Pain relief

Many people living with a terminal illness experience pain, but not everyone does. If you do, there are lots of ways to help manage pain, including medicines, practical support and emotional support. On this page, we explain what pain is, ways to deal with pain, and how to manage your medicines.

Pain is a physical sensation. It happens when areas of your body send signals to your brain. Pain might be constant or come and go. It might also affect different parts of your body (see Types of pain below).

Pain may feel worse if you feel stressed, anxious, worried, tired, or alone.

Pain could be caused by your illness, a treatment, or an operation. It could also be caused by other medical conditions, such as arthritis. Pain may be acute (lasting less than six months) or chronic (lasting a long time). Acute and chronic pain can occur together – for example, long term pain with periods where it gets worse.

There are different types of pain, and they are managed differently. You may have more than one type of pain. Your medical team might use some of these words to describe pain.

Most pain can be kept under control with medicines, either taken regularly and/or when required. It’s rare to have pain that cannot be managed. But it’s easier to manage pain when you feel you have the right emotional, psychological and spiritual support as well.

You may find that it helps to talk to a professional other than your doctor or nurse, such as a:

You could speak to your doctor or nurse about getting this kind of support.

If you’d like to talk to someone about how you’re feeling, call our free Support Line on 0800 090 2309* or email support@mariecurie.org.uk.

Your doctor or specialist nurse will talk to you about your pain so they can find the right treatment for you. They might ask questions and do a physical examination to better understand how pain is affecting you.

Sometimes they need to arrange tests to find out what’s causing the pain. They might do a blood test to help them decide which medicines are most suitable for you.

Everyone feels pain in their own way and responds to it differently. You are in the best position to say what your pain is like and how it’s affecting you.

Try to describe any pain you’re experiencing to your doctor or nurse. This can be difficult, but it helps them find out the cause and what the best treatment will be.

Keeping a pain diary can be helpful to identify a pattern to your pain, and to see how well your pain responds to treatment.

It’s useful to keep a record of:

People around you can help with this if you find it hard. You can use pen and paper, or type it into your smartphone or tablet. Macmillan Cancer Support has a pain diary template you can print out and use.

There are different medicines for treating pain. Some of them work better for different types or amounts (severities) of pain.

It can take a while to find the medicines that work best for you. Tell your doctor or nurse if your pain gets worse or feels different. They can increase your dose or give you a new medicine to try.

You might find that a combination of pain medicines works best. You might take simple painkillers like paracetamol alongside opioids like morphine, for example. You might also find that combining medicines with non-drug treatments works better for you.

With all medicines, it’s important to follow the instructions. Do not exceed the daily dose prescribed for you.

Lots of medicines have more than one name. In the table below, the generic name for the medicine is first, with some of the common trade names in brackets afterwards.

If your pain medicines are not listed below, ask your doctor, nurse or pharmacist for more information.

It’s best to take painkillers as often as your doctor prescribed, even if you’re not experiencing pain at the time. You do not have to wait until the pain is really bad before taking painkillers. This helps to keep the pain under control between doses.

Pain medications may be prescribed for you to take regularly (for example twice daily), or for you to take when required.

It is important that you take your regular pain medications even if you are not experiencing pain at the time. This helps keep your pain managed.

If you have breakthrough pain, you can take your pain medication when required. You do not have to wait until the pain is severe before taking a dose – pain medications work better and more quickly when taken earlier. Speak to your doctor or nurse if you notice you are needing your breakthrough pain relief more often, or it is not lasting as long as it used to.

If your pain cannot be controlled by medicines, there are other options for treatment of pain:

These treatments are usually provided in hospital by anaesthetists (doctors who specialise in treating pain).

All medicines can cause side effects. These are unwanted effects of a medicine. You might have one or more side effects, or none at all. Ask your doctor or pharmacist about side effects for your medicines.

If you have side effects, talk to your doctor or nurse. Do not stop taking your medicines or change the dose without talking to them. They may suggest you change the dose, try different medicines, or help you to manage side effects.

