Breakthrough pain: symptoms and treatment

Breakthrough pain is a concept that has recently been created to refer to a picture that occurs specifically in people with cancer. It is a brief pain that appears suddenly in people who already suffer from a painful pathology, Like cancer

That is to say, the irruptive pain appears in people who already have a basic pain and who, generally, are already medicated to alleviate it. However, this breakthrough pain is so intense that it exceeds the effectiveness of that treatment and It is unbearable for those who suffer.

It affects many of the people with chronic processes. It is estimated that 2 out of every 3 patients who experience cancer pain also suffer breakthrough pain.. In addition, it is something unpredictable.

It is a very hard experience that interferes even more with the quality of life and in the welfare of these people. Therefore, in this article we explain everything you need to know about it.

What is breakthrough pain?

Actually, the definition of breakthrough pain, according to the Spanish Society of Medical Oncology, is a bit more concrete. Defines it as a transient, sudden and very intense exacerbation that appears on persistent base pain.

This pain appears, therefore, in people who are already being medicated to control the pain they suffer from. Further, breakthrough pain can be classified into different types:

  • Incidental, which in turn can be predictable or unpredictable. This incidental breakthrough pain is related to a muscular movement, such as coughing or sneezing.
  • Idiopathic, which cannot be related to any specific cause.
  • Breakthrough pain that appears due to the decrease in analgesics. It is typical to appear when the dose of the analgesic that controls the base pain has been taken for a long time. Also when a lot of time passes between one analgesic and another.

What symptoms accompany it?

The presentation of breakthrough pain changes according to each patient and it depends, mainly, on the pain it has as a base. For example, it may be a sudden and sharp increase in leg pain, in the case of a knee sarcoma.

Like any other pain, It is normal for the person to be sweaty, with rapid breathing and tachycardia. The skin usually becomes paler and all muscles tense.

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How is breakthrough pain treated?

In order to establish a complete treatment, it is essential that we understand that it is not merely physical. Breakthrough pain It is a situation that complicates the patient's life and also has psychological repercussions.

Therefore, the treatment must be both pharmacological and non-pharmacological. It is necessary to provide these people with psychological support, relaxation methods and techniques to deal with such pain.

Ideally, treat the agent that causes this pain or at least Try to prevent spikes of breakthrough pain. In addition, medical treatment follows a series of therapeutic strategies depending on the type of pain and intensity.

The most used drugs are opioids; some of them are fentanyl and morphine. The problem is that, when the pain has already arrived, it is very difficult to alleviate it with common analgesics. The same happens with opioids taken orally.

Therefore, substances ‘transmucosal absorption‘ are usually used. This causes the drug to pass through the mucous membranes and reach the bloodstream directly. Thus, relief is much faster and more effective. An example is the area under the tongue.

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In conclusion

A person with an oncological process or a chronic disease that presents a basic pain may suffer exacerbation peaks of that pain, which have the name of breakthrough pain.

It is essential that we understand the complexity of this situation in order to be able to physically and mentally help the people who suffer from it. However, It must be the doctor who chooses any type of treatment.