Tips for Dealing With Breakthrough Pain

What is breakthrough pain?

Breakthrough pain (BTP) is not a new source of pain; it is a more intense bout of existing chronic pain. While some individuals with chronic pain experience relatively steady levels of pain on a daily basis, others may experience intermittent breakthrough pain. BTP typically reaches its peak within 3 minutes; however, it can last for 30 to 60 minutes. Approximately 86% of Americans with chronic pain experience breakthrough pain.

Why does breakthrough pain occur?

Breakthrough pain is unique to each individual. Oftentimes, it develops suddenly with little-to-no warning. It can also occur when an individual does something (unintentionally) to aggravate their pain, such as strenuous exercise, sneezing, coughing or simply getting dressed. Stress and illness can also be triggers. Individuals with chronic pain who take pain medication for their condition may also experience breakthrough pain due to end-of-dose failure. For example, when a pain medication is designed to work for a certain length of time, such as 12 hours, it may only work for 8 hours for some individuals; in these cases, breakthrough pain may be experienced due to end-of-dose failure. It can also occur if medication tolerance develops.

Tips for dealing with breakthrough pain

• Developing a plan to deal with future breakthrough pain is recommended.
• Determining when breakthrough pain occurs and what triggers, if any, may have provoked it helps individuals avoid triggers in the future.
• Although rest may feel like the best choice during breakthrough pain (and it may be appropriate), slowly doing gentle exercises and stretches may also help ease BTP by loosening up stiff joints and muscles.
• Staying calm is important. Getting worked up over potential breakthrough pain often tightens the muscles in the body and increases pain. Focusing thoughts on the fact that BTP does not last forever helps ease tension in the mind and body.
• Practicing stress-relieving techniques during BTP relaxes the body. If exercise is not possible, doing breathing exercises, meditation or mindfulness techniques may also help. Replacing negative thoughts with positive thoughts is also beneficial.
• Making oneself as comfortable as possible during breakthrough pain is essential. This may include using heat/ice therapy or massaging the affected area.
• Taking a dose of medication specific for BTP may help ease pain. Prescribed medication for BTP is typically a short-acting opioid that is five to 20 percent of an individual’s scheduled opioid medication. The medication may be a faster-acting formula of an individual’s prescribed opioid medication.