Different Types of Pain Found in Hospice

Discover essential information on identifying and treating various types of pain experienced by hospice patients. This comprehensive resource is tailored for hospice nurses, aides, and managers, providing clinical examples, pain characteristics, localization, and suggested treatments. Enhance your knowledge and skills in pain management to deliver compassionate care.

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Pain OriginClinical ExampleQualityLocalizationTreatment
VISCERAL
Organs, Organ capsule or covering; lining; Connecting and supporting structures
Tumor invasion
Obstruction (of ureters, colon, gastric outlet, gall bladder etc.)
Bladder, Gl distention or spasms, colic
Angina, pancreatitis, appendicitis
Cramping
Quality
Stabbing
Deep and throbbing Squeezing
Pressure
Heaviness
Sharp Intense
May have pattern of escalating intensity or waves of pain
Diffuse
Localization
hard to localize
Sometimes radiating or
referred to other non-visceral structures
Opioids
Treatment
+/- NSAIDS or acetaminophen
Dexamethasone for
distention/obstruction to reduce inflammation and tumor burden
SOMATIC
Skin; Subcutaneous tissue; Mucous membrane
Joint capsules Connective tissue
Fascia, Muscle, Bone
sunburn
minor radiation burn, IV sites
Cellulitis, shallow wounds, ulcers
herpes zoster (shingles) irritation of rectal, bladder, gynecological, urethral tissues incisions
stomatitis, mucocitis, esophagitis herpes simplex (cold sore)
arthritis; musculoskeletal pain; tendonitis, bursitis; gout, Lupus, fibromyalgia
incisional pain, muscle sprain, deep skin wounds, tumor erosion in supportive structures, bone metastasis, pathological bone fracture
burning sharp,
prickling
stabbing, zinging
sore
aching
aching, deep,
cramping, throbbing constant, dull and gnawing
Well localized
easy to “point to”
less well localized
Sometimes radiates to adjacent area (ie: sprained ankle)
NSAIDS or acetaminophen for mild to moderate discomfort
Opioid for moderate to severe pain
Consider topical anesthetic or topical opioids
*NSAIDs acetaminophen +/- opioids
+/- dexamethasone for bone pain
NEUROPATHIC
Central, peripheral nerves
Peripheral Neuropathy (diabetes, HIV, chemotherapy, radiation treatment)
Neuralgia (PHN, Trigeminal neuralgia)
Spinal cord compression plexopathy
Stinging, burning, crawling, aching, pins and needles, tingling Paroxysmal, stabbing, shooting, allodynia,
Intense, radiating, severe
Stocking/glove pattern
Radiating

Travels along nerve

Radiates down nerve
TCA
+/- anticonvulsant
+/- opioid
Radiates down nerves
+/- corticosteroid, XRT

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