Palliative Care Center

Managing Pain: Beyond Drugs

When someone is diagnosed with a serious, life-threatening illness, one of the first things they are likely to worry about is pain.

It's just about the most common question patients and their caregivers ask, says Sean Morrison, MD, director of the National Palliative Care Research Center.

"That's one of the most common questions I hear," Morrison tells WebMD. "People want to know, 'Am I going to be in pain?' You need to know that there are effective treatments for pain, and that you can put those treatment plans in place ahead of time."

Although there are many medications available to treat pain in the context of palliative care, medications are not the only option. For example, radiation therapy can sometimes be helpful in treating pain from tumor growth and in easing bone pain related to cancer.

Non-Drug Options for Easing Pain

There are a number of non-drug tools for coping with pain. They can be used on their own or in combination with drug therapies.

"Unless something is truly unsafe or contraindicated, we try to be supportive of any alternative for managing pain," says Leisa Rebold, MSW, a social worker with Capital Caring, which serves more than 1,000 people living with advanced illness in the Washington, D.C. area.

Some of the options her patients have found helpful include:

• Massage. "A lot of people find relief from gentle massage, and we even have volunteers within hospice who are trained in massage therapy," Rebold says. Several studies have found that massage is effective in relieving pain and other symptoms for people with serious illness.
• Relaxation techniques. Guided imagery, hypnosis, biofeedback, breathing techniques, and gentle movement such as tai chi. Relaxation techniques are often very effective, particularly when a patient -- or a caregiver -- is feeling anxious.
• Acupuncture. Several studies have found that acupuncture can be helpful in relieving pain for people with serious illnesses such as cancer.
• Physical therapy. "People can become immobile from being ill," says Rebold. "We'll do a physical therapy consult, and give the family some exercises to help the person do, and the case manager can assist. If you've been active before and now you're confined to bed, your body doesn't like that, and even just moving the hands and feet a little bit can really help."
• Pet therapy. If you have bouts of pain that last 5, 10, or 15 minutes, trying to find something pleasant -- like petting an animal's soft fur -- to distract and relax yourself can be helpful."
• Gel packs. "These are simple packs that you can warm up or chill, and they can ease localized pain," says Rebold.

Ask the palliative care team or hospice in your area if they can provide you a referral for any of these forms of pain management.

Maintaining a comfortable, relaxing atmosphere around the patient goes a long way toward easing pain.

"You need to find what you like: the kind of music you want playing, the kinds of colors you want to see," Rebold says. "Make the environment in the house soothing, and if you find it hard to move, plan ahead so that everything you need will be right there at hand: your piece of chocolate, your book, your medicine. People who are well don't realize how important this is."