Table of ContentsView AllTable of ContentsWhat is It?Causes and TriggersPain MedicationOther Pain TreatmentsComplications and Outlook
Table of ContentsView All
View All
Table of Contents
What is It?
Causes and Triggers
Pain Medication
Other Pain Treatments
Complications and Outlook
Breakthrough pain is sudden, intense, and short-lasting in people with chronic medical conditions.Chronic conditionslast more than one year and often require long-term medical care—including ongoing pain management with medication.Sometimes, a flare-up occurs, and pain “breaks through” your medication.This article discusses breakthrough pain—what it is, whom it usually affects, possible causes or triggers, and treatment options.South_agency / Getty ImagesWhat Is Breakthrough Pain?There are various types of pain.Acute pain most often occurs immediately after an injury. It is usually intense but typically improves as the injury heals.Chronic painis pain that has been present for at least three months. It can come on gradually or quickly, and ranges in severity. Chronic pain is common in long-standing medical conditions, such as cancer or arthritis. Healthcare providers often prescribe long-term pain medications to manage chronic pain.Despite ongoing medications, pain from chronic conditions can still arise at times—this type of pain is called breakthrough pain. Breakthrough pain can have a trigger or occur randomly.Other characteristics of breakthrough pain can include:Sudden onsetStronger intensity than the ongoing chronic painPain that lasts for a few minutes or up to an hourPain usually (but not always) occurring in the same part of the body as the chronic painWho Gets Breakthrough Pain?Breakthrough pain is common in people living with cancer, but research shows that it can occur in people with other chronic medical conditions such as arthritis andfibromyalgia.Causes and Triggers for Breakthrough PainBreakthrough pain can occur for various reasons, though the reason isn’t always known. Sometimes movements, such as coughing, using the toilet, walking, or swallowing, can trigger breakthrough pain. It can also occur from spasms of internal organs, such as the intestines.Breakthrough pain can be due to procedures and treatments used to treat chronic illnesses. Examples include:ChemotherapyRadiationDiagnostic testsSurgeryThe side effects of the underlying chronic medical condition can also cause breakthrough pain. These side effects include:ConstipationHeadachesEmotional stressSkin rashBreakthrough Pain MedicationDrugs used to treat breakthrough pain are sometimes called rescue medications. These drugs are typically fast-acting and short-lasting and are designed to treat the characteristics of breakthrough pain.Medications for Breakthrough Pain ReliefTylenol (acetaminophen) andnonsteroidal anti-inflammatory drugs (NSAIDs)can be helpful for mild breakthrough pain. Over-the-counter (OTC, not requiring a prescription) NSAIDs include:Advil or Motrin (ibuprofen)Aleve (naproxen)Bayer (aspirin)In some cases, a healthcare provider may recommendprescription-strength anti-inflammatory medicationsfor pain management, such as:Celebrex (celecoxib)Voltaren (diclofenac)Orudis (ketoprofen)Ketorolac (clonidine)Opioidsare the most common type of medication prescribed for moderate to severe breakthrough pain. Examples include:MSIR (morphine)CodeineSuboxone (buprenorphine)Percocet (oxycodone)Dolophine (methadone)Vicodin (hydrocodone)Actiq or Fentora (fentanyl)Dilaudid (hydromorphone)Ultram (tramadol)Nucynta (tapentadol)Side Effects of Breakthrough Pain DrugsAnti-inflammatory drugs can cause stomach, kidney, heart, and blood issues, especially with long-term use. Opioids can also cause unwanted side effects, such as:DrowsinessNauseaConstipationDry mouthDizzinessVomitingLow blood sugarItchingSeizuresSleeping issuesOther Treatment Methods for Breakthrough PainOther nondrug interventions can be helpful for treating breakthrough pain. Examples include:AcupuncturePhysical therapyMassage therapyStress management andrelaxation techniquesPsychotherapy or counselingHypnosisSupport groupsGentle exercise (such as walking, yoga, or tai chi)Medical marijuanaHeat or coldHow to Prevent a Flare-Up in Breakthrough PainUnfortunately, breakthrough pain can’t always be predicted or prevented. However, keeping a pain diary—logging the time it occurs, how long it lasts, and what activity you were performing when it started—can help you identify potential triggers.Potential Complications and Outlook for People With Breakthrough PainIf breakthrough pain is not adequately treated, it can significantly impact your quality of life. Eventually, it can also lead to physical disability and makeactivities of daily livingdifficult.You don’t have to live with your current level of pain. Talk to a healthcare provider about your pain to learn of available treatment options. Consider seeing a physical therapist for advice regardingassistive devicesthat can help improve your mobility or anoccupational therapistfor advice about adaptive equipment to make daily tasks easier.SummaryBreakthrough pain occurs in people living with chronic medical conditions. These individuals typically take medications that manage their baseline pain. However, sometimes pain can still break through current treatment. Triggers for breakthrough pain include certain movements, illness, testing procedures, or surgery. Sometimes, it occurs without an apparent reason.Breakthrough pain can be treated with over-the-counter medications or prescription opioids. Other interventions, such as physical therapy, massage therapy, gentle exercise, stress management techniques, and psychotherapy, can also be helpful.
