Acute Medicine | Palliative care | Managing different types of pain

Managing different types of pain
Session overview
Description
This session describes management strategies for different types of pain seen in end-of-life care. It also discusses the psychosocial, spiritual and functional effects contributing to the personal experience, that need to be recognised and addressed.

This session was reviewed by Sarah Hanrott and last updated in April 2024.

Learning objectives
By the end of this session you will be able to:

• describe the mechanisms that underlie different pain types
• provide examples of different types of pain experienced by end-of-life care patients
• outline the key aspects of the multi-modal pain management approach that can be utilised to address different types of pain

Prerequisites
Before commencing this session you should consider completing sessions:

• Assessment of pain (215-0407)
• Principles of pain management (215-0408)
• Drug management of pain: core knowledge (215-0409)
• Opioids in pain management: advanced knowledge (215-0410)

The World Health Organization (WHO) analgesic ladder can be used to provide symptom relief for the majority of patients with pain.

However, some pain syndromes are more difficult to address. In part, this may be because the pain has a predominant neuropathic, inflammatory or ischaemic element, which may respond only partially to opioid analgesics. Good analgesic control can then be difficult to attain even with the concurrent use of adjuvants. This can lead to chronic pain, disrupting both sleep and normal everyday activities, with consequent psychosocial impact on patient and family.

This session will:

• briefly review the assessment of pain and understanding of the pathophysiology of pain processes, key requisites to initiating an effective pain management plan
• describe management strategies for some of the different pain conditions experienced. For example: neuropathic pain, cancer-induced bone pain, pain from raised intracranial pressure, muscle spasm pain and cancer therapy induced pain
• discuss the psychosocial, spiritual and functional effects contributing to the personal experience, that need to be recognised and addressed