How to Manage COPD Pain ?

Pain management is an important part of treatment for Chronic Obstructive Pulmonary Disease (COPD), You need to stay on top of managing your COPD related symptoms, fitness levels, and ensuring you are maintaining a healthy weight. But that’s not all, another important aspect of COPD management that is often overlooked is pain management. The most common areas of pain in patients with COPD are in the neck, shoulders, upper arms, and chest. It can interrupt your sleep, make your breathing worse and make an otherwise good day with COPD, a bad one.

Unlike acute pain that accompanies a sudden injury, chronic pain persists long after an injury has healed. It is pain that is often constant, and one that dramatically interferes with your daily life.

What is Chronic Pain?

Acute pain and chronic pain are actually two completely different things. Acute pain is a result of a sudden injury, but once the injury is healed your pain is gone.

On the other hand, chronic pain continues even after the injury has healed. Chronic pain is a constant day in and day out, affecting the quality of your life daily.

According to pre-existing studies in regards to chronic pain and COPD, roughly 45% of all COPD patients reported chronic pain as an issue when compared to people without COPD. When looking at the placement of pain, it's most common in the chest, neck, upper arms, and shoulders.

Causes of Pain with COPD

A direct cause of pain with COPD that is experienced frequently is due to your lungs being inflamed. Since your lungs are blown up like a balloon, they induce pressure on your chest wall, spine, and your diaphragm that results in chronic pain. The chronic pain is so severe that something as simple as walking can lead to aggravation.

Another frequent symptom of COPD that induces pain is coughing. Living with an extreme cough is not only annoying, but it can also cause you to experience muscle strains in your chest muscles. A COPD related cough can even lead to a cracked rib, this is even more likely if you are also diagnosed with osteoporosis.

In the grand scheme of things, COPD overall can cause you to experience pain more intensely than someone without COPD. As the constant stress of not being able to breathe can induce anxiety. Causing your pain threshold to dramatically decrease and your pain sensitivity to skyrocket. 

Unfortunately, when experiencing both pain and anxiety simultaneously, your COPD symptoms can worsen, Furthermore, a combination of pain and anxiety can lead to worsening sleeping patterns and depression helping to further aggravate your COPD symptoms.

COPD Pain Management 

Many of these pain management techniques can be used in combination with one another for even better results.

You should first take into consideration that the methods you use for COPD pain management will depend on the cause of your pain and the current stage of COPD that you are in, If you also have osteoporosis in addition to COPD, you and your doctor need to address it directly and use appropriate pain management techniques.

As these treatments may be different from those that would be used to treat COPD related pain.

Treatment for Chronic Pain with COPD
Analgesic pain relievers are the most commonly used treatment for pain in COPD, Analgesics target a broad range of pain, from mild to severe, and include:

• Non-Steroidal Anti-inflammatory Drugs - NSAIDs – These can include Ibuprofen (e.g. Motrin), Naproxen and acetylsalicylic acid 
• Opioids – These can include morphine and codeine

NSAIDs

This class of medications includes Motrin and Aspirin. Medications used for colds, sinus pressure and allergies also fall in this classification of medications, You may already have experience using these as they are very commonly used to relieve minor aches and pains and to minimize a fever in both people with and without COPD.

There are a few things that you need to keep in mind while using non-steroidal anti-inflammatory drugs (NSAIDs). Overdosing on NSAIDs is dangerous and can lead to stomach bleeding, This is more likely if you are over the age of 60, take prescriptions for steroids or blood thinners, or if you have a history of stomach bleeding, ulcers, and/or other bleeding issues.

What's more, if you are over the age of 60 NSAIDs can result in reversible kidney damage, You may be at even more risk for this kidney damage if you take a diuretic, or if you have heart disease, high blood pressure, or a pre-existing kidney disease. 

It's important that you don't over consume these types of medications, doing so can cause your body to become immune to the medication's effects.

Opioids Medications

This class of medications includes morphine, codeine, or a topical like Capsicum. However, these types of medications need to be used with extreme caution.

Using Opioid medications in large doses can lower your breathing rate to dangerous levels, but with low yet effective dosing they can greatly minimize pain and reduce your difficulty to breathe in advanced stages of COPD.

Some methods of pain Management without medication:

• Pulmonary rehabilitation: This is the best treatment for chest and muscle pain. Pulmonary rehab strengthens the muscles of the chest wall and reduces pain. This approach includes physical therapy, breathing retraining, and emotional support. It can decrease anxiety as well as improve strength and endurance.
• Ice: It can be used to reduce swelling and inflammation associated with chronic pain.
• Heat: Increases blood flow to the tissues; this works great for arthritis-type pain.
• Massage: It can help relax stiff joints and muscles, which in turn, provides pain relief.
• Physical therapy: As mentioned in pulmonary rehab provides pain to relieve modalities such as ultrasound and electrical nerve stimulation while teaching more efficient ways to move and better cope with the pain. This may be suitable if no pulmonary rehabilitation program is available in one’s geographical location.
• Staying Active: In the absence of pulmonary rehabilitation or even physical therapy, devising one’s own personal approach, in conjunction with a physician, can help to control one’s pain.
• Acupuncture: some believe this approach alleviates the pain associated with COPD. This should be discussed with a physician first.

The relationship between COPD and pain is being increasingly recognized, although research is ongoing as to how to best manage the two conditions together. Not all physicians are as well versed in treating both conditions as we might like to see.

Pain management for COPD depends on what is causing the pain and how advanced COPD is. One may benefit from pain management strategies because of both the struggle to breathe and the emotional anxiety of having COPD. If you have COPD and are having significant pain, talk with your doctor about it. If you are struggling emotionally with pain, be sure to ask for help. Work closely with your physician to find the cause of your pain and the best treatment options for you.

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