Talking About Pain

One of the most important things you can do to help manage pain is talk about it. You are the expert on how you are feeling. Your hospice care team members need and want you to tell them when pain is happening, how bad it is, and what it feels like. Your care team will ask many questions about your pain because this information is very important in determining:

• The type of pain you are having
• The treatments that will be most effective

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Your care team members will ask questions like these to guide them in managing any pain that you are having.

• Where is the pain? Pain can be in more than one place. Let your health care team know all of the painful areas. Which site of pain is the most severe or bothersome?
• What does the pain feel like? Your description of your pain is very important in helping your care team decide which medications or treatments would work best. Which of the following words describe your pain?
  Aching, Burning, Cramping, Cutting, Crushing, Searing, Sharp, Shooting, Squeezing, Stabbing, Stinging, Tearing, Throbbing, Tingling
• How intense is the pain? A number scale is frequently used to rate pain. The scale most often used is a 0-10 scale, with 0 being no pain, and 10 being the worst pain you can imagine. You can also describe pain with words like, none, mild, moderate, severe, or worst possible pain. This helps your team to know how well your treatment plan is working and what changes need to be made.
• How does pain change your activity? Letting your hospice team know how pain is affecting your day-to-day life is very helpful. For instance, are there things you cannot do because of the pain: walking, eating, sleeping, riding in the car, turning over in bed, sitting up, bathing, going to the bathroom, talking?
• What makes the pain better and worse? Some things may make pain increase or decrease. For example, using heat or cold on the place that hurts, sitting or lying in different positions, urinating or moving bowels, and walking may affect your level of pain. Pay attention to those things that trigger and relieve the discomfort.
• When do you notice pain? When is pain the worst? Is there a pattern to your pain? When are you most comfortable?
• If you are currently taking medication for pain, how well is it working? Describe how well the treatment is working by using the 0-10 scale. Or, you can say how much of the pain is relieved – all, almost all, none, etc. Let your care team know how quickly the medication takes effect and how long it lasts. For instance, does it work well for 2 hours, but wear off before the next dose is scheduled to be taken?
• Are you having any side effects from the medications that you are taking? Most, if not all, side effects from pain medicines are preventable or treatable. Make sure you let your care team know if you are having any side effects or problems. Some common side effects that can be managed are: constipation, nausea and vomiting, sleepiness, itching and confusion.
• Has the pain changed? Pain may change over time. It may get better or worse or feel different. For example, the pain may have been a dull ache at first and has now changed to a burning, tingling feeling. Please report any changes. Changes in pain do not necessarily mean the illness is getting worse.

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