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 Origin | Clinical Example | Quality | Localization | Treatment |
| 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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