Pain is a long-lasting problem for people who have sickle cell disease. Bouts of severe pain can last for hours to days and
are difficult to treat. Pain can be exhausting for caregivers as well as for the
person in pain. A pain management plan can help a person cope with chronic pain and with pain caused by a sickle cell crisis.
Your doctor or a pain treatment specialist can help you make a pain
management plan. This plan includes instructions on how to treat mild pain at home. And it tells you when you need to go to the hospital if your pain gets worse.
Your management plan:
Clarifies your and your doctor’s preferences
ahead of time.
Explains your needs to other health professionals
who care for you.
Offers you some predictability and control during
times of crisis.
How can you prevent and treat pain at home?
Treatment of pain at home is a way of life for most people with sickle
cell disease. Sickle cell pain varies from person to person, from mild to
severe, and from occasional to constant. Some people experience numerous
sickle cell crises, or painful events, a few times a year. Others experience none.
cases, you can treat mild to severe sickle cell pain at home with a combination
of pain medicines, plenty of fluids, and comfort measures such as heating
pads or hot water bottles. Do not use heating pads with children.
Painful events can become severe and last
for days to weeks. Such extreme pain requires aggressive pain medicine that
must be monitored in the hospital. If pain is increasing and isn’t relieved by
treatment at home, call your doctor and seek emergency medical care.
Mild to moderate body pain and some sickle cell crises can be prevented by:
Drinking plenty of water and other
fluids, especially before, during, and after exercise or strenuous activity and when you have a fever or infection. Drink enough so that your urine is light yellow or clear like water.
Getting plenty of bed rest.
Keeping warm. Cold
temperatures make pain worse.
Exercise with care. If you exercise strenuously, rest when you feel tired and drink plenty of fluids to prevent dehydration.
Try to reduce and manage stress in your life.
Pain can be treated at home with:
Pain management skills. These skills can help you and/or your child focus away from the pain. They can also enhance the
effect of pain medicine. A
pain specialist can teach you pain management skills.
These skills include:
Medicine. Use the
pain management plan you developed with your doctor to help decide what type of
pain medicine to use. You are probably the best judge of when it’s necessary to
use a stronger prescription medicine.
For mild pain, use over-the-counter ibuprofen (such as Advil)
and/or acetaminophen (such as Tylenol). Children and teens younger
than 20 should not be given aspirin, which can cause Reye syndrome. Be safe with medicines. Read and follow all instructions on the label.
For moderate or severe pain, you might take
pain medicine prescribed by your doctor. Prescription pain medicine includes oral medicines such as codeine and ibuprofen, or codeine and
acetaminophen. Some people might take oral controlled-release morphine at home.
If you go to the hospital, you will be treated with a strong pain medicine. This might be an opioid medicine, such as morphine.
The medicine is given directly into a vein
(intravenously, or IV) and may be patient-controlled, allowing you to push a
button and release a dose when needed.
When you feel less pain, IV opioid medicine is gradually reduced and replaced with a less
powerful oral medicine. These actions prevent a person’s body from going
through sudden drug withdrawal symptoms.
Steinberg MH (2016). Sickle cell disease and other hemoglobinopathies. In L Goldman, A Shafer, eds., Goldman-Cecil Medicine, 25th ed., vol. 2, pp. 1095-1104. Philadelphia: Saunders.
ByHealthwise Staff Primary Medical ReviewerE. Gregory Thompson, MD – Internal Medicine Adam Husney, MD – Family Medicine Martin J. Gabica, MD – Family Medicine Specialist Medical ReviewerMartin Steinberg, MD – Hematology