Types Of Pain And How To Talk About Them

Types Of Pain and How To Talk About Them

There are different types of pain:

· acute pain starts suddenly and is short-term

· chronic pain lasts for a longer period of time

· breakthrough pain often happens in between regular, scheduled painkillers

· bone pain happens when cancer is affecting a bone

· soft tissue pain happens when organs, muscles or tissues are damaged or inflamed

· nerve pain happens when a nerve is damaged

· referred pain is when pain from one part of your body is felt in another

· phantom pain is when there is pain in a part of the body that has been removed

· total pain includes the emotional, social and spiritual factors that affect a person’s pain experience.

Pain does not feel the same for everyone. Describing your pain clearly will help your doctor or nurse find the best treatment for you. Tell your healthcare team where the pain is, what it is like (for example dull, sharp, burning), how bad it is and when it happens.

Keeping a pain diary can help you explain your pain to your doctor or nurse.

Pain terms

Your doctors or nurses may talk about your pain in different ways. We explain the different types of pain you may hear about.

Acute pain

Acute pain often starts suddenly and feels ‘sharp’. It can be caused by many different things, such as:

· an operation

· a broken bone

· an infection.

Acute pain is usually short-term, but it can sometimes last for weeks or months. Most acute pain will go away when the reason for the pain has been treated or the tissues have healed. If acute pain is not relieved, it may become a chronic pain.

Chronic pain

Chronic pain lasts for a longer period of time. It’s usually caused by the cancer itself, but it can sometimes be caused by the longer-term effects of cancer treatments.

Breakthrough pain

This is a sudden pain. It sometimes ‘breaks through’ when chronic pain is being well-controlled with long-acting painkillers.

It may be brought on quite suddenly by an activity, such as moving or coughing. It may happen when the effect of the regular painkiller wears off. Sometimes it’s not clear why someone has breakthrough pain.

Breakthrough pain is common, but it can usually be successfully managed. It is treated with short-acting painkillers.

Bone pain

If cancer is affecting a bone, it can cause pain. The cancer may have started in the bone (primary bone cancer) or spread there from another part of the body (secondary bone cancer). The pain may be a dull, persistent ache that doesn’t go away. It can happen during the day as well as at night.

Soft tissue pain

​This is pain we feel when our organs, muscles or tissues are damaged, injured or inflamed. An example is when the liver becomes enlarged, causing pain and discomfort in the tummy (abdomen). Soft tissue pain is also called visceral pain.

Nerve pain

This is pain caused by nerve damage. It may be due to the cancer or cancer treatments. The pain can often continue even when the cause has been treated. Nerve pain is also called neuropathic pain.

Like many types of pain, nerve pain can come and go. Often the area feels numb or more sensitive. You may describe it as:

· burning

· stabbing

· shooting

· tingling.

There are specific medicines and treatments used to treat nerve pain.

Referred pain

This is when pain from an internal organ can be felt in a different part of the body. For example, if the liver is enlarged, it can cause pain in the right shoulder. This may happen because pain messages from the liver travel along the same nerve pathways as messages from the skin. The brain confuses them and thinks the pain is coming from a different place.

Phantom pain

This is when the brain ‘feels’ pain in a part of the body that has been removed. It can sometimes happen after surgery to amputate an arm or a leg, and occasionally after a breast is removed (mastectomy).

Phantom pain may feel like cramping, stabbing or burning, but can cause many different pain sensations. Many people find that phantom pain gets better with time and may eventually go away. But some people find that the pain can affect them for a long time. It is important to let your doctor or specialist nurse know about phantom pain because there are specific medicines that may help.

Total pain

Total pain is a term doctors and nurses use to describe all the different parts of a person’s pain. This includes how the pain affects, and can be affected by our:

· emotions

· behaviours

· spiritual beliefs

· social activities.

Your healthcare team will consider these things when assessing your pain. Tell them about any worries you have, even if they are not about your illness.

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Talking about your pain

It’s important to talk about your pain and how it’s affecting you. Some people may not want to talk about their pain as they feel they are complaining. Others think that they just have to accept pain, and that talking about it won’t help. But you should tell your healthcare team about the pain, as there are usually ways of managing it. And the earlier the pain is treated, the more effective treatment usually is.

Having pain that is not properly controlled can make you miserable and affect your everyday life. If you are in pain and upset, this will also affect the people close to you. Tell your healthcare team how you are feeling. They can help manage your pain. Feeling less or no pain will help you do the things you want to do. It will also help you stay more positive and active.

Ways to describe pain

Describing your pain as well as you can will help your doctors and nurses find the best way of treating it. Many people find it hard to put their pain into words. The questions below will help you describe your pain.

Where is the pain?

Is the pain in one part of your body, or in more than one place? You can use a diagram like the one below to mark where your pain is. If you have more than one pain, label them A, B, C, and so on (with A being the pain that upsets you most).

What is the pain like?

You might use the following words to describe your pain:

· aching

· tender

· sharp

· shooting

· hot

· burning

· nagging

· intense

· stabbing

· tingling

· dull

· throbbing

How bad is your pain?

If you measured your pain on a scale of 0 to 10, what number would you rate it? Where 0 means no pain, and 10 means severe pain.

When are you in pain?

Are you in pain all the time or does it come and go? Is it better or worse at night? Does it keep you awake or wake you up?

Does anything make the pain better or worse?

· Do you feel better or worse when you’re standing, sitting or lying down?

· Does a heat pad or ice pack help?

· Do painkillers, such as paracetamol, stop the pain or just reduce it, and for how long?

· Can you reduce the pain yourself by reading, listening to music or watching TV?

How does the pain affect your daily life?

Think about the ways the pain is affecting what you can do in or outside the home, your sleep and your mood.

· Can you sit long enough to eat a meal?

· Does the pain stop you from concentrating?

· Does it affect your social life, or your sex life?

Knowing this will help your doctor or nurse understand the problems the pain is causing for you.

Don’t feel that you’re being a nuisance or making a fuss by talking about your pain. Your answers to these questions will help your doctor or nurse plan the best treatments for you.

Pain diary

You might find it helpful to keep a record of your pain.

Write down how bad it is at different times of day and note anything that makes it better or worse. This information can help you talk about your pain with your doctor or nurse.

Your hospital may give you a pain chart to use. Or you can use our pain diary. It has a diagram of the body so you can mark where you feel pain. And it gives examples of words that you may find helpful when describing your pain.

Writing it down means you can keep a record of the progress you have made and things you’ve learned over time.

Pain assessment

Your healthcare team will ask you lots of questions about the pain you have and how it is affecting you. They will ask you to describe your pain and will want to look at your pain diary, if you have one. The pain assessment is very important and helps to make sure your doctors give you the best painkillers for your situation.

As well as asking you questions about the pain, your doctor will examine you and may arrange for you to have some tests and investigations. Having all this information will help them to manage your pain.