Relieving pain in palliative care Whakaoraora i te mamae ki te manaakitanga whakamaene

If you are experiencing pain or you or your whānau are worried about pain, talk to your healthcare provider. They can explain what can be done to help.

Your healthcare provider may need to change your medication over time to work out the right dose. As your illness progresses, they may also need to increase the dose. This usually happens because the pain is getting worse. It does not mean that the medication is losing its effect.

There are lots of types of pain relief medicines that can be used. These include simple pain relief medicines like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin.

Pain relief medicines for adultsexternal link

If you have strong pain, your healthcare provider may prescribe stronger pain relievers called opioids.

Opioids only help some types of pain. You may need to take other pain relief medicines at the same time. Your healthcare provider will talk with you about this. The most commonly used opioid is morphine. Opioids used in palliative care include:

• Long acting morphine — My Medicinesexternal link
• Short acting morphine — My Medicinesexternal link
• Long acting oxycodone — My Medicinesexternal link
• Short acting oxycodone — My Medicinesexternal link

You might also have other types of medicines to go with your pain relief. These may include:

• steroids such as prednisone
• antidepressants such as nortriptyline or amitriptyline — at low dose, these medications block the signals that overactive nerves send out, which can make them effective in treating nerve (neuropathic) pain
• anticonvulsant medicines such as gabapentin or pregabalin.

These medicines can help control pain.

Other (complementary) techniques can also help with pain or anxiety. They may be used alongside your regular medications so long as it is safe to do so. Techniques include:

• massage or acupressure
• hot or cold compress
• distraction techniques such as listening to music or a podcast or reminiscing with friends and loved ones
• traditional techniques such as Rongoā Māori
• pacing the tasks you do and learning new ways of doing your everyday tasks.

Conserving energy

You can also use relaxation techniques such as:

• breath work (focus on taking long, slow, deep breaths)
• box breathing (inhale for 4 counts, hold for 4 counts, exhale for 4 counts, hold for 4 counts)
• progressive muscle relaxation (tense and relax each muscle group from your toes to your head)
• listening to guided imagery or a mindfulness meditation.