Nondrug methods of pain control
There are many methods of pain control that do not involve medications.
- Reduce the amount of work or chores that you are doing. For example, if housework or yard work is aggravating the pain, find others to help out, at least until the pain is better controlled.
- Take rest periods during the day. This can be useful to "recharge the batteries" and help you cope.
- Adjust your environment to your needs. Some people feel relaxed with a lot of people and noise because they find that the distraction reduces their awareness of pain. Others, however, require quiet and a few well-known friends. Ask others to help you achieve what works best for you.
- Try relaxation and visualization exercises. These have helped many people to be more in control of their pain.
- Physical therapy such as physiotherapy and massage therapy can be helpful for pain, especially muscle and joint pain.
- Hot and cold packs can be useful for musculoskeletal pain.
- Acupuncture has been helpful to many people with chronic pain.
Using medication to control pain
Choosing the right medication: the "stepped" approach
If it is appropriate to treat the pain with medication, the type chosen depends
on the type of pain, severity, what you have tried before, and any intolerance or allergies to medications that you may have. Mild pain may be treated with acetaminophen or anti-inflammatory drugs. If the pain is more severe or does not respond to previous medications, an opioid medication is added. Generally, a weak opioid is used, such as codeine alone, codeine and acetaminophen, or oxycodone. If the pain is severe or doesn't respond to the previous medications, then a stronger opioid is used. Strong opioids are generally considered to be morphine, hydromorphone, and fentanyl. This gradual approach is called the "stepped approach" to pain management, initiated by the World Health Organization in the early 1980s.
If you have worries or questions about opioids, then ask
Many people have worries about taking opioids or narcotics for pain. It is important for you to be able to ask questions about your medications and discuss any concerns you have with your health care team. No question is too "stupid" or too embarrassing. Once you are comfortable with your pain medication and see it as one of the tools you are using to control your pain, you will be on your way to achieving relief and comfort.
Opioids: pills versus needles
Opioids are given by needle only when a person cannot take medications by mouth. The best way to give opioids by needle is subcutaneously, that is, by putting a needle under the skin rather than intravenously (into a vein). Medication given subcutaneously has the same duration of action as the short-acting opioids taken in pill form.