The “extra pain” triggered by certain actions is referred to as breakthrough pain. Feeling a little extra discomfort while walking up stairs after back surgery is an example of this type of pain. There’s not always a clear trigger, but it usually means a patients needs extra medication to deal with these bursts of added pain.
Breakthrough Pain Patterns
Sometimes referred to as “flare-ups,” breakthrough pain usually has a distinct pattern. Bouts of pain often reach a peak quickly, go away, and return and last longer. According to one study, the average occurrence of flare-ups for patients was every two days and the average duration of breakthroughs was 45 minutes.
Treating Breakthrough Pain
Short-term pain-relievers are often prescribed to manage flare-ups. Some patients use such medications fairly frequently, sometimes every 4-6 hours. Using short-term pain meds around the clock may create a dependence on those medications and contribute to patients reporting more pain. Treatment possibilities include:
- Identifying possible pain triggers
- Switching to different pain medications
- Targeted physical therapy sessions that focus on areas where added pain is felt
Conditioned Pain Responses
Some patients get into a pattern of taking medications, including any extra medication that may be prescribed for breakthrough pain, on a regular schedule. Over time, the body may become conditioned to getting these medications, which often leads to a point where it’s hard to tell when flare-ups are actually occurring.
Opioid-Induced Hyperalgesia
Opioid pain meds are something of a double-edged sword for patients. While the relief these stronger drugs provide is much appreciated, sustained use of opioids may result in a cycle of physical dependency and withdrawals. Some doctors are now prescribing long-acting opioid products like buprenorphine and fentanyl transdermal patches in an attempt to minimize the risk of dependency.
Pain that “breaks through” the level of protection offered by certain medications is fairly common after surgery, but can also occur with chronic conditions such as arthritis and low back pain. One way for a patient to explain this added pain to their doctor is to keep a journal to note when it occurs and what actions seemed to trigger it.
The Spine Institute Center is a leading spine surgery center in Los Angeles. Our experienced team of spine surgeons specializes in spinal fusions and motion-preserving spine surgeries. To schedule an in-person consultation, call us today at (310) 828-7757.