Step 2 – Pain Management
Compassionate & Prompt Pain Management
The American Urology Association (Guidelines 14) states that “pain management should be an integral part of the treatment approach and should be assessed at each clinical encounter for effectiveness.” Why? The bladder, like any other part of the body, can generate pain so severe that patients require immediate medical care and treatment. Unfortunately, IC patients struggle to overcome the perception their bladder pain “isn’t that bad” or is very mild in nature. Of course, the pelvic floor muscles can also be a source of pain.
The first published epidemiological study on IC in 1987 found that the pain of IC rated equivalent to that of cancer pain on the McGill Pain Scale. Similarly, the quality of life for some IC patients was rated equivalent to patients in end-stage renal failure. Given the fact that patients suffering from cancer pain or kidney failure usually receive immediate care and attention, many IC patients also deserve prompt and compassionate pain care.
The AUA suggests the use of a multimodal strategy to treat pain including the use of:
- urinary analgesics
- narcotic medications
- nonnarcotic medications
On Narcotic Medication
The AUA specifically does NOT discourage the use of narcotic pain medication which may be required during periods of intense flares and discomfort. They state “It is clear that many patients benefit from narcotic analgesia as part of a comprehensive program to manage pain.” The use of pain medication, however, should NOT be considered or used as the only treatment. Other therapies that treat and, ideally remove, the cause of pain, should be explored, such as the treatment of painful trigger points or Hunner’s ulcers.
Pain care can be provided by the urologist, primary care provider or pain specialists. The challenge, of course, is that some care providers are simply uncomfortable providing prescriptions for opiate medication. If you, the patient, are not receiving adequate care for your pain, you can request a referral to a pain specialist.
Learn more about the IC pain, it’s potential sources, triggers and a wide variety of treatment options in the ICN Pain Resource Center
The Most Common Pain Trigger
Nine times out of ten, when someone calls our office crying in pain we can trace it back to the foods that they are eating. Remember the core concept that acid on any wound would sting, thus foods high in acid and/or caffeine are notorious for triggering IC “flares” in the vast majority of IC patients. If you are struggling with pain, please review your diet carefully. Even if a physician has told you that diet does not make a difference, research studies have proven that it does. In our experience, the patients who struggle the most with pain often continue to drink coffee, team, soda or cranberry juice, even just one cup per day. Learn more about the IC diet here, bladder friendly foods and meal ideas in the ICN Diet Center