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HealthInfo Canterbury

Relieving pain & anxiety in palliative care

Many people receiving palliative care and their families worry about pain. However, pain is not inevitable, and most pain can be managed. It's important to talk to your doctor or nurse about any pain you are feeling, or any worries you have about pain or your treatment.

We usually use medicines to manage pain for people receiving palliative care. These may be mild pain relievers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or aspirin. Or they may be stronger pain relievers called opiates. The most commonly used opiate is morphine.

You might also have other types of medicines to go with your pain relief. This may include steroids such as prednisone or dexamethasone, antidepressants such as nortriptyline or amitriptyline, or anticonvulsant medicine such as gabapentin.

The goal of pain management is to keep your pain under control, not just to try to treat it when you have it. So it's important to take your medicine as your doctor prescribes, even if you are feeling OK.

Some medicines used in palliative care are used "off label or off-licence". This means we use them to treat things they are not approved for on the licence, or used in a way that is not approved.

We often do this because the medicine helps to manage symptoms it is not licensed for. Your doctor will explain whenever they want to use a medicine like this, so you can make an informed choice about what you take.

The following pages give information about morphine, oxycodone, methadone, and fentanyl. These are opiate medicines that are all used to treat pain in palliative care. Midazolam is sometimes used to treat anxiety.

You may also find the information on medication and treatment for persistent pain useful.

  HealthInfo recommends the following pages

Written by HealthInfo clinical advisers. Endorsed by Canterbury DHB and community palliative care specialists. May 2017.

Sources

Page reference: 360226

Review key: HIPAL-17434