Summary
Pain is a common symptom in the dying patient. Family physicians should be able to thoroughly assess the source, extent, and impact of the pain. It is important not to forget that physical pain can be impacted greatly by psychological, social, and spiritual pains, and these issues must also be addressed.
Pain can be either nociceptive or neuropathic. In general, pain in the dying patient should be treated first with opioids regardless of the type of pain. In patients who are not adequately controlled with tolerable doses of opioids, there are many adjunctive medications which can be considered. Family physicians should be familiar with the variety of adjunctive medications, their side effects, and various methods of administration.