Other Ways to Manage Pain

Aprobado por la Junta Editorial de Cancer.Net, 03/2021

Medication plays an important role in relieving pain caused by cancer and its treatment, but it is not the only option. There are many medication-free ways to help you manage pain. The most successful plans to control pain often combine several methods.

Be sure to talk with your cancer care team regularly about any pain you experience, including new pain or a change in your pain, and your pain treatment plan. Caring for your symptoms and side effects is an important part of your overall cancer care, called palliative care or supportive care.

What strategies can help manage pain?

You may be looking for alternative ways besides medicine to manage your pain. These techniques can also reduce stress and help with depression and anxiety.

Some of these are practices you can do on your own. Others require a licensed or certified specialist. Talk with your cancer care team before trying these pain relief strategies.

How can I reduce pain on my own?

The tips below are strategies you can try at home, on your own. These tips can be helpful for managing intermittent or breakthrough pain that comes up during the day.

Breathing and meditation. Gentle breathing exercises can decrease pain or help you cope with pain. They can help you relax and reduce tension. You can do them while sitting in a chair and relaxing your arms at your side. Or you can do them while reclining in a chair or lying down on a bed.

Here is a breathing exercise you can try now:

  • Breathe in through your nose while you slowly count to 3 in your head.

  • Breathe out through your mouth, once again counting silently to 3.

  • Continue for 5 minutes, and slowly work your way up to 20 minutes at a time.

Mediation is another way to take your mind off of the pain. There are many phone apps, videos, and books that can help you learn different meditation techniques. Meditation exercises can involve silently repeating a calming word. Or, you might imagine breathing heat, coolness, or a feeling of relaxation into the painful areas of your body.

Distraction. Distraction is another technique for managing pain. You can distract yourself by getting immersed in an activity you enjoy, like reading, drawing, or watching TV. Research shows that laughter can help reduce discomfort, so consider watching or listening to something that will make you laugh. Talk and laugh with friends and family. Spend time with your pets. Learning something new, like a new craft, hobby, or language can be a good distraction. You can also relax by doing self-care activities that you enjoy, like taking a hot bath or shower.

Imagery and visualization. Imagery and visualization take your mind off pain by focusing it on other ideas. One technique is called the "magic glove." Before getting a needle stick, imagine you have a protective glove on your hand protecting you from feeling pain. You can also imagine a peaceful scene or replay a favorite memory. Another tool is to create a mental picture of a healing light taking the pain away. A trained therapist can teach you different exercises to do at home.

Using heat and cold for pain. You can use hot and cold compresses, heating pads, or ice packs to relieve pain. Talk with your health care team about this approach so you can come up with a plan and have the right tools on hand. Follow any special instructions, especially during or after radiation therapy or chemotherapy.

Make sure you do not hurt your skin when using heat and cold for pain relief. Use heating pads over clothing, a sheet, or a towel so that you do not burn yourself. Wrap ice packs and compresses in a towel to protect your skin. Do not apply heat or cold directly to:

  • Bare or injured skin

  • Areas that are numb, because you will not be able to feel any discomfort or injury from the heat or cold

  • Areas that have had recent radiation therapy

Try different hot or cold temperatures to find a method that provides relief. You can also alternate between hot and cold for additional relief. Start by applying heat or cold for 5 to 10 minutes at moderate temperatures.

How can specialists help manage pain without medication? (updated 09/2022)

Sometimes you may want a specialist in supportive and palliative care, pain medicine, and/or integrative/complementary therapies to help manage pain. Ask your health care team to recommend a technique or specialist. When working with any specialist, make sure they know about the kind of cancer you have and any treatments you are receiving so they can tailor the therapy.

Massage. Gentle therapeutic massage can help ease tension, discomfort, and pain. People with cancer may especially benefit from massage and a subspecialty called oncology massage. For people receiving palliative care or hospice care, the American Society of Clinical Oncology (ASCO) recommends that massage may be offered if they are experiencing pain. For people with breast cancer, ASCO also recommends that massage may be offered to anyone experiencing pain following breast cancer treatment.

Try to find a massage therapist who has experience helping people with cancer. This is because an understanding of how cancer treatments affect different parts of the body is beneficial, and they may want to modify the massage technique for safety, such as using less pressure or avoiding certain areas. Your caregiver can also do simple massage techniques at home. This may include gentle, smooth, circular rubbing of the feet, hands, or back. You can also massage yourself by applying light, even pressure to your hands, arms, neck, and forehead.

Acupuncture. Acupuncture can be used for many different problems, including pain. This form of Chinese medicine involves inserting special needles into specific parts of the body. Some clinical trials have shown that it relieves pain. ASCO recommends that acupuncture may be offered to anyone experiencing pain from cancer and anyone receiving cancer surgery or another cancer-related procedure, such as a bone marrow biopsy. For patients experiencing joint pain from an aromatase inhibitor, which is a type of hormonal therapy, ASCO also recommends that acupuncture be offered.

