[Mechanism-based pain treatment in palliative care]

Mechanism-based pain treatment in palliative care Pain is common among patients in palliative care and one of the most feared symptoms. Knowledge about effective pain management is therefore essential for clinicians. Successful pain management is mainly based on the medical history and clinical examination, resulting in an understanding of the present pain mechanism(s). The pain mechanism then forms the basis for the pharmacological treatment strategy which should be individualized and take into account factors such as kidney function, expected side effects, route of administration and concomitant medication. Strong opioids are central components of the treatment and are often supplemented by COX-inhibitors, corticosteroids, anticholinergics or antineuropathic drugs. The main goal is freedom from pain at rest without troublesome side effects.