Pain and other symptoms related to your life-limiting illness almost always can be managed effectively. Talk to your doctor and family about the symptoms you are experiencing. Your family is an important link between you and your doctor. Have a loved one report your pain if your illness prevents you from communicating. Usually it is possible to manage pain and other symptoms so that you are comfortable.
If you and your doctor are not able to control your pain, ask about seeing a pain management specialist. This is a doctor who finds ways to treat pain that won't go away.
Guidelines from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) state that pain must be assessed and controlled for people in hospitals and nursing homes.1
Many medicines are available to relieve pain. Your doctor will choose the easiest and most noninvasive form of medicine to treat your level of pain. Medicines taken by mouth (oral) are usually used first, because they are easier to take and are usually less expensive than other forms of medicines. If your pain is not severe, medicines that help to reduce pain and swelling can be purchased without a prescription. These medicines include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen. It is important to "stay ahead" of your pain by taking your pain medicines on a regular schedule. Not routinely taking pain medicines is a common cause of ineffective pain management.
Pain that is not controlled by nonprescription medicines may need stronger forms of treatment. Pain medicines such as codeine, morphine, or fentanyl may be prescribed by your doctor. These medicines may be combined with others, such as nonsteroidal anti-inflammatory drugs or antidepressants, to manage your pain.
Pain medicines can be given by mouth, such as pills, or as drops placed under the tongue (sublingual). Medicines may be given by injection, by IV, or through patches placed on the skin (transdermal patches). Sometimes medicines are put into the space next to the spine (such as epidurals). Other medicines are put under the lining of the spinal cord (intrathecal).