Managing sickle cell pain

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Learn about the 3P approach to pain management, which is a combination of psychological, physical and pharmacological (medications) strategies.

Key points

  • The most effective way to manage pain is with a combination of psychological, physical and pharmacological methods. This is called the "3P approach".
  • Psychological strategies may include managing stress, practising mindfulness and learning to think differently about pain.
  • Physical strategies include exercising and finding comfort positions.
  • Pharmacological strategies are medications. These may be a combination of pain medications and other types of medications to manage sickle cell symptoms.

Pain is much like hunger and thirst—it requires you to do something to get some relief.

Even if pain cannot be eliminated, it can be reduced by changing the pain signals that reach the brain. The most effective way to change pain signals is through the “3P approach” to pain management.

3P approach to pain management

Pain is best treated with:

  • psychological strategies, or methods
  • physical strategies
  • pharmacological strategies

Together, these form the 3P approach to pain management. Check out this animation to learn more!

Psychological strategies

Psychological strategies include learning how to manage stress, practise mindfulness, relax tense muscles and think differently about pain. All these strategies can help people reduce pain. The goal is to find the strategies that will help your teen manage their pain in healthy ways and let them do the things they enjoy.

A number of psychological strategies are based on the principles of cognitive behavioural therapy (CBT).

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a form of psychological treatment. It focuses on how someone thinks and feels about pain (the “cognitive” part), what they do to manage pain (the “behavioural” part) and how other people respond to their pain.

The image below shows how what you think, what you do and how you feel are all related to each other.

CBT has been used for over 30 years with people dealing with many different pain conditions. It can alter pain signals and change how someone perceives pain. It is one of the best methods for reducing pain and helping people do more of their everyday activities.

Cognitive strategies help with thinking. They include:

  • skills to manage stress
  • skills to improve communication and relationships
  • thinking in new ways (sometimes called cognitive coping skills)

Behavioural strategies relate to actions. They include:

  • deep breathing and relaxation
  • strategies to manage sleep problems
  • strategies to increase physical activity

Parent and caregiver strategies include ways to change responses to your teen’s pain and ways to reduce your own stress. They include:

  • problem-solving skills
  • communication strategies
  • strategies to encourage positive behaviours and coping skills

Your teen will learn more about different psychological strategies to help manage pain throughout their skills modules.

Physical strategies

Physical strategies include finding positions of comfort and exercising. Learning how to get active in the right way can help your teen in a number of important ways. Leading a more active life can, for example:

  • improve blood flow
  • train the pain system to be less sensitive
  • reduce your teen’s pain
  • improve your teen’s mood, sleep and energy levels
  • improve your teen’s physical function and overall wellbeing

Your teen will learn more about physical strategies in the module on keeping a healthy lifestyle.

Pharmacological strategies

Pharmacological strategies are another name for medications. They can also be helpful when used with physical and psychological strategies.

Pain medications are designed to reduce pain signals at specific points in the pain pathway. Your teen’s health-care provider may recommend other medications or treatments to help manage other sickle cell disease symptoms, improve sleep, reduce anxiety and help manage your teen’s mood.

You can find more information on pharmacological strategies in the treatment and medications section of the sickle cell library.

Last updated: February 21st 2024