Causes and Mechanisms of Pain in Palliative Care Patients

There are several specific pain syndromes that may present difficult diagnostic and therapeutic problems, of which the palliative care specialist needs to be aware during the evaluation of the cancer patient with pain. There are a few reports on the course of post amputation pain in malignant disease. Like cancer pain syndromes, noncancer pain syndromes may be nociceptive or neuropathic in nature. Abdominal pain discomfort and nagging or stabbing pain is frequently reported by cirrhotic patients and is thought to be secondary to the compression of adjacent abdominal or thoracic organs from hepatomegaly/splenomegaly or by the distention of the hepatic capsule itself. Spontaneous bacterial peritonitis can cause worsening abdominal pain along with fever, malaise, and altered mental status. Patients with portal vein thrombosis may complain of progressively worsening abdominal pain most commonly reported in the right upper abdominal quadrant.