Sickle Cell Disease: Pain Management

Overview

Pain is a problem for many people who have sickle cell disease. Bouts of severe pain can last for hours to days and are hard to treat. A pain management plan can help you cope with chronic pain and with pain caused by a sickle cell crisis.

Your doctor or a pain treatment specialist can help you make a pain management plan. This plan includes instructions on how to treat pain at home. And it tells you when you need to go to the hospital if your pain gets worse.

Your management plan:

• States your and your doctor's preferences ahead of time.
• Explains your needs to other health professionals who care for you.
• Helps you know what to expect and do during times of crisis.

How is pain from sickle cell disease treated?

In many cases, you can treat pain at home. You can use a combination of pain medicines, plenty of fluids, and comfort measures such as heating pads or hot water bottles. Do not use heating pads with children.

A painful event (crisis) can become severe and may last for days to weeks. If home treatment doesn't help enough, you'll need strong pain medicine that must be monitored in a hospital or treatment center.

Treating pain at home

Pain can be treated at home with:

• Pain management skills. These skills can help you and/or your child focus away from the pain. They can help even when you also take pain medicines. A pain specialist can teach you pain management skills. These skills include:
  • Guided imagery.
  • Relaxation.
  • Distraction.
  • Deep breathing.
  • Positive, encouraging self-talk.
• Medicine. Use the pain management plan you developed with your doctor to help decide what type of pain medicine to use. You are probably the best judge of when it's necessary to use a stronger prescription medicine.
  • For mild pain, you might use over-the-counter ibuprofen (such as Advil) and/or acetaminophen (such as Tylenol). Children and teens younger than 20 should not be given aspirin, which can cause Reye syndrome, a serious illness. Be safe with medicines. Read and follow all instructions on the label.
  • For moderate or severe pain, you might take pain medicine prescribed by your doctor. These are usually opioid medicines. You and your doctor will talk about which medicines to use, how much to take, and how often to take them. The instructions may change depending on how bad your pain is.

Treating pain at the hospital

If you go to the hospital, you will be treated with a strong pain medicine. This is usually an opioid medicine, such as morphine.

• The medicine is given directly into a vein (intravenously, or I.V.). You may be given a button to push to release a dose when needed.
• When you feel less pain, I.V. opioid medicine is slowly reduced. It's replaced with a less powerful medicine you take by mouth. These actions can prevent your body from going through sudden drug withdrawal symptoms.