Topic Overview

Palliative care is medical care that provides an extra layer of support for people who have serious and chronic illnesses. With palliative care, you have the help of a medical team who are experts in managing treatment side effects such as pain, shortness of breath, or nausea.

Managing pain

Managing pain is not easy. But it is essential to your quality of life. For example, pain can make you feel tired or depressed. It can also make it hard for your body to heal.

Almost always, pain can be controlled with the right medicines in the right amounts. The goal of good pain management is to have the least possible pain with the fewest side effects.

Palliative care providers are specially trained to treat physical pain. They know about the medicines to control various types of pain. Because each person responds differently to pain medicines, it may take more than one try to find the best medicines for you.

Your palliative care team also may recommend treatments other than medicines. These may include physical therapy, massage, or the use of heat or cold.

Sometimes emotional pain can make it harder to cope with physical pain. Emotional pain can be difficult to treat with medicines, but it may be helped with other types of therapy, such as counseling.

It is important to be open and honest about your pain. You do not have to pretend you are strong or able to handle pain. Telling your doctor exactly how you feel is one of the most important parts of controlling pain. Your doctor may ask you:

• Where do you feel pain?
• What does it feel like? Sharp? Dull? Throbbing? Burning? Steady?
• How strong is the pain?
• How long does the pain last?
• What reduces the pain? What makes it worse?
• What medicines do you take, and how much do they help?
• Which pain medicines have worked for you before? Which have not helped?
• How are you coping with your situation?

Your palliative care doctor or nurse may ask you to rate your pain on a scale of 0 to 10. Zero means no pain. Ten means the pain is as bad as it can be.

Concerns about opioid pain medicines

Many people who have a serious illness are concerned that taking opioid pain medicines will lead to opioid use disorder. Moderate to severe opioid use disorder is sometimes called addiction. This usually isn’t an issue in people who don’t have a history of substance use disorder. If your pain or illness improves, your doctor can slowly and safely lower your dose of pain medicine until you don’t need it any more.

While taking pain medicines, you may worry about feeling tired or not thinking clearly. But these side effects often do not last. Many people who take pain medicines for a long time do not have problems thinking clearly. After you and your doctor find the right amount of medicine for you, you may be able to drive, work, and do other activities.

If you are worried about side effects or about developing a substance use disorder, talk to your doctor. He or she can talk to you about your concerns and about the best medicines for you.

Other treatments for pain

Your palliative care team may suggest:

• Heat or cold therapy to relieve painful areas of the body.
• Stretching, yoga, and movement to help maintain strength, flexibility, and mobility.
• Relaxation, biofeedback, meditation, or guided imagery to relieve stress.
• Acupuncture, healing touch, light massage, and reiki to reduce pain, ease muscle tension, and improve sleep.
• Education and emotional support. Your doctor can refer you to the social services department of your local cancer treatment center or hospital.

Symptoms other than pain

Your palliative care team can help with more than just pain. They can help you with problems such as shortness of breath, nausea, lack of energy, anxiety, depression, constipation, or difficulty sleeping.

Sometimes side effects bother you more than anything else. Tell your palliative care provider about all of your side effects. He or she may be able to give you medicines or other treatment that can help if:

• You feel like you cannot breathe well.
• You do not want to eat or you feel like you are going to throw up.
• You feel tired or weak.
• You have problems sleeping.
• You cannot have a bowel movement (constipation) or you have problems urinating.
• You have itchy skin or a dry mouth.
• Your mind is changing or you cannot think clearly.
• Your muscles are twitching or jerking.