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.

Treatment

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.

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.