Comfort Measures  >  Recognizing and Relieving Pain

Need to Know

woman checking on patient in bed

Types of Pain

There are different types of pain. Knowing how they differ can help you decide when you need to act. You can do this by getting the person help or by offering some basic comfort measures. You should never try to decide the source or cause of a person’s pain on your own. But knowing the differences will help you choose the best ways to make a person comfortable.

Acute Pain

Acute or sudden pain tells us when we have an injury or physical problem. It tells us something is wrong. Acute pain is best described in these ways:

  • It is short term, lasting several seconds to many days or weeks, depending on the cause.
  • In most cases acute pain will not last longer than 6 months but unrelieved acute pain can lead to chronic pain.
  • Acute pain will end after the damaged area heals.
  • A person’s physical and mental energy focuses on pain relief.
  • At first, complete relief might not be possible, but reducing pain is realistic.
  • There is often limited tissue injury.
  • The course of the pain is usually predictable.

Examples of conditions that cause acute pain include: surgery, injury, burns and cuts, labor and childbirth, dental work, kidney stones, and heart attack.

Chronic Pain

Chronic or long-term pain can be constant or an “off and on” type of pain. It doesn't stop after an injury heals and it keeps on past the time when relief is expected. Many times, chronic pain is hard to treat because the cause is unclear. There are two types of chronic pain; non-cancer pain and cancer pain.

woman in pain

Chronic non-cancer pain can best be described in these ways:

  • Long term, lasting longer than expected, usually 6 months or longer
  • Pain that may last for many years.
  • Pain that can lead to great personal suffering.
  • Physical effects include tense muscles, limited ability to move, a lack of energy and loss of appetite.
  • Mental effects include depression, anger, anxiety, and fear of re-injury.
  • Pain is usually not life-threatening.
  • A person does not always show obvious symptoms.
  • The inability to get relief frustrates both the person in pain and their caregiver.
  • In most cases the pain is caused by nerve, muscle or bone conditions.

Examples of conditions that cause chronic non-cancer pain: arthritis, low back pain, migraine headaches, shingles, neuropathy, and fibromyalgia.

Chronic cancer pain does not affect all persons with cancer. It is usually due to growth of a tumor or the effects of cancer treatments. Chronic cancer pain can best be described as:

  • Long term, lasting over the course of the person’s disease.
  • Causing physical effects including fatigue, nausea, and loss of appetite.
  • Having mental effects such as depression, anger, and anxiety.
  • A pain that may involve the site of the tumor, or be felt in another part of the body (called referred pain).

Pain relief is possible with pain medicines or combinations of medicines. Cancer pain is common in cancers such as bone cancer, and advanced cancers that have spread to organs in the body such as the liver, stomach, and colon.

The Myths about Pain

Many of us, even doctors, nurses and therapists hold myths, or ideas about pain that aren't true. Myths might cause you to ignore someone in pain or not provide the type of comfort that is available. Understanding the myths will help you act responsibly when the person you care for tells you he or she is having pain. Here are some common myths.

Myth

Truth

Pain is just a part of growing old.

Pain is not a natural part of aging. But, older adults are more at risk than younger adults for many painful conditions. Sometimes an older adult is unable to tell you and endures pain for much longer than they need to.

Therefore if you care for an older adult who tells you he or she is in pain, pay attention.

Being able to feel or sense pain lessens with age

No, there's no proof that as a person gets older they are less able to feel pain. An older adult may not tell you about their pain for many reasons. Such as: hearing problems that affect how well they can communicate, or not being able to think clearly.

Taking pain medicine will make you addicted

Many people are under treated or fail to take their pain medicines because of this myth. Pain medicines are generally ordered in an amount and frequency that are safe. This is especially true after surgery when it is very important for a person to tell nurses when they have pain. Pain control is needed for healing.

Persons with dementia or those who do not speak, do not have pain

There is no proof that persons with dementia have less pain or that their reports of pain don't mean anything. Persons with dementia or those who have trouble communicating are often under-treated. They often don't get the right pain control because they are unable to report the pain and describe it. Always accept the person’s report of pain.

Persons should expect to have pain in the hospital

No, persons should expect to receive pain relief when in the hospital. Pain control is very important for allowing a person to be able to move about and begin to recover from injury or illness.

Types of Pain Medicines

  • Analgesics are the most common and best form of pain relief. There are three types: non-opioids, opioids (called narcotics), and co-analgesics
    • Non-opioids are for mild to moderate acute pain. Examples include Acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, Ibuprofen, Naprosyn and others. The anti-inflammatory drugs reduce swelling and soreness. These medicines may be combined with others for improved pain control. Note that Aspirin, Ibuprofen and Naprosyn may cause stomach upset or other gastrointestinal symptoms like cramping and diarrhea. Read the instructions carefully as you might need to take some of these medicines with food.
    • Opioids are for moderate to severe pain. Examples include Morphine, Oxycodone, codeine and Fentanyl. These medicines may cause drowsiness, nausea, or constipation.
    • Co-analgesics increase the effects of analgesics. These drugs are usually for other conditions but have been shown to help lessen pain. The medicines are to be taken with an analgesic because this makes the analgesic work better. Examples include anti-depressants, anti-anxiety, and anti-convulsant medicines.

Safe Use of Pain Medicines

Many people today take pain medicines to control or relieve their pain. You often hear or read in the media the problems of drug dependence and addiction. Most drug addiction today is due to overuse of prescription medicines for reasons other than pain control or taking prescription medicine too often or combining prescriptions from different doctors.

The truth is that analgesics are the most common and effective method of pain relief, when taken correctly. You need to understand the effects and uses of the drugs you will be giving to the person you are caring for.

Persons at risk for addiction include:

  • A person who takes more than one medicine for the same painful condition
  • A person suffering anxiety, depression and loneliness
  • Person’s with a genetic tendency towards addiction

See our lesson on Safe Use of Pain Medicines.