Tips for COPD Pain Management

How often does pain affect your quality of life? If you say on a daily basis, you are not alone. Pain is a significant problem in chronic obstructive pulmonary disease (COPD), and one that is often under-recognized. It can interrupt your sleep, make your breathing worse and make an otherwise good day a bad one. How can pain be effectively managed in COPD? Let's take a closer look.

Unlike acute pain that accompanies a sudden injury, chronic pain persists long after an injury has healed. It is pain that is often constant, and one that dramatically interferes with your daily life.

Causes

Pain, in and of itself, is not a symptom of COPD; rather, it is often musculoskeletal in nature and commonly associated with the work of breathing. Chronic pain may also be connected to the following conditions, which are unrelated to COPD:

• Back, neck and pelvic pain
• Headaches and migraines
• Fibromyalgia
• Arthritis
• Reflex sympathetic dystrophy
• Sciatica
• Carpal tunnel syndrome
• Temporomandibular joint disorder

In addition, there are six main types of chronic pain, including nociceptive, somatic, visceral, neuropathic, psychogenic, and idiopathic.

Research

While there is limited clinical data surrounding the issue of pain and COPD, existing research suggests that approximately 45% of all COPD patients report chronic pain compared to 34% of people without COPD. Moreover, people with COPD often report their pain as moderate to severe and located primarily in the chest, shoulders, neck, and upper arms.

Many people with COPD report their pain as incomprehensible and unbearable. And, as if pain is not bad enough, a vicious cycle of symptoms often accompanies pain associated with COPD. These symptoms negatively affect one another and include pain, breathlessness, sleep disturbance, and anxiety.

Treatment

According to research, analgesic pain relievers are the most commonly used treatment for pain in COPD. From mild to severe, analgesics target a broad range of types of pain and include:

• NSAIDs — including Motrin, Naproxen, and aspirin
• Opioids — including morphine, codeine, and topical analgesics like Capsicum.

Non-Pharmacological Methods of Pain Control

The problem with analgesic medications is that some of them, like morphine and codeine, can be addicting. In addition, taking too many of them, either all at once or over a period of time, can depress the respiratory center in the brain, causing you to stop breathing.

With non-pharmacological methods of pain relief, there is no need to worry about addiction or respiratory depression. They can be used in place of analgesics if the pain is mild, or, in cases of moderate to severe pain, as an adjunct to analgesics for better pain management. Here are some non-pharmacologic methods of pain control to consider:

• Ice — can be used to reduce swelling and inflammation associated with chronic pain.
• Heat — increases blood flow to the tissues; works great for arthritis-type pain.
• Massage — can help relax stiff joints and muscles, which, in turn, provides pain relief.
• Guided imagery — helps relax muscles, providing a distraction from pain.
• Physical therapy — provides pain-relieving modalities such as ultrasound and electrical nerve stimulation while teaching you more efficient ways to move and better cope with your pain.

Two other non-pharmacological methods of pain relief, acupuncture and transcutaneous electrical nerve stimulation, may also be beneficial for pain relief.