Although medication often plays an important role in relieving pain related to cancer or cancer treatment, several additional self-care and support options are available. Using a combination of methods is often the most successful approach to pain management. This article describes medication-free ways of relieving pain. For an overview of treating cancer pain with medication, read Part I.
Self-care and support methods
The methods described below have helped many people with cancer achieve better pain management. In addition to the potential for pain relief, these methods may help reduce negative feelings such as stress, depression, anxiety, and loss of control to help you cope better with cancer.
Some of these methods you can do on your own, while others require you work with a specialist, preferably one who is licensed or certified (up to date on training requirements in a specific field of work). Talk with your doctor or other member of your health care team before you try a method that is new to you.
Acupuncture. This ancient form of Chinese medicine, which involves inserting special needles into specific areas of the body, has been shown to relieve pain in some clinical trials. Make sure to see an experienced and reputable practitioner who only uses sterile needles.
Biofeedback. Using this technique you can learn how to control many of your body’s functions, such as your heart rate. Electrodes (painless electrical sensors) are attached to your skin so you can get information about your body’s processes. Using this information, a trained biofeedback therapist can help you focus your mind on making subtle changes or adjustments to your body, such as relaxing specific muscles, to get the results you want, such as reducing pain.
Breathing exercises/meditation. Gentle breathing exercises can enhance relaxation, reduce tension, and decrease pain. They can be done while sitting up in a chair, arms relaxed gently at your side, or while lying down in a reclining chair or bed. Try breathing in through your nostrils while you slowly count to three in your head, and then breathe out through your mouth, once again counting silently to three. Continue for five minutes initially, gradually working up to 20 minutes. You can also try meditation exercises, such as softly repeating a calming word or imagining breathing heat or a feeling of relaxation in and out of areas of pain in your body.
Counseling and support groups. Talking with a trained counselor or attending a cancer support group gives you the opportunity to hear about pain management techniques that have worked for others and may help you identify strategies that could work for you. Discussing concerns and getting support may also help relieve some of the physical and emotional tension that often makes pain worse.
Distraction. Activities such as taking a warm bath, reading a book, watching television or a movie, drawing, doing needlework, listening to music, or taking a short walk outdoors can distract the mind from pain.
Heat and cold. Applying hot or cold compresses, heating pads, or ice packs to aching, sore, or painful areas of the body may help diminish discomfort. Discuss this approach with your doctor and follow any special instructions, particularly during or after radiation therapy or chemotherapy. Start with short applications of five to 10 minutes at moderate temperatures. Do not apply heat or cold directly on bare or injured skin, areas that are numb, or areas that have received recent radiation therapy. Wrap ice packs and compresses in a towel to protect the skin and use heating pads over clothing, a sheet, or a towel. Experiment with temperatures to find a method that provides relief comfortably. A warm bath is another way to get heat evenly applied to a large area at once.
Imagery and visualization. Many imagery techniques are useful for pain and discomfort associated with treatment. For example, the "magic glove" is a technique in which you imagine putting on a glove before getting a needle stick, and visualize that the glove protects your hand from the sensation of pain. Or, you may benefit from simple visualization exercises in which you imagine a peaceful scene, replay a favorite memory, or create a mental picture of a healing light that takes pain up and away. A trained therapist can teach you different exercises you can do at home.
Massage. A qualified massage therapist who has experience working with people with cancer can provide gentle therapeutic massage to alleviate tension, discomfort, and pain. Simple massage techniques, including gentle, smooth, circular rubbing of the feet, hands, or back, can be done at home by a caregiver. You can also massage yourself by applying light, even pressure to your hands, arms, neck, and forehead.
Nutritional support. Cancer and cancer treatments sometimes cause side effects, such as mouth sores or nausea (the urge to vomit or throw up), that make it difficult to maintain proper nutrition. Not getting enough vitamins, minerals, and other important nutrients from food can cause pain or discomfort or make these sensations worse. A dietitian (a food and nutrition professional) or your doctor may recommend you take certain nutritional supplements or change your diet to address those side effects.
Physical therapy or occupational therapy. The role of a physical therapist is to evaluate nerve, muscle, and fitness problems that make it difficult for a person to function well on a daily basis. A physical therapist can teach you how to use devices, such as prostheses (artificial devices that replace missing body parts), splints, or braces, to help ease pain. An occupational therapist helps people prevent and live with illness, injury, and disability. For example, an occupational therapist may help someone avoid lymphedema (a painful buildup of fluid) after cancer surgery.
Tracking pain reduction
Tracking the results of your pain management techniques may help you determine which ones work best for you. One idea is to create a simple chart. List the days of the week across the top. Down the left-hand side, create categories such as time of day, pain management techniques, activity level, and mood. You may want to include a pain rating category where you can enter a pain rating of zero to 10, with 10 being the greatest amount of pain.
By entering information regularly and reviewing the chart, you will be able to see which situations and techniques are helping your pain the most. If you would prefer to use a pre-made chart, search the Internet using terms such as “pain management chart” or “pain tracking chart.”
ASCO Answers: Managing Pain