It’s important not to take extra doses of your medicines, even if you think you need them. Using tools like dosette boxes can stop you accidentally taking too much.

If you think you’ve taken too much, call your doctor or 111 for advice. If there’s someone else in the house with you, tell them as well.

If you become unwell after accidentally taking some medicine, contact 999 or go to a hospital (A&E).

A lot of people worry about taking morphine or other opioids. If you're worried about anything, including the questions below, speak to your doctor or nurse.

You might find it difficult to organise your medicines. There are things that can help:

If you need medication through a syringe driver, this will be set up by your specialist palliative care nurse or district nurse. Your nurse will visit you and refill the medicine in the syringe driver each day.

It’s important to store medicines safely and securely. Nobody else should be able to access them, unless they are helping you to take them. It can be dangerous if other people take them.

You should:

It’s important to get rid of leftover medicines safely. You may have leftovers if you stop taking them or they go past their use-by date.

Take medicines you have not used to a pharmacy. They can dispose of them safely. If you’ve used needles to take medicines, you will have been given a container to put them in (sometimes called a ‘sharps bin’). Ask your pharmacist, GP or district nurse what you should do with the container, as this can vary depending on where you live.

You should not keep leftover medicines, throw them in the rubbish bin, flush them down the toilet or give them to anyone else. They could harm other people, animals or the environment.

Sometimes, people want to stop taking their medicines. This is usually because they do not think their medicines are helping them or because of side effects.

If you’re not sure whether your medicines are helping you, or you’re experiencing side effects, talk to your GP, nurse or pharmacist. They can tell you more about why the medicines have been prescribed for you and discuss the risks and benefits of stopping them. They may be able to change your medicines, change the dose (the amount you’re taking) or help you manage the side effects.

You should only stop taking medicines after getting advice from your doctor, nurse or pharmacist. If you stop taking them, you may experience side effects, or your symptoms could get worse.

Your hospice or hospital team will give you medicines to take until your next prescription is due from your GP. The amount can vary depending on the hospice or hospital and the type of medicines you’re taking. Ask how many days of medicines they’ll give you.

They will give you written information about:

Each medicine will come with instructions about how to take and store it safely.

Speak to your doctor, nurse or pharmacist if you are not sure why you’ve been given a medicine or how you should take it.

Your hospice or hospital team will send your GP information about the medicines you’re taking. This is sometimes called a ‘Discharge letter’ or ‘Treatment to take out (TTO) letter’.

You should also get a copy of this letter. It can be helpful to keep a list of your medicines in case you speak to your GP before they see the letter. If you have not been given a copy of your discharge letter, ask your hospice or hospital doctor, nurse or pharmacist to give you one.

It’s important that you do not run out of medicines. Stopping them abruptly could make your symptoms or side effects worse.

To get more medicines:

Find a pharmacy in:

A friend or family member can help you organise and collect your prescription. You can also ask your pharmacy whether they offer home delivery.

Occasionally, your GP may not be able to prescribe a certain medicine. This is because they are specialist medicines and can only be prescribed by a specialist team. If this is the case, your GP will tell you how to arrange your prescriptions.

You might be supporting someone with a terminal illness in lots of different ways, including helping them with pain and medication.

If someone has difficulty communicating, it can be hard to know if they’re in pain or what type of pain they have. Ask the nurse or doctor for other ways to tell if they’re in pain. They might suggest a visual chart or picture cards to help the person express what their pain is like.

If the person cannot communicate at all, look for signs that they are in pain. These include:

If you notice any of these things, or if you are worried that someone is in pain, speak to their healthcare team.

As well as using medicines, people often feel less pain when they feel relaxed and supported. They can also be distracted from pain when they have things to do.

You can help them to feel more comfortable by:

Ask the nurse if there is a carers support group in your local area where you can get more support.

Helping someone to manage their pain can be challenging. For emotional support, call the free Marie Curie Support Line on 0800 090 2309 or email support@mariecurie.org.uk.