If you have breakthrough pain—sudden spikes of extreme pain your chronic pain medication can’t control—you know it can be tough to tame.

See Medications for Breakthrough Pain

Since breakthrough pain can reach its peak in 5 minutes or less, the medication has to take effect quickly.
Common Risks and Side Effects of Treating Breakthrough Pain

Breakthrough pain comes on quickly, and usually lasts less than an hour, meaning most painkillers don’t take effect quickly enough to help you. Short-acting and immediate-release opioids, also called narcotics—are often needed to take on the pain.

See Medications for Back Pain and Neck Pain

Many people with low back pain or arthritis pain deal with these flare-ups—often at least once a day. Try these three strategies to minimize the painful disruptions:

See Managing Breakthrough Pain


1. Keep a diary to record when the breakthrough pain occurs

A detailed pain diary showing when your breakthrough pain began and ended, and what you were doing when it occurred, can help you work with your doctor on ways to ease the pain.

Watch Acute Back Pain vs. Chronic Back Pain Video

Is it most likely to happen following some kind of activity, such as taking a shower? Or does the pain spike when the next dose will be taken soon—but you’re not quite there yet?

See When Acute Pain Becomes Chronic Pain

If it’s possible to identify the triggers for your breakthrough pain, it will be easier to make adjustments to try to prevent it. Adjustments could include a change in your level of physical activity or in your round-the-clock medication.

Watch Treatment for Chronic Lower Back Pain Video

Yoga can be a safe and effective way to alleviate back or neck pain and help prevent ongoing problems.
Yoga Poses

2. Consider therapies besides medication

Concerns about addiction and side effects are prompting increased interest in pain relief options that don’t require medication.

See Opioid Medication Potential Risks and Complications

Physical therapy is one of the most common approaches, offering safe exercises that strengthen your body and improve flexibility. Warm-water therapy, or water exercise, is a type of physical therapy popular with those in pain. The therapy is often done in a pool heated to at least 86 degrees Fahrenheit—much warmer than a typical swimming pool—which many people find soothing. The warm water helps warm up your muscles to make the exercise more tolerable.

See Getting Started with Pool Therapy

Other pain management therapies worth looking into include:

  • Massage can improve circulation, relax muscles, and ease tension related to dealing with chronic pain. Massage can also release endorphins, the body’s natural pain reliever, to make you feel better.
  • See Neuromuscular Massage Therapy

  • Biofeedback is a therapist-guided process that uses a machine to offer “feedback” about certain body functions, such as muscle tension. By working with the machine, a person with chronic pain can learn relaxation techniques to ease this tension, reducing the perception of pain. Once the techniques are learned, the machine is no longer needed.
  • See Chronic Pain Coping Techniques - Pain Management

  • Meditation helps you learn to reach a relaxed state of mind that can ease the perception of pain.
  • See Healing Benefits of Yoga

These therapies may not replace a medication, but may ease your symptoms and improve your outlook enough to allow you to take a medication less often or at a lower dose.

3. Treat your depression or anxiety

If you’re struggling with depression or anxiety, it is important to get treatment for those symptoms as well as for your pain. You may not realize that chronic pain and depression are interrelated. Chronic pain can lead to depression, and depression can be a factor in making chronic pain worse.

See Depression and Chronic Back Pain

Discuss your depression or anxiety with your doctor, and request a referral to a psychologist or psychiatrist. Depression or anxiety are most often treated with antidepressant medication, talk therapy, or both. In talk therapy, you’ll discuss your thoughts, feelings, and behaviors with a therapist as you work together to improve your situation.

The unpredictable nature of breakthrough pain makes it especially difficult to bear. Keeping close tabs on your symptoms, looking at all the options for pain relief, and taking action if depression and anxiety are weighing you down can make life a little easier.

Learn more

11 Chronic Pain Control Techniques

Chronic Pain As a Disease: Why Does It Still Hurt?