What is sickle cell crisis?

Sickle Cell Crisis

Sickle cell crisis: Overview

Sickle cell crisis is a painful episode that may begin suddenly in a person with sickle cell disease.

Sickle cell disease turns normal, round red blood cells into cells that look like sickles or crescent moons. The sickle cells are also rigid and aren't able to carry oxygen like normal red blood cells. They can get stuck in blood vessels, blocking blood flow and causing severe pain. The pain can occur in the bones of the spine, the arms and legs, the chest, and the abdomen.

An episode may be called a "painful event" or "painful crisis." Some people who have sickle cell disease have many painful events, while others have few or none.

Treatment depends on the level of pain and how long it lasts. Sometimes taking nonprescription pain relievers can help. Or you may need stronger pain relief medicine that is prescribed or given by a doctor. You may need to be treated in the hospital.

It isn't always possible to know what sets off a painful event. But triggers include being dehydrated, cold temperatures, infection, stress, and not getting enough oxygen.

Sickle cell crisis

Sickle cell crisis is a painful episode that may begin suddenly in a person with sickle cell disease and may last for up to a few hours or days. Sickle cell disease affects how hemoglobin—the protein in red blood cells—is able to move oxygen from the lungs to the rest of the body.

People with sickle cell disease have only hemoglobin S, which turns normal, round red blood cells (hemoglobin A) into abnormally curved (sickle) shapes. A sickle cell crisis occurs when these sickle-shaped red blood cells clump together and block small blood vessels that carry blood to certain organs, muscles, and bones. The pain most often occurs in the bones of the spine, arms and legs, the chest, and the abdomen. It may last from hours to days.

Treatment depends on the level of pain and how long it lasts. Sometimes, taking nonprescription pain relievers can help. Other times, a person needs stronger pain relief medicine that is prescribed or given by a doctor.

What are the symptoms of a sickle cell crisis?

The symptom of a sickle cell crisis is pain. It may be mild to severe, and it may last from hours to days. The pain most often happens in the spine, arms, legs, chest, and abdomen. Some people who have sickle cell disease have many crises, while others have few or none.

How is a sickle cell crisis treated?

Treatment depends on the level of pain and how long it lasts. Sometimes, nonprescription, or over-the-counter, pain relievers such as ibuprofen can help. Other times, a person needs stronger pain relief medicine that is prescribed or given by a doctor. Some painful episodes may need I.V. therapy for fluids and powerful pain medicines, such as morphine, to ease the pain.

You can prepare for a crisis in advance by creating a pain management plan with your doctor. This plan should include not only the types of medicines you can take at home but also other actions you can take at home to relieve pain. Also, your plan helps you know when to call your doctor or go to a hospital.

How can you prevent a sickle cell crisis?

It isn't always possible to know what sets off a crisis. But triggers include dehydration, cold temperatures, infection, stress, and low oxygen intake.

Here are some tips for preventing a crisis.

  • Drink plenty of fluids, especially before, during, and after exercise or strenuous activity. Also drink plenty of water when you have a fever or infection.
  • Dress warmly in cold weather. Try to avoid getting cold. Exposure to cold air, wind, and water may trigger red blood cells to sickle in exposed areas of the body.
  • Exercise with care. Rest when you feel tired, and drink plenty of fluids. Getting dehydrated or having reduced blood oxygen levels from strenuous exercise may cause red blood cells to sickle.
  • Avoid things that can reduce your blood oxygen level. These include cigarette smoke and high altitudes (commercial air travel should be safe).
  • Get plenty of sleep.
  • Reduce and manage stress in your life.

How is a sickle cell crisis diagnosed?

Your doctor will ask about your symptoms and do a physical exam. You'll also be asked about your health history, including if you've been diagnosed with sickle cell disease. This condition is usually diagnosed during routine newborn screening tests. But adults can also be diagnosed using a blood test.

How can you care for yourself when you have a sickle cell crisis?

  • Create a pain management plan with your doctor. This plan should include the types of medicines you can take and other actions you can take at home to relieve pain.
  • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Avoid alcohol. It can make you dehydrated.
  • Dress warmly in cold weather. The cold and windy weather can lead to severe pain.
  • Do not smoke. Smoking can reduce the amount of oxygen in your blood.
  • Get plenty of sleep.

What is a sickle cell crisis?

A sickle cell crisis is a painful episode that may begin suddenly in a person who has sickle cell disease.

A sickle cell crisis occurs when sickle-shaped red blood cells clump together and block small blood vessels that carry blood to certain organs, muscles, and bones. This causes mild to severe pain and other problems. The pain can last from hours to days. "Painful event" and "painful crisis" are other terms used to describe these episodes. Some people who have sickle cell disease have many painful events, while others have few or none.

The pain can happen in any part of the body. But the most common areas include the:

  • Bones of the spine.
  • Bones in the arms and legs.
  • Chest.
  • Abdomen.

Treating pain from sickle cell disease at home

If you have sickle cell disease, you can take steps to treat pain at home.

  • Use a hot water bottle or a heating pad set on low.

    Do not use a heating pad when you are in bed. You may fall asleep and burn yourself.

  • Learn pain-management skills.

    These can help take the focus off of the pain, or they can help the pain medicine work better. You can work with a pain specialist to learn about different techniques, such as:

    • Guided imagery. This process uses your senses to guide your imagination into a more relaxed state.
    • Progressive muscle relaxation. This process helps you relax your muscles, which can help lower tension and anxiety.
    • Distraction.
    • Deep breathing.
    • Positive, encouraging self talk.
  • Use pain medicines.

    You and your doctor can make a pain management plan. You're probably the best judge of when you need to use a stronger medicine.

    • For mild pain, use over-the-counter ibuprofen (such as Advil), acetaminophen (such as Tylenol), or both.
    • For moderate or severe pain, you might take pain medicine prescribed by your doctor. Prescription pain medicine includes oral medicines such as codeine and ibuprofen, or codeine and acetaminophen. Some people might take oral controlled-release morphine at home.

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