Assessing or measuring pain is the first step to treating it. The best judge of pain is the person having it. The way you feel pain is unique and it can be treated according to your specific needs.
You may feel uncomfortable and may not want to talk about your pain. Many people with cancer feel this way. Try to remember that:
- You do not have to accept pain as part of your disease. Treating pain is an important part of your care.
- Others will not think you are a failure because you admit that you have pain.
- You aren't being a nuisance or making a fuss. Talking about your pain allows you to work with your healthcare team to develop a program to manage pain that will work for you.
Finding the cause
The doctor will often do a physical examination to help find out the cause of the pain. They may check to see if there is altered sensation in a painful area. The doctor may also order some tests to find out the cause of pain.
Describing pain
When describing pain to the healthcare team, go into as much detail as possible. It might be helpful to create a pain journal that describes your pain across time. In a pain journal:
- list how bad the pain is at different times of the day
- note anything that makes it better or worse
There are a number of tools to help assess and describe pain. The questions below can help you describe details about pain. Circle the words that best describe the pain or write descriptions beside the questions.
When did the pain begin?
- Has it been getting worse over time or has it stayed about the same?
- Did it begin at a certain time of day or night?
What were you doing when the pain began?
- Walking?
- Lifting something?
- Resting?
Where is the pain?
- Is it in one part of the body or in more than one place?
- Does it start in one place and move?
- Does the pain feel like it is deep inside or close to the surface?
Use the drawing below to show where the pain is.
What does the pain feel like?
Have you had pain like this before?
- Is it similar to a toothache or a stomach ache?
How bad is the pain?
- Try to rate the pain by comparing it to pain you have had before (like a headache, a sports injury or childbirth).
- Use a scale of 0 to 10 to rate it – 0 means no pain and 10 is the worst pain imaginable.
- Describe the pain using words such as none, mild, moderate, severe, the worst possible.
How long does the pain last?
- Does it come and go?
- Is it worse at a certain time of the day or night?
- Does it keep you awake? Does it last for a long time?
Does anything make the pain better or worse?
- Is the pain better when sitting or lying down?
- Does eating smaller meals help?
Does taking medicine or other treatments stop the pain?
- Does it help if you take a pain reliever or use a hot water bottle? If it does, for how long?
Ongoing assessment
Once the cause of pain is identified and pain is assessed, the healthcare team will decide the best way to manage the pain. Regular and ongoing assessment of cancer pain is very important. It is important to let the healthcare team know what works and what doesn't.
Be sure to tell the healthcare team about any changes in the pattern of your pain: if pain comes back more often, if it becomes more severe, or if new pain develops. The plan for treating pain may need to change and new pain may need to be checked out. It is very important to let the healthcare team know right away about new pain, especially lower back pain with leg weakness or loss of bowel or bladder control. This could be a sign that the cancer is putting pressure on the spinal cord.