Chronic pain is pain that lasts longer than 3 months or past normal healing time. It affects sleep, mood, work, and relationships. Your priorities are believing the client's report, improving function, and combining medication with non-drug strategies.
Each care plan below follows the nursing process (ADPIE).
Chronic Pain
- Ongoing tissue or nerve damage
- Chronic conditions such as arthritis, back injury, or neuropathy
- Muscle tension and stress
- Client reports pain lasting more than 3 months
- Guarding or limited movement
- Fatigue and poor sleep
- Withdrawal from usual activities
- Changes in mood such as irritability or sadness
- Client rates pain at or below their personal comfort goal within 48 hours
- Client names 2 non-drug pain strategies by the end of the shift
- Client takes part in daily activities with pain at a level they find acceptable
- Client follows a pain management plan at home
- Pain location, intensity, quality, timing, and what helps or worsens it
- Impact on sleep, mood, and daily function
- Current medications and how well they work
- Side effects such as constipation or sedation
| INTERVENTION | RATIONALE |
|---|---|
| Accept the client's report of pain and use the same pain scale each time | Pain is whatever the client says it is, and a consistent scale shows trends. |
| Give scheduled pain medications as ordered rather than only as needed | Steady dosing keeps pain more controlled than waiting for it to peak. |
| Teach non-drug methods such as heat or cold, relaxation, distraction, and gentle movement | These reduce pain and give the client more control. |
| Prevent and treat medication side effects, such as giving stool softeners with opioids as ordered | Untreated side effects make clients stop taking needed medications. |
EVALUATION
- Client reports pain at or below their comfort goal
- Client uses at least 2 non-drug strategies
- Client sleeps longer and joins in more activities
Ineffective Coping
- Ongoing pain with no clear end
- Loss of role or ability to work
- Feelings of hopelessness
- Client states they cannot cope
- Sleep problems
- Social withdrawal
- Increased reliance on substances or medication
- Client talks openly about feelings related to pain within 24 hours
- Client names 1 support person or resource before discharge
- Client uses healthy coping strategies and stays involved with family and activities
- Mood, anxiety, and signs of depression
- Support system and resources
- Use of alcohol or other substances
- Thoughts of self-harm
| INTERVENTION | RATIONALE |
|---|---|
| Use active listening and give the client time to talk | Feeling heard builds trust and reduces stress. |
| Help the client set small, realistic goals for activity | Small wins build confidence and a sense of control. |
| Refer to resources such as support groups, counseling, or physical therapy as ordered | Chronic pain is best managed by a team. |
| Screen for depression and report any thoughts of self-harm right away | Chronic pain raises the risk of depression and suicide. |
EVALUATION
- Client shares feelings about living with pain
- Client names a support person or group
- Client reports using at least 1 new coping strategy
Practice this in Pharmacy
Practice safe pain medication choices and catch side effects before they cause harm.
Play PharmacyQuick answers
How does chronic pain look different from acute pain?
Clients with chronic pain often have normal vital signs and may not grimace or cry. The body adapts over time, so the nurse must rely on the client's report, not on how they look.
Is a client with chronic pain who asks for pain medication always drug-seeking?
No. Requests for pain relief should be assessed and treated. Physical dependence and tolerance are expected with long-term opioid use and are not the same as addiction.
For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.