Transitory exacerbation of pain that occurs on a background of controlled persistent pain.
Breakthrough pain refers to asudden and brief flare-up of pain from a chronic condition like arthritis or cancer.
Sometimes it has an obvious trigger.
About 86 percent of patients with chronic pain have episodes of breakthrough pain.
These episodes typically last about 30 minutes.
The sudden onset of pain may strike only on occasion, or as often as four times a day.
Breakthrough pain can be managed by changing the pain medication, avoiding triggers, and trying alternative pain relief techniques.
It’s common in people with cancer, but it can also occur in those with:
arthritis
fibromyalgia
back pain
multiple sclerosis
Episodes of breakthrough pain can be triggered by something as seemingly harmless as a cough or sneeze.
Breakthrough pain causes include:
stress
illness
exercise
Breakthrough pain may occur if one develops tolerance to pain medications.
To treat episodes of breakthrough pain, rescue medication, a pain reliever that is fast acting and lasts for a short period of time can be used.
A commonly used fast-acting opioid for breakthrough pain is the narcotic fentanyl.
Techniques to prevent and manage breakthrough pain:
acupuncture
massage therapy
relaxation techniques such as deep breathing and meditation
tai chi
yoga
heat and cold therapies
Breakthrough pain can cause anxiety distress and negatively impacts quality of life, and ca be associated with decreased mobility, sores, constipation, pneumonia, and blood clots
depression and anxiety and
loneliness.
Prevalence of cancer breakthrough pain is 50-90%.
Typically breakthrough cancer pain is rapid in onset with a meantime of onset to peak pain intensity is approximately 1-3 minutes and of brief duration with a mean of 30-45 minutes.
Patients with cancer pain report an average of 1-6 breakthrough cancer pain episodes per day.
Up to 50 pain episodes of breakthrough cancer pain have been reported per day.
Breakthrough cancer pain is associated with more severe chronic pain, impaired function and psychological distress.
Prevalence in chronic pain unrelated to cancer is similar to cancer related breakthrough pain.
Associated with more severe chronic pain, more psychologic distress, more impairment in physical functioning, reduced responsive to analgesics and increased costs.
Typical breakthrough pain peaks within minutes, therefore oral opioid analgesics are not optimal since the onset of analgesia may follow the peak of target pain.
Breakthrough pain associated with movement is called incident pain.
Incident pain can be associated with significant functional limitation and is a marker of pain that is more difficult to control.