Controlling pain without drugs

There are various non-drug treatments or complementary therapies that may help with pain. Some people find these work well, but they don’t work for everyone.

Non-drug treatments and complementary therapies can be used on their own or with painkillers. If you decide to use a complementary therapy, always talk to your doctor first. Complementary therapies should not replace any treatments prescribed by your doctor.

Some treatments or therapies aim to help you cope better with pain, for example by teaching you techniques that relax and de-stress your body and mind. Others use physical therapies to relieve the pain.

There are many different treatments and therapies available, including:

  • physiotherapy and exercise
  • TENS (trans-cutaneous electrical nerve stimulation)
  • acupuncture
  • cognitive behavioural therapy (CBT)
  • hypnosis
  • massage therapy
  • meditation
  • reflexology
  • relaxation
  • visualisation (imagery)

If you use any of these therapies you should always check with your healthcare team and use a qualified therapist.

Non-drug treatments and complementary therapies to help cancer pain

Many people find non-drug treatments and complementary therapies can help relieve pain.

Some treatments or therapies aim to help you cope better with pain, for example by teaching you techniques that relax and de-stress your body and mind. Others use physical therapies to relieve the pain. These non-drug treatments or therapies can be used on their own or with painkillers.


Physiotherapy and exercise

Pain may stop you from using the part of your body that hurts. This may lead to muscle or joint stiffness. You may be able to see a physiotherapist who will help treat the problem with gentle massage and exercise. This may help to relieve the pain.

A physiotherapist can also help you stay active and get some exercise, which may help to improve your pain. When you exercise, your body releases endorphins. These are natural substances produced in your body that have a similar effect to morphine and help to reduce pain. Ask your doctor or physiotherapist whether it is safe to exercise and what type of activity may help.


TENS (trans-cutaneous electrical nerve stimulation)

TENS is a way of managing pain using a mild electrical current.

A TENS machine is a small battery-powered device with wires. The wires are attached to sticky pads, which are put on the surface of your skin (usually near the area of your pain). The machine sends a small electrical current into your body that feels like a tingling sensation. Some people say that using a TENS machine has helped ease their pain.

It is important to check with your healthcare team before using a TENS machine. They are not suitable for everyone. Pain teams, physiotherapists and many palliative care teams can give you advice about whether this treatment is suitable for you and how to use it. You should always continue to take your prescribed painkillers as a TENS machine alone won’t be enough.

You may be able to get a TENS machines on a short-term loan from the NHS. You can also hire them, or buy one from a pharmacy or online.


Complementary therapies

There are various complementary therapies that may help with pain. Some people find these very helpful, but they don’t work for everyone.

If you decide to use a complementary therapy, always talk to your doctor first. Complementary therapies should not replace any treatments prescribed by your doctor.

There are many different types, including:

  • acupuncture
  • cognitive behavioural therapy (CBT)
  • hypnosis
  • massage therapy
  • meditation
  • reflexology
  • relaxation
  • visualisation (imagery).

If you do use any complementary therapies, you should always use a qualified therapist. The British Complementary Medicine Association (BCMA) has details of qualified therapists. Or your local hospice or hospital team may be able to recommend someone.

Acupuncture

Acupuncture uses fine needles that are inserted just under the skin at certain points on the body. It is not painful as the needles are so tiny. It’s thought that acupuncture may work by stimulating the body to produce endorphins. These are natural substances produced in the body, with a similar effect to morphine, and they help to reduce pain.

Acupuncture can help some people with cancer pain. It may also help relieve other cancer symptoms, such as feeling sick. When carried out by a trained professional, acupuncture is generally safe and side effects or complications are rare. You shouldn’t have acupuncture if you are having certain treatments that could lower your blood counts, such as chemotherapy. If you have lymphoedema, or you’re at risk of getting it, you should not have acupuncture in the affected area.

Some specialist NHS pain and palliative care teams offer acupuncture. Your GP or cancer specialist can refer you. You may have to pay for this.

