Chronic non-cancer pain
Chronic non-cancer pain is pain that usually lasts longer than three months. It may begin with an injury but doesn’t get better as expected. It is influenced by many things, including:
- How you are feeling
- Past experiences of pain
- Your understanding of why you have the pain and any worries you have
- How you deal with your pain
- How pain affects your life
When pain doesn’t get better it can make you feel, distressed, tired and irritable. It can affect your sleep, ability to do day-to-day activities, ability to work and relationship with family and friends.
Medications – What can you expect?
- Pain killing medications (analgesics) are available but it is unlikely that they will relieve your pain completely, it might be more helpful to call them ‘pain modifiers’.
- The aim of treatment is to reduce your pain to a level where you can enjoy a good quality of life.
- Around one in four people benefit from these medications and on average get a 30% reduction in their pain.
- Medications work best if you combine them with other management strategies including:
- Regular activity and exercise
- Doing things that are satisfying or enjoyable
- Getting involved in social activities
Why don’t pain medications work for everyone?
Chronic non-cancer pain is complex and arises through many different mechanisms. Most drugs only work on one of these mechanisms. Some pains do not respond to any medications.
Your body can also become tolerant to medications over time – this means you need to take more and more of the medication for it to have the same effect. This is common with opioid medications. Eventually increasing the dose has no benefit and can cause harmful effects.
Before starting a medication
- It is important to agree goals with your prescriber – you can then see if the medication is helping improve your life or not. The goal may not be a reduction in pain, but may be the ability to do a certain task for example being able to walk to your local shop, do some gardening or go out for a meal with friends.
- Most pain medications affect the brain and spinal cord and can cause drowsiness, dizziness and confusion. They can also affect your breathing. Normally a medication is started at a low dose and increased gradually if necessary, depending on your response. Increasing the dose gradually minimises the risk of side effects. If you take multiple pain medications it is important to be aware that you are at a higher risk of these side effects.
Whilst taking a medication
It is important to take note of how the medication is affecting:
- Your pain
- Your quality of sleep
- Your ability to do day-to-day tasks and, or ability to go to college, university or work
- Also take note of how the medication makes you feel. Are you experiencing any side effects?
- This will help you and your prescriber decide if the medication should be continued
You and your prescriber may want to stop your medication for a number of reasons, for example:
- It is not providing useful pain relief
- You are unable to tolerate the side effects
- You have been taking the medication for a long time and want to see if you can manage your pain without medication
It is important that you discuss stopping your medication with your prescriber. Some medications require careful dose reductions and cannot be stopped suddenly.
South Tees Hospitals pain service has produced information leaflets on medications commonly prescribed for pain, using information from the Faculty of Pain Medicine and other NHS resources. Leaflets are available for the following medications:
- Opioids – for example Codeine, Morphine, Oxycodone, Buprenorphine, Fentanyl
- Opioid reduction
- Non-steroidal anti-inflammatory drugs – for example Ibuprofen, Diclofenac, Naproxen
- Capsaicin cream and 8% patch
- Lidocaine plasters
If you are prescribed a medication please also read the manufacturer’s leaflet, which is provided with the medication.
Contacting the pain service
If you have any questions or concerns, you can contact the outpatient pain service on 01642 852671, Monday to Friday 9am until 4pm.
Out of hours, please leave a message on the answer phone and a member of the team will call you back in working hours, or contact your GP or NHS 111.