specialists, physical therapists, psychiatrists, chiropractors, and acupuncturists.

Hospital-based pain centers often also have access to advanced diagnostic equipment, new techniques, and information gained from on-site research studies.

A hospital near your home may have recently begun such a program. If your pain continues to be unrelieved, ask your doctor for a referral to a pain management center.