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.
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.
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:
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.
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?
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.
2. Consider therapies besides medication
Concerns about addiction and side effects are prompting increased interest in pain relief options that don’t require medication.
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.
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.
- 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.
- Meditation helps you learn to reach a relaxed state of mind that can ease the perception of pain.
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.
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.