Breakthrough pain is sudden, intense, and short-lasting in people with chronic medical conditions.Chronic conditionslast more than one year and often require long-term medical care—including ongoing pain management with medication.Sometimes, a flare-up occurs, and pain “breaks through” your medication.
This article discusses breakthrough pain—what it is, whom it usually affects, possible causes or triggers, and treatment options.
South_agency / Getty Images
What Is Breakthrough Pain?
There are various types of pain.Acute pain most often occurs immediately after an injury. It is usually intense but typically improves as the injury heals.
Chronic painis pain that has been present for at least three months. It can come on gradually or quickly, and ranges in severity. Chronic pain is common in long-standing medical conditions, such as cancer or arthritis. Healthcare providers often prescribe long-term pain medications to manage chronic pain.
Despite ongoing medications, pain from chronic conditions can still arise at times—this type of pain is called breakthrough pain. Breakthrough pain can have a trigger or occur randomly.
Other characteristics of breakthrough pain can include:
Who Gets Breakthrough Pain?Breakthrough pain is common in people living with cancer, but research shows that it can occur in people with other chronic medical conditions such as arthritis andfibromyalgia.
Who Gets Breakthrough Pain?
Breakthrough pain is common in people living with cancer, but research shows that it can occur in people with other chronic medical conditions such as arthritis andfibromyalgia.
Causes and Triggers for Breakthrough Pain
Breakthrough pain can occur for various reasons, though the reason isn’t always known. Sometimes movements, such as coughing, using the toilet, walking, or swallowing, can trigger breakthrough pain. It can also occur from spasms of internal organs, such as the intestines.
Breakthrough pain can be due to procedures and treatments used to treat chronic illnesses. Examples include:
The side effects of the underlying chronic medical condition can also cause breakthrough pain. These side effects include:
Breakthrough Pain Medication
Drugs used to treat breakthrough pain are sometimes called rescue medications. These drugs are typically fast-acting and short-lasting and are designed to treat the characteristics of breakthrough pain.
Medications for Breakthrough Pain Relief
Tylenol (acetaminophen) andnonsteroidal anti-inflammatory drugs (NSAIDs)can be helpful for mild breakthrough pain. Over-the-counter (OTC, not requiring a prescription) NSAIDs include:
In some cases, a healthcare provider may recommendprescription-strength anti-inflammatory medicationsfor pain management, such as:
Opioidsare the most common type of medication prescribed for moderate to severe breakthrough pain. Examples include:
Side Effects of Breakthrough Pain DrugsAnti-inflammatory drugs can cause stomach, kidney, heart, and blood issues, especially with long-term use. Opioids can also cause unwanted side effects, such as:DrowsinessNauseaConstipationDry mouthDizzinessVomitingLow blood sugarItchingSeizuresSleeping issues
Side Effects of Breakthrough Pain Drugs
Anti-inflammatory drugs can cause stomach, kidney, heart, and blood issues, especially with long-term use. Opioids can also cause unwanted side effects, such as:DrowsinessNauseaConstipationDry mouthDizzinessVomitingLow blood sugarItchingSeizuresSleeping issues
Anti-inflammatory drugs can cause stomach, kidney, heart, and blood issues, especially with long-term use. Opioids can also cause unwanted side effects, such as:
Other Treatment Methods for Breakthrough Pain
Other nondrug interventions can be helpful for treating breakthrough pain. Examples include:
How to Prevent a Flare-Up in Breakthrough PainUnfortunately, breakthrough pain can’t always be predicted or prevented. However, keeping a pain diary—logging the time it occurs, how long it lasts, and what activity you were performing when it started—can help you identify potential triggers.
How to Prevent a Flare-Up in Breakthrough Pain
Unfortunately, breakthrough pain can’t always be predicted or prevented. However, keeping a pain diary—logging the time it occurs, how long it lasts, and what activity you were performing when it started—can help you identify potential triggers.
