Back pain – Lymph connected

Hello Tony,

I am so sorry to hear that your wife is experiencing pain such as you described. I will ask you just a few questions about her pain, and will also suggest that you keep in close contact with her oncologist or a palliative care physician as they are skilled in cancer pain control.

In the U.S. we ask individuals to rate their pain on a 0-10 scale. 0 is no pain, and 10 is the worst pain imaginable. How would she score herself on this scale? Is her pain interfering with her regular daily activities? Is she experiencing any new loss of sensation, numbness or tingling in her feet/toes/legs? Is she having bowel or bladder control issues that are new, or loss of balance?

Has she taken any opioids like morphine before? Physicians generally follow an analgesic ladder to treat pain. She could ask the oncologist if taking an NSAID such as ibuprofen would be alright, or perhaps Tylenol (or Paracetamol in Europe) if her liver functions are fine. If her pain level is anywhere above a 4-5 on that 0-10 scale though, she should seek assistance from the physician to prescribe a short acting opioid. It is best to treat her pain earlier rather than later. It is much more difficult to control pain when it has become severe, and as research has shown, early pain control will decrease the occurrence of nerve sprouting and further increased pain episodes.

I hope this will help you both! Increasing levels of pain significantly impacts a persons quality of life, so please do not hesitate to insist on aggressive pain management from her providers.

Karen, RN, CHPN

Hi Tony,

I too have lymph node involvement and due to the fact they are close to my aorta, treatment is not really an option and I have opted to take the quality of life course. In the past few weeks I have had uncomfortable dull aches in my lower back and across my front between my hips. I have been taking paraceutomol, but in the last couple of days the pain has worsened and I now cannot lie on my back. I too do not want yo start on morphine but realise that I am heading in that direction. I think when the time comes to start morphine, it will be another quality of life decision. I appreciate this answer won’t offer you much help.

I wish you and your wife the best.

Thinking of you
Sandie