Drug Therapy Pain Relief
When people experience pain, most of the time they have tried something that has worked for them in the past. Many people start with drugs you can get over the counter. Many drugs work quickly, have few risks, and don’t cost a lot.  Different drugs work for different people.  The World Health Organization (WHO) developed a 3-step program for dealing with pain.  This program starts with mild medicines for pain and then stronger ones if the pain lasts or gets worse.

  • If you have mild to moderate pain, try pain medicine you can buy on your own such as aspirin, acetaminophen, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen.  Some people cannot take some of these drugs so check with your doctor first. Acetaminophen should be used with caution if you drink alcohol or have liver disease. All of these medicines should be taken as prescribed on their packaging or as prescribed by your doctor.
  • NSAIDs work well to relieve mild pain.  They may be given with drugs called “opioids” for the relief of mild to severe pain.  Acetaminophen also relieves pain, although it does not have the anti-inflammatory effect that aspirin and NSAIDs do.
  • If pain lasts or increases, your health team may add drugs called “opioids” to aspirin, acetaminophen, or NSAIDS. You will need a prescription for these drugs. These drugs are very helpful in the relief of mild to severe pain. While they do not cure the reason for the pain, they act on the brain so that you don’t feel the pain as intensely.
  • Some commonly used opioids are morphine, codeine, methadone, and fentanyl.  The right dose is the amount of drug that controls pain with the fewest side effects.  Take only the amount of drug that the doctor tells you to take.  Some people worry about becoming addicted to drugs like these. This is not very common.  By using these medicines as prescribed, in the lowest effective dose, you can avoid some of the problems associated with these medicines.
  • If pain lasts or gets worse, your doctor may increase the opioid dose.  Take the medicine regularly (at scheduled times) to keep up a constant level of the drug in your body; this will help stop the pain from coming back. You don’t want to “chase the pain”, which can happen when you wait until the pain becomes too much to handle.
  • Your doctor may prescribe more doses or different classifications of drugs if you are having pain between the times when you take your pain medicine.
  • Other drugs may be given at the same time as the pain medicine to help it work better and treat side effects (such as Mepergan- a combination of Demerol and Phenergan).
  • Chronic pain may best be treated by a pain management specialist.

Feeling sleepy is a common result of taking pain medicines.  That feeling will usually end in about three days when your body gets used to pain medicine.  Here are a few tips to help you learn ways to deal with feeling sleepy.

  • Drinking liquids with caffeine such as coffee, tea, or sodas will help to work against drowsiness.
  • Get up and move around or do some stretching when you feel yourself getting sleepy.
  • When you feel sleepy, be careful to avoid doing things like driving, cooking, climbing stairs, or working where you could hurt yourself and others.  Taking pain medicines should not stop you from doing these things, but do not do them when you feel sleepy.
  • Rest as much as needed.  If you keep on feeling sleepy, talk to your doctor or nurse.  Make sure that they know all of the medicines that you take,   including prescribed and over-the-counter medicines that may make you feel sleepy. After taking one of these medicines plan for a rest period.

When Do You Need to Seek Help?
Talk to your doctor or nurse if you are not having relief from the pain medicines that you are taking.  You may need to have your pain medicine adjusted.

Useful websites:
Cancer pain: Relief is possible
Cancer pain: Pain treatment
Pain center: Drug therapy
M. D. Anderson Cancer Pain Research Group

Non-Drug Pain Relief Tip Sheet

Non-drug pain relief methods can be used with drugs and other treatments to manage pain.  There are many kinds of non-drug pain relief.  Here are a few tips to help you:

Heat may be used for muscle tightness after surgery or arthritic pain.

  • Heat includes warm to hot baths, heating pads, or chemical packs.
  • Chemical packs can be heated in the microwave or boiling water.  Make sure that you have some sort of wrap around it, and not to place the pack directly on your skin. Be careful not to make it too hot!
  • You can make your own hot pack by taking a long sock and filling it with dry rice. Tie the open end of the sock, and heat by putting it in the microwave for 1-2 minutes.
  • Avoid heat to the chest wall if you have had radiation.
  • Avoid heat in the radiated breast if you have had treatment with anthracycline (doxorubicin) chemotherapy.  If you use heat in this area, you may develop a severe skin reaction.
  • Avoid heat in your arms, chest or legs if you have any numbness or tingling in the area.

Non-drug pain relief with cold: Cold may be used for relief of itching, muscle spasms, nerve pain, and severe pain.

  • include ice massage, ice bags and gel packs.  Gel packs that you can get at the store are not costly, can be used over and over and are easy to use.
  • the painful area until you begin to feel relief.  Avoid the shock of sudden, intense cold.
  • a well-wrapped cold pack.   layers of cloth from the cold pack until the area is cool enough.
  • may be more effective than the use of heat or cold alone.  This may be very helpful for even severe pain. You can alternate every 20 minutes or so.

Non-drug pain relief with lotions and creams:  Lotions or products that contain menthol provide a feeling of warmth or coolness to an area.  They may also help with pain.

  • , such as Ben Gay®, Icy Hot® and Vicks®, are often used with sports injuries and are popular home cures.
  • (such as a heating pad or heat pack, or the sun), as the heat can cause a burn.
  • if you have had radiation to the painful area or if your doctor has told you to avoid the use of aspirin products.
  • warm up regular lotions you use, and rub them on the affected area.

Thinking and behavior methods are also helpful in treating pain.  These methods help you gain a sense of control.  Many methods can be tried, and one or more should be used regularly.

  • Relaxation: Simple relaxation methods such as deep breathing may be used for periods of brief pain.  (See our Tip on Relaxation Techniques)
  • Redirecting thinking and distraction: Thinking about something other than pain or negative feelings that come with pain may help.  You can talk to yourself (for example, counting, praying, or saying things like “I can cope”).  Try doing something with others or out loud (for example, music, television, talking, listening to someone read, or looking at something specific).  You can also learn to stop negative thoughts and replace them with more positive thoughts and images.  
  • Exercise and stretching: some women find relief in performing yoga exercise stretches or gently exercising the area they have pain in. If pain worsens, do not continue to exercise. For women with arthritis, exercise may help keep their joints mobile.
  • Therapeutic massage, acupuncture, and chiropractic care are alternative ways that can help with pain as well. Finding a practitioner with experience and caring can make a huge difference in your pain levels.

When Do You Need to Seek Help?
Always talk to your doctor or nurse if the non-drug pain methods are not working.

Useful websites:
Cancer pain: Alternative and complementary methods
National Cancer Institute: pain control
Exercise and Arthritis:
Breast Cancer Treatment
Yoga for breast cancer:

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