Background pain is ongoing pain that you can manage with regular pain relief. If it isn’t fully controlled, you may have pain shortly before your next dose of pain relief is due. If this happens, you may need a different dose or type of pain relief.
Sometimes, you might get short bursts of severe pain that come on quickly and last for a few minutes or a few hours. This is called breakthrough pain, as it “breaks through” your regular pain relief.
Treatment for breakthrough pain includes some fast acting (immediate release) opioid painkillers. If you are getting a lot of breakthrough pain, you may need a different dose or type of pain relief.
Incident pain is similar to breakthrough pain but it is caused by an activity, like moving around. If you know what is likely to cause pain, you may be able to prevent it by taking fast acting (immediate release) painkillers 20 to 30 minutes before doing that activity, or by changing the activity.
Nerve (neuropathic) pain
Many people with pancreatic cancer have some nerve pain. This is also called neuropathic pain.
There is a bundle of nerves, called the coeliac plexus, behind the pancreas. These nerves send messages from the pancreas to the brain. Pancreatic cancer can press on the coeliac plexus or damage it, causing pain in the tummy area and back.
Nerve pain can come and go and can be difficult to describe. Some people say it feels like a burning, shooting or stabbing pain, or like pins and needles. Opioid painkillers help treat nerve pain for some people, and other drugs such as amitriptyline and pregabalin are also used.
A nerve block is a treatment that can sometimes be used for nerve pain.
Soft tissue (visceral) pain
If pancreatic cancer spreads to nearby organs, like the liver or bowel, it can cause a type of pain called soft tissue or visceral pain. The pain may feel deep, squeezing, aching or cramping. You may find it difficult to say exactly where the pain is coming from.
Soft tissue pain can sometimes cause pain in another part of the body. For example, you may feel pain in your neck or shoulder. This is called referred pain. It is common and can be managed.
Treatments for soft tissue pain can include painkillers and nerve blocks. Drugs called antispasmodic drugs are sometimes used to help with tummy cramps and pain.