There are many painkillers available to treat different types and levels of pain, whether it’s mild, moderate or severe.
Painkilling drugs are known as analgesics. Your medical team will aim to find the right combination of painkillers and other therapies to ensure that your pain is managed in the best possible way.
Some people with cancer have constant pain, so they need to take painkillers regularly to keep the pain under control. It’s important not to let pain build up until it’s severe. Severe pain can cause fear, anxiety and difficulty sleeping, which can make the pain worse and more difficult to control.
Painkillers taken by mouth (oral medicines)
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Painkilling drugs are usually taken by mouth - either as tablets or capsules. For people who find it hard to swallow, many oral medicines are available as liquids and some can be dissolved in water.
There are several other ways of taking painkillers that can be helpful if you can’t swallow or are being sick:
If you have a feeding tube, such as a PEG or RIG tube, some liquid or soluble painkillers can be given through the tube.
These are stuck on to the skin. These are useful when your pain control is more settled. They only need to be changed every few days.
Buccal and sublingual medicines
These are absorbed from the tissues in the mouth, so they don’t have to be swallowed. They are usually used for controlling breakthrough pain, as they work quickly.
Some painkillers can be sprayed into the nose. These work best for breakthrough pain.
These are inserted into the back passage.
Many painkillers can be given by injection, either into a muscle or more usually under the skin (subcutaneously).
Some painkillers can be given by infusion over a period of time:
A subcutaneous infusion involves giving a continuous dose of a drug or drugs into a fine needle or cannula (fine, plastic tube) that is placed just under the skin. A small portable pump known as a syringe driver is used to give the drugs this way.
Intravenous infusion using a patient-controlled analgesia (PCA) pump
After surgery, you may have a PCA pump to control your pain. A cannula is placed in a vein in your arm or the back of your hand and a thin tube is used to connect the cannula to the PCA pump. The pump has a handset that you press to give yourself a set dose of a painkiller, usually morphine. You can press the handset as often as needed to ensure your pain is controlled.
Occasionally painkillers may be given by infusion into the space that lies just outside the membranes surrounding the spinal cord. This is known as epidural analgesia. Sometimes the painkiller is given into the fluid around the spinal cord - this is known as intrathecal analgesia. These specialised techniques are usually only used to control severe pain and are managed by anaesthetists, who specialise in pain control.
If you need to have your painkillers by injection or infusion, your doctor or nurse will discuss this with you.
It’s very important to store painkillers carefully. Make sure that they are properly labelled, and lock them up or keep them out of reach of children.
If you’re worried about forgetting to take them, write a note to yourself and put it somewhere you will see it rather than leaving the medicines out. Alternatively, you could ask your partner, relative or friend to remind you to take them, or you could create an alarm on your computer or mobile phone and title it ‘Painkillers’.
It may help you keep track of when your drugs are taken by writing them in your pain diary [PDF, 286 Kb]. Always return any unused medicines to a pharmacist, who can dispose of them properly.