Approach to managing incident pain in palliative care

Incident pain is pain associated with an activity (eg movement, dressing changes). It is distinct from breakthrough pain, which suggests inadequate regular pain management or fluctuating pain. Incident pain and breakthrough pain are managed separately.

Consider the key principles of pain management outlined in Approach to managing pain in palliative care.

Acute severe uncontrolled pain is a medical emergency—see Acute pain in palliative care.

Incident pain commonly occurs in patients with bone metastases or tumour in soft tissues—palliative radiotherapy may be appropriate. For further information on the management of bone pain associated with cancer, see Managing bone pain associated with cancer in palliative care.

For incident pain associated with activities of daily living such as standing or showering, nurses, physiotherapists and occupational therapists can provide valuable advice on modifying activities to minimise pain.

When dressing changes cause pain, it may also be possible to modify the frequency and type of dressing (see Painful wounds in the Ulcer and Wound guidelines for advice). See also Wounds in palliative care for general information.