Pain (PDQ®): Supportive care - Patient Information [NCI] - Physical, Integrative, Behavioral, and Psychosocial Interventions
Noninvasive physical, integrative, thinking and behavioral, and psychological methods can be used along with drugs and other treatments to manage pain during all phases of cancer treatment. These interventions may help with pain control both directly and indirectly, by making patients feel they have more control over events. The effectiveness of the pain interventions depends on the patient's participation in treatment and his or her ability to tell the health care provider which methods work best to relieve pain.
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Weakness, muscle wasting, and muscle/bone pain may be treated with heat (a hot pack or heating pad); cold (flexible ice packs); exercise (to strengthen weak muscles, loosen stiff joints, help restore coordination and balance, and strengthen the heart); changing the position of the patient; restricting the movement of painful areas or broken bones; or controlled low-voltage electrical stimulation.
Integrative interventions include massage therapy, acupuncture, and music.
Massage therapy has been studied as part of supportive care in managing cancer-related pain. Massage may help improve relaxation and benefit mood. Preclinical and clinical trials show that massage therapy may:
Stimulate the release of endorphins (substances that relieve pain and give a feeling of well-being).
Increase the flow of blood and lymphatic fluid.
Strengthen the effects of pain medications.
Decrease inflammation and edema.
Lower pain caused by muscle spasms and tension.
Physical methods to help relieve pain have direct effects on tissues of the body and should be used with caution in patients with cancer. Studies suggest that massage therapy may be safe in patients with cancer with the following precautions:
Avoid massaging any open wounds, bruises, or areas with skin breakdown.
Avoid massaging directly over the tumor site.
Avoid massaging areas with deep vein thrombosis (blood clot in a vein). Symptoms may include pain, swelling, warmth, and redness in the affected area.
Avoid massaging soft tissue when the skin is sensitive following radiation therapy.
(For more information on massage, see Exercise 2 in the following section.)
Acupuncture is an integrative intervention that applies needles, heat, pressure, and other treatments to one or more places on the skin called acupuncture points. Acupuncture may be used to manage pain, including cancer-related pain. See the PDQ summary on Acupuncture for more information.
Music interventions may help relieve pain and decrease anxiety in some patients. Music has been used to relieve pain caused by the cancer and by procedures and treatments. Studies have reported that music may work on areas of the brain that increase pleasant feelings and decrease unpleasant responses. Favorite music from the patient's own collection has been shown to help the most. Music that begins before a procedure is more effective than music that begins during or after a procedure. Music may be used along with pain medicine.