Pain Management - General

Pain and fear are normal reactions to injury. It can feel worse if the person is frightened or distressed.

To relieve pain, first listen to the client and acknowledge the reality of their symptoms. A good definition of pain:

‘Pain is what the patient says it is.’

Types of Pain

Acute Pain

This can be described as a very intense or strong pain that is felt immediately following an injury or the beginning of an illness.

Chronic Pain

This is the type of pain that lasts a long time and interferes with the enjoyment of daily life.

The Cycles of pain

Negative Cycle

Untreated pain and fear can become a negative cycle. Pain is made worse if the person is…

Positive Cycle

Pain is improved the person is…

Assessment of Pain

Try to find out how strong the pain feels to the injured person.

  • Look at the person’s face and body posture for signs of pain or discomfort.
  • Assess how the person is coping the injury and the pain.
  • If he is able to talk, ask him which area of the body is painful and how strong the pain feels to him
  • You can ask him to choose a number between 0 – 10 to describe the amount of pain.

Pain Index

0 / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10

Mild ModerateSevere

Treatment for Pain

Problems / Goals / What to do
Acute Pain / Relieve acute pain immediately /
  • Keep the family close, use touch, and encourage sleep & rest
  • Teach the person to focus on breathing out
  • Use cold to relieve swelling and inflammation

Chronic Pain / Relieve chronic pain or reduce it to a level which the person can tolerate /
  • Encourage the person to keep active, spend time with others and think about other things
  • Teach the person to relax his body and mind
  • Use warmth

Warning! Never put ice directly against the skin. Always wrap it first.

  • Wrap some ice in a cloth.
  • Put the bundle against the swollen part
  • Keep it there for 10 minutes.

Chronic Pain

Goal

Relieve chronic pain or reduce it to a level which the person can tolerate.

What to do

  1. Keep active, spend time with others and think about other things.
  • Find out what the person usually enjoys and do well. Help make it possible for the person to do these things again.
  • Encourage the person to spend time with friends and family.
  • Encourage the person to find others who will help with his/her own therapy.
  1. Teach the person to relax his body and mind
  • Try to teach relaxation exercises to a group of people
  • Find a quiet, warm place to do them.
  • At the end of relaxation, always ask the person to lie still fro a few minutes, roll to the side, sit up and then slowly stand up.
  • The person may become more emotional, that is, tearful or angry after any of these exercises. Be prepared for this and explain this to the patient.
  1. Relaxing the muscles throughout the body
  2. Ask the person to lie down and make himself as comfortable as he can.
  3. Use a small pillow to support the head.
  4. Ask the person to think about each part of the body in turn and relax the muscles there.
  5. E.g. “Relax your shoulders. Feel your elbows away from your body. Stretch out your fingers and thumbs. Roll your legs out at the hips. Feel your knees. Move your feet away from your body. Feel your body supported on the bed. Move your head into the pillow. Breathe slowly and evenly. Unclench your teeth. Close your eyes. Breathe slowly and evenly.
  6. Deep Breathing
  • Encourage the person to relax as much as she can.
  • Ask her to gently put her hands over the ribs.
  • Say: “Breathe in. Let the breath move the hands up and out as you push the air into the bottom of your lungs. Slowly breathe out. Let your hands fall down and inward as the chest falls.”
  • Ask the person to repeat this 3 – 4 times, then breathe normally.
  1. Massage
  1. Use warmth

There are many different ways to warm the body to relieve pain. For example,

  • Put a water bottle against the painful part of the body
  • Keep the painful area warm with blankets or clothing.
  • Cover painful hands with baby oil and put hands inside rubber gloves.
  • Exercise a hand or foot in a big bucket of water. Try getting warm first. Then exercise afterwards.

Reference: Hobbs L., McDonough S., & O’Callaghan A (2002) Life After Injury. TWN, Penang