Pain management in palliative care

Gallard, Siân and Rawlinson, Fiona 2026. Pain management in palliative care. Medicine 10.1016/j.mpmed.2026.09.013

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Abstract

Pain management plays an important role in palliative care, and approaches to pain relief differ from those used for acute or chronic pain in other contexts. Treatment goals should prioritize the patient's preferences and values. Patients can have more than one site and type of pain and may be experiencing ‘total pain’, which comprises physical, psychological, spiritual and social elements arising from the fact that they are facing the uncertain prognosis of a life-limiting illness. Comprehensive pain assessment requires both a holistic history and physical examination to identify the underlying cause(s) of pain; this can then guide reversible treatments and inform appropriate interventions and choice of analgesia. The role of explanation cannot be emphasized enough. This short review covers key aspects in pain assessment and discusses non-pharmacological and pharmacological management strategies including strong opioids. Practical frameworks are outlined including measures for pain that is not responding to initial management. Readers are encouraged to complement the British National Formulary, or their country's equivalent for prescribing guidance, with any local palliative care guidelines.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Medicine
Publisher:	Elsevier
ISSN:	1357-3039
Last Modified:	10 Nov 2026 12:45
URI:	https://orca.cardiff.ac.uk/id/eprint/190821

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