At-Home Pain Management of Sickle Cell Disease

About 1 in 3 people with sickle cell disease (SCD) experience pain every day. People with SCD treat pain at home 10 times more often than in the hospital, so it is important to create a plan with your doctor that details how to treat pain at home. This plan may change over time, but it helps to know ahead of time what to do when a pain episode starts.^1,2

Your at-home pain management will likely include some type of pain medicine, such as a non-steroidal anti-inflammatory drug (NSAID) or opioid. It may also include additional techniques to manage pain, such as hydration, bed rest, yoga, and relaxation.

How do I use NSAIDs to manage pain at home?

NSAIDs are common drugs used to relieve pain and fever. They work by blocking the production of chemicals in the body that lead to inflammation. Some over-the-counter (OTC) NSAIDs that are used to manage acute pain episodes at home include:³

• Ibuprofen (Motrin, Advil)
• Aspirin (Bayer)
• Naproxen sodium (Aleve)

Acetaminophen (Tylenol) is technically not an NSAID, but it may also be used to relieve pain. There are also stronger NSAIDs available by prescription, such as diclofenac (Voltaren).³

Always tell your doctor about any OTC or prescription NSAIDs that you take. Your doctor can help make sure you are taking them safely. Long-term NSAID use can increase the risk of heart attack, stroke, and kidney problems. However, using them occasionally at low doses usually does not cause problems.³

What other pain medicines may be used at home?

More severe pain may be managed with oral opioids. In fact, opioids are part of at-home pain management about 80 percent of the time. Your doctor will prescribe you certain types depending on the severity of your pain and what has worked in the past. They will also include in your pain management plan when and how to take them.^1,2

This could include short-acting opioids, long-acting opioids, or a combination of both. Some examples of commonly used opioids to manage sickle cell pain include:⁴

• Codeine
• Fentanyl
• Hydrocodone
• Hydromorphone
• Morphine
• Oxycodone
• Oxymorphone
• Tapentadol
• Tramadol

What other techniques can I use to treat pain at home?

Other techniques can also help manage pain at home. These therapies are meant to be done with pain medicines, but not to replace them. These are sometimes called “adjuvant therapies.” Adjuvant therapies are therapies that are done in addition to the primary treatment. Your personalized pain management plan should include which techniques to use and how to use them with pain medicines.⁴

Some examples of adjuvant therapies used to manage sickle cell pain include:⁴

• Hydration
• Bed rest
• Heat packs or warm baths
• Massage
• Relaxation or breathing exercises
• Yoga
• Self-hypnosis
• Treatment for sleep-disordered breathing
• Antidepressants

The goal of these approaches is to take control of painful symptoms while maintaining daily activities. Studies have shown that pain management approaches that combine pain medicines with adjuvant therapies reduce hospital visits.^5,6