Breakthrough Pain: What is it and how can it be treated?

Breakthrough pain management – what is it, why does it occur, and what are the treatment options?

 If you suffer from chronic pain, you may be familiar with the concept of breakthrough pain.  Breakthrough pain is a sharp spike in pain. An example of this would be if you do something that activates extra pain, for instance standing up too fast after back surgery and feeling a sudden and painful tweak in your lower back.

Often times, breakthrough pain occurs without any obvious cause. This can sometimes indicate that patients need to revise their medication regimen so that it covers both the chronic pain as well as the breakthrough pain.

A study published in the Journal of Opioid Management determined that breakthrough pain is highly prevalent in noncancer patients, which came as a bit of a surprise because it is typically associated with cancer patients.

Why does breakthrough pain occur?

Breakthrough pain can occur for no clear reason. Alternatively it can occur and can be activated by things like coughing, exercising moving after his surgical procedure using the restroom or even simple movements like getting dressed in the morning. It can also occur because the narcotic the pain sufferer is taking is wearing off for their tolerance is too high.

Whatever the reason, breakthrough pain can attack very suddenly, without any warning and can reach a peak intensity very quickly, often times when three minutes.

Typical episodes last between 30 to 60 minutes.

According to a American Pain Foundation study, individuals who take opioid painkillers experience breakthrough pain on average twice a day.

The National Pain Foundation estimates that over 80% of chronic pain sufferers who are taking medications for their pain will experience breakthrough pain.

Understanding narcotics and the brain

Breakthrough pain and narcotics

If you are taking narcotics to measure pain, breakthrough pain can be an indication that your body has developed a tolerance to narcotics. This means that you need to take more of the drugs over time to have the same pain relieving effects. Oftentimes doctors will increase the dosage of the painkiller, but the negative side effects also increase with it.

A good solution to managing breakthrough pain, if in fact you are experiencing it because of tolerance to a narcotic, is to change to a different drug.

With new drugs you will likely be able to take a smaller dose that will have a larger effect.

NMDA antagonists (N-methyl-D-aspartate) Represents an advance in pain management strategies. They work by blocking the NMDA receptors which helps to minimize opioid tolerance. An NDMA allows patients to experience pain relief at a lower dose of the narcotic drugs that they are taking- they help prevent tolerance.

Actiq and Fentora are two medications approved for the use of breakthrough pain associated with cancer in patients that are also taking another opioid medication for pain relief.

Other common breakthrough pain medications include Dilaudid, Morphine, and oxycodone. These three drugs have similar methods of action but are known to act quickly and then disappear from the system pretty quickly.

This makes them effective pain management tools for breakthrough pain relief.

Final thoughts

Research still needs to be done to understand the origins and best options for the treatment of chronic pain. Advances in pain management are occurring frequently, so chronic pain sufferers should be comforted to know that there is research being done to discover an effective remedy.

If you are experiencing breakthrough pain, it is best to consult with your physician to discuss treatment options.