Five most common questions about controlling pain

By Pam Harris, MD, FAAPMR, FAAHPM, Medical Director at Kansas City Hospice & Palliative Care

I hear five common questions about controlling pain almost every day as a hospice physician. My goal is to control pain so people can enjoy activities, do household tasks, enjoy company and sleep. Uncontrolled pain may cause anxiety or depression.

Studies show people respond better to treatment and have more active immune systems when pain is controlled. They recover faster from surgery and are less likely to have nerve changes that extend pain past healing.

Today, we have excellent treatments for controlling pain. Most people find relief in medicines taken by mouth. Some people can’t swallow or don’t get enough relief with oral medications or those taken under the tongue. They may use a skin patch, suppository or injection. People with pain that’s harder to control may need to add other medications, use radiation therapy (for cancer), nerve blocks or surgery.

The most effective strategies for controlling pain may combine several medications, therapies, and mind-body techniques. Also, non-medicinal treatments can be helpful. Consider relaxation, music, distraction with pleasant activities, massage, imagery, hot or cold packs, rest, counseling and support groups.

September is Pain Awareness Month, a time when various organizations work to raise public awareness of issues in the area of pain and pain management.

Question:   Should I take medicine for controlling pain only when I’m in pain?

Answer:  Pain control is much easier if you take medicine before the pain becomes intense. The goal is to prevent pain or to keep it at a mild level, and to reach this goal, many hospice patients take the medicine on a schedule.

Question:   If I take the stronger drugs now, will they work later on when I really need them?

Answer:  Yes. Sometimes your body gets used to a drug and you will need to take more to control pain. Your doctor will adjust your dosage as needed.

Question:   Will I get “hooked” or addicted to pain medicine?

Answer:  Addiction is dependence on a drug for mental reasons such as “getting high.” People who take medications to relieve pain rarely have problems with addiction. They take only the medications they need to control pain. Uncontrolled pain can have negative long-lasting effects. So your doctor will strongly encourage you to take pain medicine if you need it. If you must stop the medicine for any reason, your doctor will slowly reduce the dose over a few days. This lets your body adjust. Do not stop medications abruptly without consulting your doctor.

Question:   Are morphine and other strong pain relievers used only for the last stages of life?

Answer:  No. Anyone who has moderate or severe pain should take medicine that is strong enough to relieve that pain, even if the pain is temporary. For example, some people recovering from common surgery receive morphine for post-surgical pain control.

Question:   If I ask for pain medicine, will I be viewed as a “bad” patient?

Answer:  We want you to enjoy a good quality of life! Because, that’s an important goal of medicine. Pain is a normal part of many conditions and your physician does not want you to suffer if relief can be provided. A “good” patient is one who provides a highly accurate picture of the problem to the doctor. So don’t withhold the information that your doctor needs to provide you with the best treatment.

To learn more about controlling pain, see Simple Facts about Controlling Pain.

Dr. Pamela Harris joined Kansas City Hospice as an associate medical director in 2006. She graduated from the University of Kansas School of Medicine where she specialized in physical medicine and rehabilitation. She is board-certified in hospice and palliative medicine. She’s also board-certified in physical medicine and rehabilitation, and spinal cord injury medicine. Dr. Pam is also an ordained minister in the United Methodist Church.

Kansas City Hospice & Palliative Care is committed to providing expert care, peace of mind, comfort, guidance and hope within the greater Kansas City area. If you have questions about the types of care that we offer from home health care at the start of serious illness to the end of life, please call 816.363.2600.


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