Breakthrough Pain: When the Usual Drugs Stop Working

Here is a scary real-life scenario: A chronic pain sufferer has her pain under control using a non-narcotic medication or a slow-release opioid, which has in the past worked for more than 12 hours. One day as she goes about things, a sharp spike of severe pain stops her in her tracks and she wonders what is going on.

Special drugs and approaches can control pain that "spikes" out of normal range. (HEALTH)
This is breakthrough pain, which is defined as a severe pain that spikes through controlled chronic pain, showing up like a horrible surprise guest and then departing.

A recent study in the Journal of Pain found that 74% of chronic noncancer pain patients reported experiencing severe-to-excruciating breakthrough pain.

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One such patient is Andrea Cooper, 52, of Phoenix, Md., who has fibromyalgia and spinal degeneration: "I'll take a pain med, which lasts between 12 and 24 hours. Well, after 10, let's say, I'll be walking down the street and get this searing pain that's building and building in my shoulder to the point that I feel my arm is going to blow off."

Cooper's breakthrough pain has been so severe at times that she's been forced to stop everything she's doing and lie down, even in places like a department store, until the wave of pain diminishes.

Breakthrough pain usually peaks quickly and lasts for a relatively short period of time—typically up to an hour.

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Lead writer: Suzanne Levy
Last Updated: April 14, 2008

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