Pain in respiratory disease

Abstract

Pain may be classified as nociceptive or neuropathic and somatic or visceral. Neuropathic pain can be further subdivided into that due to nerve compression, nerve destruction or sympathetically maintained pain. The chapter describes the assessment and diagnosis of the cause of pain and the concepts of total pain and regular and breakthrough pain. Management starts with explanation and general non-drug measures. Disease modification runs alongside the use of non-opioid analgesics and then the WHO opioid ladder. Oral morphine is the main strong opioid used, but the indication for alternative drugs and routes is considered. Neuropathic pain -usually requires the use of adjuvant analgesics. The role of other adjuvants in certain circumstances is described as well as the use of topical analgesics and anesthetic interventions.