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Pain is your body’s way of telling you that something is wrong. The simplest example is placing your hand on a fire, instantly the painful sensation goes to your brain and your reflexes remove your hand from the flame. Pain can be described using a lot of different adjectives. The way you describe your pain, and its location can tell you a lot about the type of pain and what could be causing it. For example, sharp, shooting pain down the legs to the toes may indicate peripheral neuropathy or nerve damage. But chronic lower back pain may be due to muscle damage. It’s very important when discussing your pain with your doctor to use words that accurately describe your pain, as different types of pain are treated differently. 

Nurses like to use the PQRST assessment to cover all facets of a patient's pain. 

P- Provokes. What causes the pain? And is there anything that you notice, that makes the pain better or worse? You may notice that your pain only comes on during cold weather, but weather gloves or keeping your hands warm reduces the pain. Eating may cause your pain in your stomach, but sipping on fluid or sitting upright makes the pain fade away. 

Q- Quality. The quality of pain looks at how you would describe it. This has been briefly discussed above. Words that can be used are burning, shooting, dull, cramp, stabbing, sharp and crushing. Don’t let anyone else try and tell you what your pain should feel like, only you feel it, so people may be able to provide helpful words, but don’t let me sway you. 

R- Radiates. Pain can be in one place, or it can be in many places. Sometimes, pain can be experienced in another part of your body, when caused somewhere completely different. Commonly, heart attacks are known for causing pain in the jaw or the left arm, even though the pain is being caused to the heart. Right shoulder tip pain can be caused by gallbladder problems. Additionally, pain that is pinpoint versus radiating can also mean different things. So it is important to identify if you can point exactly to where your pain is or if it’s in a more generalised location. 

S- Severity. Normally, nurses and other healthcare professionals like to use the pain scale to understand the severity of your pain. There are many different types of pain scales available, but the most popular is a numbered scale, 1 to 10, rating your pain, with 10 being the most pain you have ever experienced in your life, and 1 being pain-free. 

T-Time. How long have you been in pain for? And if the pain comes and goes in waves, how long does it last? Also is there anything you know you did which could have caused the pain. And if so, how long ago was it? 

 

 

The pain scale is way to measure how much pain you are in. Pain is subjective, no one knows how much or little pain you are in except you. So it can be difficult to quantifying your pain levels. Similarly, two people experiencing the same procedure may rate their pain differently, one may say they are in lots of pain, while the other says not too much, but they both may respond differently to pain relief. 

Pain can interfere with your day to day activities. It can make you feel nauseous, keep you up at night and reduce your appetite. It can also affect mobilising, showering and toileting. Being on top of your pain can greatly impact your daily life and activities. Pain management is the overarching term used to encompass everything medication, and non-medical treatment you use to reduce your pain. Non-medical treatments can include exercising, physiotherapy, medical devices such as tens machines or non-medical devices such as heat packs. It can also include medication that may not be pain relief but could be associated with pain. For example, if you are experiencing abdominal pain AND nausea, anti-nausea medication would also be included in pain management to ensure you don’t vomit and increase your abdominal pain. Pain management will differ from person to person, depending on your requirements, abilities and type of pain. 

There are a few reasons why you may experience pain during your cancer diagnosis. The first and foremost is the cancer itself. For many people, the tumour can be large enough to put pressure on another organ or part of your body causing pain. It is usually this pain, that may increase and not resolve, that causes a person to see their doctor in the first instance. Many patients with advanced cancer often experience pain, this can be due to the cancer spreading to another part of your body. Unfortunately, some cancers can cause your bones to become quite weak and easily break. These types of fractures are called pathological fractures and can happen with patients with certain stages of cancer. Treatment can also lead to pain. 

Surgery causes trauma to the body. When the body starts to repair itself this can begin to feel painful. Usually, the pain is a throbbing pain at the site of trauma, but depending on the type of surgery, the pain may feel different. 

Radiotherapy can cause the skin to become red and irritated, which can lead to a burning sensation, similar to sunburn. Topical anaesthetic and creams can help relieve this type of pain. Medications can also help to reduce this type of pain. 

Some chemotherapies can cause damage to nerves and cause something called chemotherapy-induced peripheral neuropathy. Peripheral neuropathy can feel like a tingling or shooting pain down your arm and leg. Pain management slightly differs for this type of pain, but there are medications that can help.