Acupressure and reflexology are practices similar to acupuncture, but during these practices, the specialist uses their hands instead of needles to apply pressure to specific points on the body. ASCO recommends that acupressure or reflexology may be offered to anyone experiencing pain while receiving systemic therapy for their cancer, such as chemotherapy, targeted therapy, or immunotherapy, as well as anyone receiving cancer surgery or another cancer-related procedure.

Ask your health care team for recommendations on acupuncturists or practices. If you are receiving acupuncture, make sure to see an experienced practitioner who only uses sterile needles and preferably has experience working with people with cancer so appropriate modifications are made for safety.

Biofeedback. Biofeedback helps you control your body's functions, such as your heart rate. A trained therapist places painless sensors on your skin to gather information about your body's processes. Then, the therapist uses this information to help you focus on making small changes to your body. These changes may include relaxing certain muscles to reduce pain.

Guided imagery. Guided imagery is a technique in which you focus on positive mental images to help you relax. ASCO recommends that guided imagery may be offered to anyone experiencing pain from cancer treatment in combination with progressive muscle relaxation. Progressive muscle relaxation is when you tense 1 group of muscles at a time and then release that tension before moving on to the next group of muscles.

Hypnosis. Hypnosis is a relaxation technique during which a trained therapist uses verbal repetitions and mental imagery to help you reach a trance-like state. ASCO recommends that hypnosis may be offered to anyone experiencing pain during procedures for diagnosing or treating cancer.

Music therapy. During music therapy, a music therapist uses sound and music to help address the side effects of cancer and its treatment, including pain. ASCO recommends that music therapy may be offered to anyone experiencing pain from cancer surgery.

Nutrition counseling. Cancer and its treatment sometimes cause mouth soresnausea, or other difficulties with eating well. You may not feel like eating the kinds of food you normally enjoy and have trouble getting enough nutrients.

Not getting enough important nutrients from food can cause further pain or discomfort. A dietitian or your doctor may suggest you change your eating habits or take supplements to reduce these side effects.

Physical or occupational therapy. Physical therapy can help relieve pain. A physical therapist treats nerve, muscle, and fitness problems. The therapist can help identify the source of pain and strengthen your body. They can teach you how to relieve pain using simple exercises or devices. This includes artificial body parts, splints, or braces.

An occupational therapist helps people live with illness, injury and disability. Sometimes occupational therapists help people with cancer cope with pain after treatment. For example, an occupational therapist may help someone avoid or manage lymphedema after cancer surgery. Lymphedema is a painful buildup of fluid caused when lymph nodes are removed. You may also want to see a certified lymphedema therapist (CLT), who specializes in managing lymphedema.

Hatha yoga. Hatha yoga is a slower-paced form of yoga that focuses on the breath. ASCO recommends that hatha yoga may be offered to anyone experiencing pain following treatment for breast cancer or head and neck cancer.

This information is based in part on the ASCO and Society for Integrative Oncology (SIO) joint guideline, “Integrative Medicine for Pain Management in Oncology.” Please note that this link takes you to another ASCO website.

How can counseling or support groups help with pain management?

Talking to a trained counselor can also help with pain. Opening up about your physical and emotional pain can relieve tension. Your counselor may give you strategies for managing pain, such as breathing exercises or visualizations.

Going to a cancer support group could help you learn about pain management techniques that have worked for others. Hearing how others with cancer experience and manage pain may help reduce feelings of isolation and loneliness.

Tracking pain management results

Tracking the results of your pain management techniques can help you find out which ones work best for you. Try creating a simple chart of pain strategies used, including the time of day, the type of technique, what your pain level was when you began and what it was after you did the technique. You can also record your activity level and mood for the day, which can impact your pain as well. Enter these details regularly.

By doing this, you will be able to see what situations and techniques help your pain the most. While you can make this chart yourself, you can also find premade charts online. Try searching for "pain management chart" or "pain tracking chart." You can also use the chart on page 26 and 27 of the ASCO Answers Managing Cancer-Related Pain booklet (PDF). Or, if you prefer to track symptoms on your phone, the free Cancer.Net app allows you to securely record the time, severity, and other details of symptoms and side effects.

Questions to ask the health care team

  • Is pain likely at any point in my cancer treatment? If so, when?

  • Who should I tell about any pain I experience? How soon?

  • What pain management techniques do you recommend?

  • What medication-free ways to relieve pain could help me?

  • Should I talk with a palliative care specialist, a therapist, or a complementary therapy specialist as part of my pain management?

  • Who should I contact if my pain continues?

Related Resources

Pain: Causes and Diagnosis

Treating Pain with Medication

Evaluating Complementary and Alternative Therapies

How Mindfulness Helped Me Cope with Cancer

More Information

National Institutes of Health: 6 Things to Know When Selecting a Complementary Health Practitioner

National Cancer Institute: Complementary and Alternative Medicine