Potential Complications and Outlook for People With Breakthrough Pain
If breakthrough pain is not adequately treated, it can significantly impact your quality of life. Eventually, it can also lead to physical disability and makeactivities of daily livingdifficult.
You don’t have to live with your current level of pain. Talk to a healthcare provider about your pain to learn of available treatment options. Consider seeing a physical therapist for advice regardingassistive devicesthat can help improve your mobility or anoccupational therapistfor advice about adaptive equipment to make daily tasks easier.
Summary
Breakthrough pain occurs in people living with chronic medical conditions. These individuals typically take medications that manage their baseline pain. However, sometimes pain can still break through current treatment. Triggers for breakthrough pain include certain movements, illness, testing procedures, or surgery. Sometimes, it occurs without an apparent reason.
Breakthrough pain can be treated with over-the-counter medications or prescription opioids. Other interventions, such as physical therapy, massage therapy, gentle exercise, stress management techniques, and psychotherapy, can also be helpful.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.About chronic diseases.National Cancer Institute.Breakthrough pain.National Cancer Institute.Pain management.Rudowska J.Management of breakthrough pain due to cancer.Contemp Oncol (Pozn). 2012;16(6):498-501. doi:10.5114%2Fwo.2012.32481National Cancer Institute.Cancer pain (PDQ)—patient version.Caraceni A, Davies A, Poulain P, Cortés-Funes H, Panchal SJ, Fanelli G.Guidelines for the management of breakthrough pain in patients with cancer.Journal of the National Comprehensive Cancer Network. 2013;11(suppl_1):S-S-36. doi:10.6004/jnccn.2013.0211Dell DD, Stein DP.Exploring the use of medical marijuana for supportive care of oncology patients.J Adv Pract Oncol. 2021;12(2):188-201. doi:10.6004%2Fjadpro.2021.12.2.6
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.About chronic diseases.National Cancer Institute.Breakthrough pain.National Cancer Institute.Pain management.Rudowska J.Management of breakthrough pain due to cancer.Contemp Oncol (Pozn). 2012;16(6):498-501. doi:10.5114%2Fwo.2012.32481National Cancer Institute.Cancer pain (PDQ)—patient version.Caraceni A, Davies A, Poulain P, Cortés-Funes H, Panchal SJ, Fanelli G.Guidelines for the management of breakthrough pain in patients with cancer.Journal of the National Comprehensive Cancer Network. 2013;11(suppl_1):S-S-36. doi:10.6004/jnccn.2013.0211Dell DD, Stein DP.Exploring the use of medical marijuana for supportive care of oncology patients.J Adv Pract Oncol. 2021;12(2):188-201. doi:10.6004%2Fjadpro.2021.12.2.6
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.About chronic diseases.National Cancer Institute.Breakthrough pain.National Cancer Institute.Pain management.Rudowska J.Management of breakthrough pain due to cancer.Contemp Oncol (Pozn). 2012;16(6):498-501. doi:10.5114%2Fwo.2012.32481National Cancer Institute.Cancer pain (PDQ)—patient version.Caraceni A, Davies A, Poulain P, Cortés-Funes H, Panchal SJ, Fanelli G.Guidelines for the management of breakthrough pain in patients with cancer.Journal of the National Comprehensive Cancer Network. 2013;11(suppl_1):S-S-36. doi:10.6004/jnccn.2013.0211Dell DD, Stein DP.Exploring the use of medical marijuana for supportive care of oncology patients.J Adv Pract Oncol. 2021;12(2):188-201. doi:10.6004%2Fjadpro.2021.12.2.6
Centers for Disease Control and Prevention.About chronic diseases.
National Cancer Institute.Breakthrough pain.
National Cancer Institute.Pain management.
Rudowska J.Management of breakthrough pain due to cancer.Contemp Oncol (Pozn). 2012;16(6):498-501. doi:10.5114%2Fwo.2012.32481
National Cancer Institute.Cancer pain (PDQ)—patient version.
Caraceni A, Davies A, Poulain P, Cortés-Funes H, Panchal SJ, Fanelli G.Guidelines for the management of breakthrough pain in patients with cancer.Journal of the National Comprehensive Cancer Network. 2013;11(suppl_1):S-S-36. doi:10.6004/jnccn.2013.0211
Dell DD, Stein DP.Exploring the use of medical marijuana for supportive care of oncology patients.J Adv Pract Oncol. 2021;12(2):188-201. doi:10.6004%2Fjadpro.2021.12.2.6
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