Sickle Cell Pain Crisis

Sickle cell anemia is also called sickle cell disease (SCD). It's an inherited disease that affects your red blood cells. It occurs most often in people of African descent. The most common symptom of sickle cell anemia is a pain crisis. This occurs when the red blood cells change shape and block blood flow in the smaller blood vessels. Pain crisis can affect the bones, joints, chest, or belly (abdomen). This may happen if you:

  • Don't drink enough fluids (get dehydrated)

  • Have an infection

  • Drink too much alcohol

  • Are stressed

  • Are exhausted

Having too little oxygen in your blood may also trigger a pain crisis.

Home care

Follow these guidelines when caring for yourself at home:

  • Drink at least 3 quarts of fluid (12 8-ounce glasses) over the next 24 hours. This will make sure you aren't dehydrated.

  • Rest until all your pain is gone.

  • Apply heat to the painful areas. Don't use ice as it can make the pain worse.

  • Take any prescribed pain medicines as directed. You may take acetaminophen or ibuprofen instead for milder pain. If you have long-term (chronic) liver or kidney disease, talk with your healthcare provider before using these medicines. Also talk with your provider if you’ve had a stomach ulcer or GI bleeding.

Preventing future attacks

  • Keep yourself well-hydrated. Drink at least 8 glasses of water and other fluids every day. Drink more when you have a fever, are driving at high altitudes or traveling by air.

  • Don't overexert yourself or be exposed to very hot or cold temperatures. Don't do strenuous work or exercise, such as training for an athletic competition. These may make you very tired or dehydrated.

  • Limit how much alcohol you drink. A drink once in a while may be OK when you don’t have symptoms. Always check with your healthcare provider.

  • Try to stay away from high altitudes. Don't fly, go mountain climbing, or go to cities with a high altitude.

  • Take your prescribed medicines.

    • Adults with severe SCD may take medicines (such as hydroxyurea or L-glutamine) to help reduce the number of pain crises. Research shows that hydroxyurea therapy may also help babies and children with SCD.

    • Some people have severe pain and must use an opioid medicine (such as morphine) daily, along with additional pain medicine.

  • Don’t allow smoking in your home or car. Stay away from secondhand smoke.

  • Keep all appointments for follow-up. If you use hydroxyurea, your healthcare provider will likely check you often. This is to prevent complications such as infections.

  • Talk with your family and friends about SCD. People are often not aware of how painful the disease can be.

  • If your pain crisis is severe, you may need to go to the hospital for intensive treatment.

Follow-up care

Follow up with your healthcare provider, or as advised. Keeping all routine follow-up appointments is key for managing sickle cell disease. Talk with your provider if there are issues that make it hard for you to follow up (such as not having health insurance coverage for prescribed medicines). Wear a medical alert bracelet or necklace.

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Pain that doesn’t get better after taking the medicines prescribed

  • Fever of 100.4°F (38ºC) or higher, or as directed by your provider

  • Cough with dark sputum or shortness of breath

  • Blood (pink, brown, or red) in your urine

  • Trouble with speech or vision

  • Any painful joint that gets hot, swollen, or red

  • Headache that is different from normal

  • Not being able to move, or feeling like a part of your body is numb

  • Sudden weakness or numbness

  • Painful erection that doesn't go away

  • New symptoms not seen before with the disease

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