Overcoming cancer pain


Describing pain

Wednesday 13 February, 2019

Describing your pain will help your health care team understand what you are feeling, work out the cause of the pain, and plan the most appropriate way to treat it.

Questions your doctor may ask

Thinking about these questions may help you describe your pain.

  • In which parts of your body do you feel pain or discomfort?
  • How bad is the pain? (See below.)
  • How does it compare to pain you have felt in the past?
  • What does it feel like? For example, is it dull, throbbing, steady, constant, shooting, stabbing or burning? Are there any pins and needles or tingling? Are there areas where it feels numb?
  • Does your pain spread from one area to another (radiate)?
  • When did the pain or discomfort begin?
  • Is your pain constant? If not, how often does it occur? How long does the pain last each time it occurs? (Try timing the pain.)
  • Do you have any flare-ups of pain?
  • Which of your daily activities does it prevent you from doing? (Examples include: getting up, dressing, bending down, walking, sitting for long periods, exercising, carrying things, driving.)
  • What activities do you think you could do or would like to do if the pain improves?
  • How does the pain make you feel emotionally?
  • What relieves your pain? What makes it worse?
  • What pain relief methods have you tried? What helped or didn't help?
  • Did you have any side effects from pain medicines?
  • What have you done in the past to relieve other types of pain?
  • Is there anything you are worried about with respect to the pain?

Tools to describe pain

Using a pain scale or keeping a pain diary can help you describe your pain and how it is affecting you. This will help your health care team find the best pain control methods for you.

Use a pain scale

Some people rate the level of pain on a scale. There are different kinds of scales.

Word scale: rates the pain from none or mild through to moderate or severe Number scale: rates the pain from 1-10; the higher the number, the worse the pain Activity tolerance scale: rates how much the pain affects what you can do, e.g. walking or carrying things Facial scale: use facial experssion to show how the pain makes you feel
no pain 0,1 no pain   No pain facial expression
mild pain 2 can be ignored Mild pain facial expression
moderate pain 3,4 interferes with tasks Moderate pain 3 to 4 facial expression
moderate pain 5,6 interferes with concentration Moderate pain 5 to 6 facial expression
severe pain 7,8 interferes with basic needs Severe pain facial expression
worst pain possible 9,10 bed rest required Worst pain possible facial expression

Make a note of triggers

Write down what seems to cause your pain. This is called a trigger, and it may be a specific activity or situation. Knowing what triggers your pain might help you to prevent or relieve it.

Keep a contact list

Make a list of the health professionals in your team and their contact details. Keep this list handy in case you (or your carer) need to get in touch.

When to seek help

Talk to your doctors about what should prompt you to call and who to call, particularly if it's after hours. For example, you may be instructed to call if you need to take four or more doses of breakthrough pain relief, or if you are feeling very sick or sleepy.

Keep a pain diary

A written record of your pain can help you and those caring for you understand more about your pain and how it can be managed. Note down how the pain feels at different times of the day, what you have tried for relief and how it has worked. Some people track their pain using an app on a mobile device, such as a smartphone or tablet.

Key points about pain

Types of pain

  • Pain may be caused by the cancer itself or as a side effect of treatment.
  • There are many types of pain, which are felt in different areas of the body and have different sensations.
  • Acute pain can be mild or severe but usually resolves within a few days or weeks.
  • Chronic pain is often constant and usually lasts for more than three months.

Who helps manage pain

  • A multidisciplinary team (MDT) of health professionals work together to help you manage cancer pain.
  • A palliative care team works to improve a person's quality of life by easing cancer symptoms, including pain.
  • Pain teams in hospitals work along with the palliative care and oncology teams to help manage acute pain.
  • A pain medicine specialist can help if your pain is not well controlled or your pain persists after active treatment is finished.

Tools to describe pain

  • Explaining how the pain feels can help your doctor work out the cause of the pain.
  • A pain scale can help you describe how bad the pain is to your health care team.
  • A pain diary can help you keep track of your pain, how long it lasts, and any triggers.

Expert content reviewers:

Dr Tim Hucker, Clinical Lead, Pain Service, Peter MacCallum Cancer Centre, and Lecturer, Monash University, VIC; Carole Arbuckle, 13 11 20 Consultant, Cancer Council Victoria; Anne Burke, Co‑Director, Psychology, Central Adelaide Local Health Network, SA, and President Elect, The Australian Pain Society; Kathryn Collins, Co-Director, Psychology, Central Adelaide Local Health Network, SA; A/Prof Roger Goucke, Head, Department of Pain Management, Sir Charles Gairdner Hospital, Director, WA Statewide Pain Service, and Clinical A/Prof, The University of Western Australia, WA; Chris Hayward, Consumer; Prof Melanie Lovell, Senior Staff Specialist, Palliative Care, HammondCare Centre for Learning and Research, Clinical A/Prof, Sydney Medical School, and Adjunct Professor, Faculty of Health, University of Technology Sydney, NSW; Linda Magann, Clinical Nurse Consultant, Palliative Care and Peritonectomy Palliative Care, St George Hospital, NSW; Tara Redemski, Senior Physiotherapist, Gold Coast University Hospital, Southport, QLD.

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