Pain: What Is It?

What Is Pain

Pain is a sensation that hurts. It may cause discomfort, distress or agony. It may be steady or throbbing. It may be stabbing, aching, or pinching. However you feel pain, only you can describe it or define it. Because pain is so individual, your pain cannot be "checked out" by anyone else.

Pain may be acute or chronic. Acute pain is severe and lasts a relatively short time. It is usually a signal that body tissue is being injured in some way, and the pain generally disappears when the injury heals. Chronic pain may range from mild to severe, and it is present to some degree for long periods of time.

What Causes Pain People With Cancer?

Cancer patients may have pain for a variety of reasons. It may be due to the effects of the cancer itself, or it could result from treatment methods. For example, after surgery a person feels pain as a result of the operation itself. Or the pain could be unrelated to the cancer-a muscle sprain, a toothache, or a headache.

Remember that not all people with cancer have pain. And those who do are not in pain all the time.

Cancer pain may depend on the type of cancer, the ]]>stage]]> (extent) of the disease, and your ]]>pain threshold]]> (or tolerance for pain). Cancer pain that lasts a few days or longer may result from:

• The tumor causing pressure on organs, nerves, or bone.
• Poor blood circulation because the cancer has blocked blood vessels.
• Blockage of an organ or tube in the body.
• ]]>Metastasis]]> --cancer cells that have spread to other sites in the body.
• Infection or inflammation.
• Side effects from ]]>chemotherapy, radiation therapy]]> , or surgery.
• Stiffness from inactivity.
• Psychological responses to illness such as tension, depression, or anxiety.

Whatever the cause, pain can be relieved.

What Can Be Done for Cancer Pain?

The best way to manage pain is to treat its cause. Whenever possible, the cause of the pain is treated by removing the tumor or decreasing its size. To do this, your doctor may recommend surgery, radiation therapy, or chemotherapy. When none of these procedures can be done, or when the cause of the pain is not known, pain-relief methods are used.

This booklet describes many methods for controlling pain. They include pain medicines, operations on nerves, ]]>nerve blocks, physical therapy]]> , and techniques such as ]]>relaxation, distraction]]> , and ]]>imagery]]> . Only you and your doctor and nurse-who know where your pain is, how bad it is, the kind of cancer you have, and your general health-can decide which methods might be best for you.

What Do I Tell Those Caring For Me About My Pain?

If you are feeling pain, you need to be able to describe it to those who are trained to help you. Some people find pain very hard to explain. Try to use words that will help others understand what you are feeling. Your doctor and others who are caring for you need to know:

• Where do you feel your pain?
• When did it begin?
• What does it feel like? Sharp? Dull? Throbbing? Steady?
• How bad is it?
• Does it prevent you from doing your daily activities? Which ones?
• What relieves your pain?
• What makes it worse?
• What have you tried for pain relief? What helped? What did not help?
• What have you done in the past to relieve other kinds of pain?
• Is your pain constant? If not, how many times a day (or week) does it occur?
• How long does it last each time?

Pain has different effects on different people. Be sure that those who are caring for you know about the effects.

Don't hesitate to talk about your pain to those who can help you. You have a right to the best pain control you can get. Relieving your pain means you can continue to do the everyday things that are important to you. Remember, only you know what you are feeling.

Some of the Effects of Pain

Symptoms accompanying your pain : nausea, headache, dizziness, weakness, drowsiness, constipation, diarrhea, perspiration

Ability to sleep : good, fitful, can't sleep

Desire to eat : good, some, little, can't eat

Emotional effects : anger, depression, crying, mood swings, irritability, suicidal feelings

Lifestyle changes : work, recreation, interpersonal relationships, ability to get around, self-care activities

How Can I Describe How Bad or Intense the Pain Is?

Understanding how bad your pain is helps your doctor decide how to treat it. You can rate how much pain you are feeling by using a pain scale like the one below. Try to assign a number from 0 to 5 to your pain level. If you have no pain, use a 0. A 5 means the pain is as bad as it can be. As the numbers get larger, they stand for pain that is gradually getting worse.

You may wish to make up your own pain scale using numbers from 0 to 10 or even 0 to 100. Be sure to let others know what pain scale you are using: for example, "My pain is a 7 on a scale of 0 to 10."

You can use a rating scale to answer:

• How bad is your pain at its worst?
• How bad is your pain most of the time?
• How bad is your pain at its least?
• How does your pain change with treatment?

How Can I Remember All the Details About the Pain I Have, and What I Do To Relieve It?

You may find it helpful to keep a record or a diary about your pain and what you try for pain relief. The record helps you and those who are caring for you understand more about your pain, the effects it has on you, and what works best to ease your pain. Items that should be included are:

• The number from your rating scale that describes your pain before and after using a pain-relief measure.
• The time you take pain medicine.
• Any activity that seems to be affected by the pain or that increases or decreases the pain.
• Any activity that you cannot do because of the pain.
• The name of the pain medicine you take and the dose.
• How long the pain medicine works.
• Any pain relief methods other than medicine you use such as rest, ]]>relaxation techniques, distraction, skin stimulation , ]]> or ]]>imagery . ]]>

Can Anxiety Or Depression Cause Pain?

No, but these feelings can make the pain seem worse. People often have an emotional reaction to pain. You may feel worried, depressed, or easily discouraged when you are in pain. Some people feel hopeless or helpless. Others feel alone or embarrassed, inadequate or angry, frightened or frantic.

People with cancer have many reasons for feeling anxious or depressed even when they are not in pain. Try to talk about your feelings with your doctors, nurses, family members, friends, a member of the clergy, or other cancer patients. Talking with family members is often helpful, even though this might be hard for you to do at first.

In some communities, cancer patients meet informally to talk about their feelings and share how they have coped with this disease. Just understanding that others feel the same way as you do might help you deal with having cancer. For information about support services in your area contact your local Unit of the American Cancer Society, the Visiting Nurses Association, the Cancer Information Service at 1-800 4 CANCER (1-800422-6237), or someone from a hospice, if one is located in your area.

If you feel that these informal ways to lessen your anxiety or depression are not helpful, you may wish to talk with a counselor, a mental health professional who is skilled at dealing with such problems. Your doctor or nurse may be able to help you find a counselor who is specially trained to help people with chronic illnesses. The social services department at your local hospital is another source of information about people who can help you deal with anxiety and depression.

Another option is to ask your doctor about medication. Sometimes, medicine such as ]]>antidepressants]]> or ]]>tranquilizers]]> can be helpful. Some of these medicines relieve pain in addition to their antidepressant effects.

How Does Fatigue Affect My Pain?

Fatigue can make it harder for you to deal with pain. When you are tired, you may not be able to cope with the pain as well as when you are rested. Many people notice that pain seems to get worse as they get tired. Lack of sleep can increase your pain. Be sure to tell your doctor or nurse if you have not been sleeping well because of pain or worry.

What Is Phantom Limb Pain?

If you have had an arm or leg removed by surgery, you may still feel pain or other unpleasant sensations as if they were coming from the absent limb. Doctors are not sure why it occurs, but phantom limb pain is real; it is not imaginary. This also can occur if you have had a breast removed-you may have a sensation of pain in the missing breast.

No single pain-relief method controls phantom limb pain in all patients all the time. Many methods have been used to treat this type of pain, including pain medicine, physical therapy, and nerve stimulation. If you are having phantom pain, ask your doctor, nurse, or pharmacist about how you might relieve it.