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Categories > Pain > Pain management

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The pain problem
Get relief with medicine, massage and more

» What causes the pain?

» Relief is within reach

» Medications

» Physical interventions

» Behavioral methods

Worried about addiction?

With some pain medications, like opioids, it’s possible for your body to become used to them over time, so that you need higher doses of the medication to get the same relief. This is not the same as an addiction, which implies a psychological dependence on it. If your medication no longer relieves your pain effectively, tell your doctor or nurse, who can adjust your regimen, increase the dose, add a different medication or suggest other interventions like acupuncture or hypnosis. Don’t try to “tough it out” or go without.

It’s a good idea to keep a pain diary in which you record your pain, when and where you have it, when you take your medication and how well and for how long it works. Include how you feel emotionally. Note whether anything, like rest, sitting or eating, makes it better or worse. Seeing it written on paper can help you and your doctor better evaluate your pain and what you may try next to get effective pain control.

Many people associate having cancer with pain. However, not all people with cancer have pain, and those who do can almost always get relief. You should never accept pain as part of the illness.

What causes the pain?

The pain can be caused by the cancer itself, such as when a tumor invades the bone or presses upon the spinal cord, nerves or other organs. Pain may result from procedures like surgery to remove a tumor. “Phantom pain” is pain felt in an extremity that has been removed, such as an arm, leg or breast. This pain is real and should be treated. Treatments like radiation therapy and chemotherapy can cause side effects such as skin burns, mouth and throat sores and peripheral neuropathy (a painful burning, tingling or numb sensation in the hands, arms, legs and feet).

Relief is within reach

Doctors have several ways to control pain and will often combine methods, including the following:

Medications

Pain-relieving drugs can be delivered by mouth, injection, skin patch, patient-controlled analgesia pump or as spinal analgesia, an epidural or a nerve block. Some are quick-acting and others provide longer-term relief; your doctor may prescribe both and include one or more of the following:

Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDS) like aspirin and ibuprofen help relieve mild to moderate pain and can be used along with stronger medications like opioids. But talk to your oncologist before taking these drugs, as they carry some special risks for people with cancer.

Opioids. These drugs can relieve moderate to severe pain and include morphine, hydromorphone, oxycodone, methadone and fentanyl. Side effects may include nausea, sleepiness, constipation, breathing problems and gradual overdose. Opioids should be taken as prescribed on a fixed schedule that keeps you comfortable and makes side effects tolerable.

Other drugs. Your healthcare provider may prescribe drugs such as antidepressants, anticonvulsants, local anesthetics, corticosteroids, bisphosphonates or stimulants to increase the effectiveness of your medication.

Physical interventions

Some pain can be relieved by physical or manual methods like applying heat or cold packs, pressure, vibration or low-voltage electrical stimulation. Exercise designed to strengthen muscles, improve balance and coordination and ease joint stiffness can help relieve pain, too.

Acupuncture. This practice, in which thin needles are inserted into the skin at various locations, is now a widely accepted method of pain control. Check with your doctor first, especially if you’re receiving chemo-therapy, and use only a licensed professional.

Massage. Manual methods like massage or applying pressure can help relieve pain and promote relaxation.

Behavioral methods

Ask your pain specialist to refer you to professionals who can teach you how to use the following tactics:

Relaxation techniques. Relaxation methods like breathing exercises, imagery and visual concentration may help reduce pain by easing muscle tension, helping you to sleep better and reducing anxiety.

Hypnosis. Achieving this state of deep concentration can help you to block out awareness of pain or substitute the feeling of pain with something else.

Talking it out. Feelings of worry, depression and fear can make pain worse. Being able to discuss these feelings with a doctor, peers (via a support group), a counselor or clergy member may help.

Learning about cancer pain and how it can be treated may help lessen the fear of it, or any reluctance to address it. You must be honest with your doctor or nurse and report any pain and its severity right away. Working with your healthcare team to relieve pain is an important part of treatment. When discomfort is effectively controlled you can sleep and eat better, continue to work and enjoy leisure activities or being with family and friends.


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