Cognitive-behavioural therapy (CBT)

CBT is a talking therapy that helps people change the way they feel, by changing the way they think and behave. This may help someone feel more in control of their illness. Some people say this has helped them with their pain. It cannot make the pain go away, but it may help someone to cope better and think about it in a different way.

You can have CBT on a one-to-one basis with a trained therapist, or in group sessions. You will often need a course of sessions over a few months. If you think it may help, ask your healthcare team.

Hypnotherapy

Hypnosis is a form of deep relaxation. It can help you to think about your pain differently. It will help you to focus your thoughts and feelings on something other than pain. You can learn how to hypnotise yourself. This is called self-hypnosis.

Hypnosis can help you change the way you think about pain and help you cope with difficult treatments or situations. It can make other treatments, like CBT, more effective. If you use hypnosis, it’s important to get help from a trained professional. This could be a doctor, nurse or psychologist.

Your GP may have a list of local therapists who provide hypnosis, or you can contact the National Register of Hypnotherapists and Psychotherapists.

Massage therapy

Massage therapy is when someone strokes or applies gentle pressure to your body. It may help you relax and improve your mood. Some people find it reduces pain.

There are different types of massage therapy. Some are soft and gentle, while others are more active. Your therapist will be able to adjust the pressure for your comfort. Cancer doctors and complementary therapists will usually advise you to try gentle massage and avoid vigorous, deep tissue massage.

Massage therapists working with people who have cancer must be properly trained and qualified. They should have some knowledge of cancer and its treatments. Check with your doctor to see whether massage may help and if it is suitable for you.

Meditation

There are many different types of meditation and they all aim to calm your mind. To meditate, sit quietly and focus on your breathing without trying to control it. If you have a thought, try to 'let it go' and only concentrate on your breathing. If you prefer, you can put an object in front of you, such as a lighted candle or picture, and focus on that instead.

Some hospices or hospitals have people who can help you meditate. Ask your doctor, specialist nurse or palliative care team about it.

If you’re having treatment for any mental health problems, check with your doctor before using meditation.

Reflexology

Reflexology is a form of foot or hand massage related to acupressure. Reflexologists believe different areas on the feet or hands represent, and are connected to, different parts of the body.

They apply gentle pressure to specific points on the feet or hands. The aim is to help you feel more relaxed.

Reflexology has been used to try to improve symptoms related to cancer or treatment, such as:

  • feeling sick (nausea)
  • tension
  • pain
  • fatigue. 

So far, medical evidence hasn’t proven that it’s effective when used in this way. But, some evidence shows that reflexology can help people feel more relaxed and many people use it to help ease stress and anxiety.

Relaxation

Learning to relax and let go of your fears and anxieties can also help control pain. Even if you can only do this for a short time each day, it will help. There are two main types of relaxation exercises.

Physical exercises

These release tension in your body and so reduce pain. A technique called progressive muscle relaxation involves learning to tense and relax particular groups of muscles in the body. This could be muscles in the stomach, neck and other areas, individually or together. When you know how, you can start using the technique during stressful times. When you have learned the basic technique, you can use it to help with pain relief during more difficult times.

Mental exercises

Mental exercises can help relax your mind. They can be helpful if you find that anxiety is making your pain worse. An example of this is visualisation (see below).

To practice relaxation, find a space that is quiet, warm and dimly lit. Make sure you will not be disturbed, and lie or sit in a well-supported position. These techniques are most helpful if you practise them for 5 to 15 minutes each day. Using relaxation CDs can help.

You may want to try different things until you find the best sort of relaxation exercise for you. You can ask your doctor if there is a healthcare professional who can help you. This might be an occupational therapist, physiotherapist or psychologist.

Visualisation

Visualisation is when you bring helpful, relaxing pictures into your mind. Remembering pleasant sounds, sights, tastes or smells may help you feel more relaxed. It may help to distract you from the symptoms of pain and discomfort. Someone who has had special training can help you to practise visualisation. Check with your healthcare team about finding a trained therapist.