Causes of Chronic Pain

What is chronic pain?

About one-third of patients receiving cancer treatment have pain. In advanced cancer cases (spread or repeated), this rate rises to about two-thirds. For these patients, controlling the pain and keeping the symptoms under control are important targets of the treatment.

Pain affects every aspect of quality of life. Patients with chronic pain (mild, moderate, severe but prolonged) may not participate in their daily routine activities, have sleep and eating problems, and may be disappointed that they do not always understand what their families and friends feel.

Cancer pain is a common problem and can only be treated by an experienced team. The team should consist of surgeons, medical oncologists, pain specialists, psychiatrists, psychologists, oncology and algology nurses. It should be kept in mind that each patient is different from each other and that treatment should be arranged according to the individual pain situation of each patient.

Ask Your Doctor For Your Pain Control:

What can be done to reduce pain?
What can we do if the medications do not reduce the pain?
What other options do I have for my pain control?
What side effects can I have with the medications I use for my pain?
What can be done to deal with these side effects?
Will my treatment limit my daily activities (work, drive, etc.)

Causes of pain relief

Pain in patients with cancer can be seen due to different reasons. The most common cause is cancer itself. When cancer spreads to soft tissues (muscles, ligaments, etc.), organs or bone, there may be pain due to nerve injury, if the cancerous tissue is compressing a nerve or increasing pressure inside the head. May cause pain in surgery, radiotherapy or chemotherapy. In this case the pain is called depending on the treatment. In a patient whose arm or leg has been cut, he may still feel pain in the missing limb (phantom pain). This pain is real, but the cause is unknown. Many chemotherapeutic agents can cause numbness, tingling and burning. Radiation may cause painful skin irritation.

In general, pain has nothing to do with cancer or its treatment. In patients with cancer, headaches and muscles may be seen in everyone. Sometimes a waist or neck hernia in everyone may be the cause of pain.

There are 3 types of pain:

Visceral Pain: Pain is seen as a result of tissue damage caused by cancer in the organ. It is often not a single point, it is a sharp pain in the form of pain.
Somatic pain: skin, muscle or bone involvement in a particular area. As the knife is stuck, it is expressed as a throbbing or a feeling of pressure.
Neuropathic Pain: It occurs due to injury or pressure on peripheral or central nervous system structures. Nerve injury or compression may be due to a peripheral nerve or spinal cord injury or injury to both. It is expressed as a sharp, flammable pain.

It is important to determine the type of pain, because each is treated differently.

Barriers to the Treatment of Cancer Pain

In fact, although the pain of almost all cancer patients can be controlled, an effective discontinuation of the pain in these patients can still be a problem. The main reason for this is lack of knowledge, beliefs and fears.

Fear of Addiction: Many patients believe that the use of opioids (such as narcotic-like drugs) will be addictive. But this is rarely seen. There may be a change in the need for drugs in cancer patients, such as changes in insulin needs of diabetics.

Fear Against Side Effects: Patients often use less than the given dose because they are afraid of side effects. However, these side effects can be prevented and corrected.

Inadequate Information: Pain treatments in cancer patients should be treated by teams who are experienced in this field and who are familiar with alternative therapies.

Inadequate Pain Scoring: Patients often do not mention their pain without being asked. They want to look strong. Sometimes they don’t talk about their pain if they ask them because they are afraid to learn what the current pain means. For these reasons, the pain of many patients remains unresolved.

Before starting the treatment of your cancer pain, doctors need detailed information about the pain of patients. The medical history from the patient or family members or friends comes from the patient’s physical examination.

Patients are asked the following questions about their pain.

What is the severity of your pain?
Where’s your pain?
How much does the pain affect your daily activities?
Are the pain somatic, visceral or neuropathic?
When did it started?
Did the pain change in any way?
Anything that makes your pain better or worse?
Are you experiencing side effects related to treatment?
Have you had any psychological problems before?
What you know about pain and pain control


If the questions are answered and after your physical examination is performed, x-ray, MRI and blood tests may be requested in order to plan your treatment. For example, if pain is a bone pain and a fracture is suspected, a radiograph would be appropriate. The Pain Assessment Scale is used to help patients express their pain. These scales can be used in patients older than 3 years. How to Treat Cancer Pain After all the researches about your pain are made, a treatment plan is created and discussed with you. Cancer pain can be reduced in many ways, including the treatment of underlying cancer with options such as chemotherapy, radiotherapy or surgery. Medications are the methods to be used primarily in the treatment phase. Opioids (narcotics, the strongest available pain relievers) and non-opioid drugs, additional painkillers (drugs used in other diseases, but in some special cases that can reduce pain) can be used for this purpose. Physical therapy or surgery may be a treatment option in some patients. Pain pumps and pain cells attached to the spine can be used to relieve pain when the pain does not respond to current treatments or when side effects occur. Some of the important messages for the patient and his family are as follows: Living with pain is of no use. If these drugs are insufficient, there are different alternative therapies to relieve pain. Morphine and morphine-like drugs are often used to relieve the pain. These drugs are rarely addictive if they are used to relieve pain in cancer patients. Communication with the doctor and nurses is very important. Doctors and nurses want to know if there is a problem with the supply or use of drugs. However, the following is in your hand in writing you will be very helpful to avoid mistakes later. List of all prescribed drugs, which is used for what purpose? When and how to take it? Possible complications? What to do if development? List of drugs that can be taken? Check appointment time For your questions or for possible problems during the weekdays, or in the evening or at the weekend, the list of telephone numbers that can be reached: Nausea and vomiting that prevent your diet for more than 1 day Stopping movements for more than 3 daysHearths that may be experienced in awakening or awakening during the day What are the side effects of pain medications and how to control them? Some patients may experience drowsiness and some may experience nausea. Vomiting doesn’t happen very often. In most patients, these side effects disappear within 1-3 days. There are different nausea medications that can be used today for nausea and vomiting. In order to reduce drowsiness and drowsiness, opioids are started at low doses and dose adjustment is made. The main aim of the dose adjustment is to achieve the maximum pain-relieving effect with the lowest side effect. Constipation usually occurs after a few days of use and continues throughout the drug use. Constipation can sometimes be very painful, and may even require hospitalization, so its development should be avoided if possible. By following the following paths, the development of constipation can often be avoided: Increasing fluid intake Increasing the uptake of fibrous products such as fruit, vegetablesDuring exercise with the knowledge and recommendation of your doctor or physiotherapist. This may be due to increased pain or the development of drug tolerance. If the tolerance develops, small increases in dose or replacement of the drug will help to reduce the pain. People sometimes think that drug tolerance and addiction are the same. Both are very different. Tolerance develops over time, indicating that the body needs higher doses of medication to get the same effect. Increasing the drug dose is not a sign of dependence. Opioids Termination causes some symptoms such as a disease or diarrhea. Therefore it should be stopped slowly. Your doctor will inform you about the medication.