What is Breakthrough Pain?

Breakthrough pain is a type of severe pain which can occur in people who are on pain management regimens. Patients who are taking medications for chronic and severe pain can occasionally experience bursts of pain which literally “break through” the pain management medications. This type of pain can be extremely debilitating, and management of this kind of pain is an important part of any pain management plan.

Cancer patients are at risk for breakthrough pain, as are people recovering from extremely painful surgeries, and people with conditions characterized by chronic pain, such as damage to the spine. In these individuals, a regular pain management regimen is carefully designed to prevent pain. However, pain can flare up suddenly and be extremely severe even with these pain medications.

The treatment for breakthrough pain is a rescue medication which can be delivered rapidly for relief in five to 10 minutes. Lozenges which deliver medication through the mucosa of the mouth are an option, as are pills and injectable medications. A doctor typically prescribes rescue medication along with the medications used in the regular regimen, setting a limit for patients so that they do not put themselves in danger of overdose or addiction. For example, a patient may be told that one lozenge can be used every four hours for the pain.

It is important to distinguish this kind of pain from pain which flares up shortly before another dose of scheduled medication is to be delivered. In this case, the pain indicates that the medication dosage or schedule needs to be adjusted so the patient will be more comfortable. It is not advisable to treat this type of pain with rescue medications, as this can mean that no medication is available for breakthrough pain.

It is important to treat pain, not only because it is a quality of life issue, but because it can hinder a patient's recovery. People in severe pain experience slower healing times. For this reason, it is also important for patients to take rescue medication when they experience breakthrough pain, rather than trying to ride it out.

Pain management is extremely complicated, and people with chronic painful conditions can struggle with it. Patients who experience severe pain are sometimes treated as drug seekers due to the high dosages of analgesics, opiates, and other drugs which they require, and they may not get the treatment they need. Conversely, doctors have to be careful when prescribing pain medications because they do not want a patient to overdose or to develop an addiction, and they also do not want to feed existing medication addictions.

One of the best options for management of chronic pain is a referral to a pain clinic. Pain clinics specialize in assessing and helping patients with painful conditions, and they can work with a patient and his or her medical team to develop an appropriate medication schedule.