Pain management

When a wound is slow to heal it is called a ‘chronic wound’- patients with these types of wounds, such as leg ulcers or pressure ulcers, have reported significant pain levels. In fact, in some research studies pain is often reported as the greatest issue when living with a wound. Please remember that you are not alone and there are ways of helping you to manage your wound pain!

Wound pain has been divided into different types of pain reported – try to think about which type your pain falls into from the list below so you can discuss this with your healthcare practitioner. Different types of pain need different management techniques.

Wound related pain is of course personal to you!

The four different types of pain are:

• Background pain: the pain is persistent or intermittent and is there even if a dressing change is not taking place. It may be related to the underlying cause of the wound (for example, poor blood supply in an arterial leg ulcer), or local wound factors such as infection.   
• Incident (breakthrough) pain: here, you experience pain if for example, you move, the wound is exposed to air, or the dressing slips across the wound surface.   
• Procedural pain: this usually occurs when you have your dressing removed, the wound cleaned and the dressing reapplied. 
• Operative pain: this type of pain occurs when you have a procedure, for example when your wound is debrided (cleaned of foreign tissue)

Health care practitioners can suggest a number of ways of helping you to manage your wound related pain including pain relief medication. However, there are also many non-pharmacologic interventions that can be introduced. For more information, go to the Speak Out section of this website.

To help children hurt less during dressing changes

The exact sort of help a child needs will depend on how old they are, but some general principles apply.

Be on hand to comfort your child during the dressing change. If it is to be done at home, choose a quiet, warm room. Explain what is going to happen, how long it will take and whether it is likely to hurt. Be honest!

• Let your child apply the dressing to a favourite doll or teddy bear
• • Help distract attention with toys, books, games etc. 
• Ask the nurse if you can help with the dressing change if you think it will make your child more comfortable
• If your child wants to be involved, ask your nurse 
• Ask for additional pain relief if you think it's needed
  

They may simply ask you and may use a pain assessment tool. Click here to  view an example.

For children, this normally takes the form of a series of faces that range from smiling to crying. Your child can indicate which face shows his or her pain.

What if the procedure becomes more painful?

If the procedure begins to cause pain, tell the person doing the dressing. Don’t be shy! They do not want you to be in pain. They may stop the dressing change for a while, or discuss other dressings which may help.

It is important that you feel in control of the dressing change in order to help minimise pain and anxiety. Ask for your dressing to be removed gently and, if you want to stop at any time during the procedure, ask for a ‘time-out’ break. Ask if you want to be able to remove the dressing yourself. Showering or soaking the dressing with saline or water may help before removal, ask your healthcare professional.
Distraction techniques can also be helpful – soft music, a warm environment, hand holding, guided imagery or even aromatherapy may all help to reduce the distress caused.

Discuss with your doctor or nurse, options for pain relief medication that you may be able to take before the dressing change starts.