Pain is information, and it deserves an answer

Pain management during wound recovery starts with telling the people treating you what you feel. Many people do not. Some assume pain is the price of healing and say nothing. Others worry about being seen as complaining, or about being offered medicine they do not want.

Wounds can hurt, and so can the things done to treat them. Pain that is described clearly can usually be addressed, and a change in pain is one of the clues clinicians use to judge how a wound is doing. Decisions about medication belong to the prescriber. Your part is to give them good information.

How pain affects healing

When pain goes unaddressed, people sleep badly, eat less, move less and sometimes avoid the treatments that help, such as compression, offloading or dressing changes. Less movement raises the risk of pressure injuries, stiffness and falls.

Pain also wears on mood, and low mood makes pain harder to bear. Raise it at your next visit, and see the guide on loneliness and low mood during recovery.

Describing pain so it can be acted on

“It hurts” gives a clinician little to work with. These details help:

  • Where: in the wound, around it, or somewhere else such as the calf or heel
  • When: all the time, at night, when walking, when the leg is raised, or at dressing changes
  • What it feels like: aching, burning, throbbing, stabbing, tingling or tightness
  • How strong: a number from 0 to 10, at its best and at its worst
  • What changes it: position, rest, movement, a particular dressing, or a medicine you already take
  • What it stops you from doing: sleeping, walking to the bathroom, wearing a shoe, finishing a meal

The guide on talking about wound pain and discomfort has wording you can borrow.

Some people cannot describe pain in words, including many people with dementia. Caregivers can watch for grimacing, guarding, moaning, restlessness or pulling away during care, and report it.

Pain at dressing changes

For many people the worst pain comes when a dressing is removed or the wound is cleaned. Say so, and ask the treating clinician:

  • Is there a dressing that would come off more gently?
  • Can we pause if I need a break during the change?
  • Would it make sense to time my pain medicine around dressing changes?

Our page on dressing selection and changes explains what goes into choosing a dressing.

Who decides about pain medicine

The prescriber does, with you. That may be the primary care clinician, the wound care clinician, a surgeon or a pain specialist. A safe choice depends on kidney and liver function, other medications, fall risk, breathing and your own goals, which is why Gateway staff do not advise on what to take.

Do not start, stop, combine or change the amount of any pain medicine, including over-the-counter products, without checking with the prescriber or a pharmacist. Tell them everything you use for pain, including creams, patches and supplements. A medication review puts the whole list in front of one clinician.

Comfort is not only about medicine. Positioning, support surfaces, treating swelling and gentler dressings can all be part of the clinician’s plan.

What Gateway arranges

Gateway coordinates wound care and primary care follow-up delivered by Gateway clinicians across Greater St. Louis and the Metro East. We pass your concerns to the treating clinician, help get records and medication lists to each office, and keep your existing physician informed when you have one.

When comfort becomes the main goal, as it can with advanced illness, we also help coordinate palliative wound care with the treating team.

Pain changes to report quickly

New or worsening pain can be a warning sign. Call the treating clinician promptly for:

  • Pain that is steadily increasing or suddenly different
  • Pain along with spreading redness, warmth, swelling, new drainage, odor or fever (see the signs of wound infection)
  • New pain in the calf, or foot pain at rest that eases when the leg hangs down
  • Pain medicine that leaves you very drowsy, confused, unsteady or constipated

Call 911 for chest pain, trouble breathing, sudden severe pain in a limb that turns cold, pale or blue, severe pain after a fall, or a person who cannot be woken after taking pain medicine.

How to start

Call 314-325-0126 or ask us to call you back. The form takes a name and number only. On the phone, tell us who is treating the pain now, so the request reaches the clinician who can act on it.

Common questions

Is it normal for a wound to hurt more as it heals?

Some discomfort, itching or tenderness is common as tissue repairs. Pain that keeps increasing is not something to accept as normal. It can point to infection, swelling, poor circulation, pressure or a dressing that does not suit the wound. Tell the treating clinician about any rise in pain.

Does less pain always mean the wound is getting better?

No. Some people have nerve damage, often from diabetes, that dulls feeling in the feet and legs, so a wound can worsen with little or no pain. Regular assessment and daily foot checks matter even when nothing hurts. Report changes in color, drainage, odor or size either way.

What can I do if pain keeps me awake at night?

Tell the clinician the pain is worse at night and describe what you have noticed, such as whether raising or lowering the leg changes it. The pattern helps the clinician sort out the cause. The guide on sleeping comfortably with a wound covers positioning questions to raise.

I am worried about taking strong pain medicine. Can I say no?

Yes. You can ask about every option, including approaches that do not involve medicine, and you can turn down a medicine you are not comfortable with. Tell the prescriber what worries you, whether it is drowsiness, falls, constipation or dependence, so the plan can take it into account.

Related pages

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.