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 you cannot remove your pain, you can reduce it by changing the pain signals that reach your brain. The most effective way to change your pain signals is through the "3P approach" to pain management.

3P approach to pain management

Pain is best treated with:

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


Psychological strategies

Three circles intertwined. Above the top circle it says 'Pharmalogical', the bottom right circle says 'Psychological' in bold and the bottom left circle says 'Physical' with the words 'Your pain management' in the middle of all three circles.

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. Your goal is to find the strategies that will help you manage your pain in healthy ways and let you do the things you 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. Its name comes from its focus on the role of thoughts (the cognitive part) and behaviours in how we feel and what we do.

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

Tope circle has a drawing of a teen inside of the circle. Words across the top say 'What do you think?' On the left it says 'There are some things that help with my pain. I can get my life back'. On the right it says 'I will always have pain and can't do anything I want to.' The bottom right circle has a drawing of two teens. One is shooting a basketball. The other teen is sitting down. Text reads ' What you do.' Bottom left circle has a drawing of two teens looking at each other. Text reads 'How do you feel?'

CBT has been used for over 30 years with teens 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 get back to doing their everyday activities.

Cognitive strategies are ways to help with your thinking. They include:

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

Behavioural strategies are related to your actions. They include:

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

You will learn more about different psychological strategies to help manage your pain throughout the skills modules.

Physical strategies

Three circles intertwined. Above the top circle it says 'Pharmalogical', the bottom right circle says 'Psychological' and the bottom left circle says 'Physical' in bold with the words 'Your pain management' in the middle of all three circles.

Physical strategies include finding positions of comfort and exercising. Learning how to get active in the right way can improve blood flow and even train your pain system to be less sensitive. Leading a more active life can improve your mood, sleep and energy level as well as reduce your pain. It also improves your physical function and overall well-being.

Pharmacological strategies

Three circles intertwined. Above the top circle it says 'Pharmalogical' in bold, the bottom right circle says 'Psychological' and the bottom left circle says 'Physical' with the words 'Your pain management' in the middle of all three circles.

'Pharmacological strategies' is another name for medications. These can also be helpful when you use them with physical and psychological strategies.

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

You can find more information on pharmacological strategies in the treatment and medications section in the About sickle cell disease tab.

Last updated: September 25th 2023