Pain management without drugs
Some people find non-drug treatments and complementary therapies helpful in managing pain.
Certain treatments or talking therapies aim to help you cope with pain. For example, this can be with techniques to relax and de-stress your body and mind. Others use physical therapies to help with pain control.
Pain can stop you from using the part of your body that hurts. This may lead to muscle or joint stiffness. A physiotherapist may be able to help reduce pain and stiffness with gentle massage and exercise.
A physiotherapist can help you stay active and show you exercises which may help with pain relief. Exercise helps your body release endorphins. These are natural substances produced in your body that can have a painkilling effect. Ask your doctor or physiotherapist whether it is safe to exercise and what type of activity may help.
TENS is a way of managing pain using a mild electrical current.
The current is delivered from a TENS machine which is a small battery-powered device with wires. The wires attach to sticky pads. You put on these the surface of your skin, usually near the area of pain.
The machine sends a small electrical current into your body that feels like a tingling sensation. It has a dial that allows you to control the strength of the electrical current. Some people find that using a TENS machine has helped ease their cancer pain. Check with your healthcare team before using a TENS machine. They are not suitable for everyone.
Pain teams, physiotherapists or a palliative care team can give you advice about whether TENS may be suitable for you. They can show you how to use the machine. They may also be able to give you one on a short-term loan. If it works well for you, you can hire one or buy one from a pharmacy or online.
You should always continue to take your prescribed pain medicines. A TENS machine alone will not be enough to manage the pain.
Cognitive behavioural therapy (CBT) is a talking therapy. It helps people to manage their problems by changing the way they think and behave. It does not make pain go away but may be used to help you to cope with pain.
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 doctor or specialist nurse.
CBT is sometimes combined with a type of meditation called mindfulness meditation (see below).
There are different complementary therapies that may help with pain management. Some people find these helpful, but they do not 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.
If you use any complementary therapies, always use a qualified therapist. The British Complementary Medicine Association (BCMA) has details of qualified therapists. Your hospital team or local hospice may be able to recommend someone.
Acupuncture uses fine needles inserted just under the skin at certain points on the body. It is not painful as the needles are so tiny.
Acupuncture may help some people with cancer pain. Some doctors think it may work by stimulating the body to produce endorphins (the body’s natural painkillers).
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.
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.
Massage therapists can sometimes teach relatives or friends how to do basic massages, so they can support you at home.
There are different types of meditation but they all aim to calm your mind. Some hospitals or hospices may have people who can help you meditate. Ask your doctor, specialist nurse or palliative care team about it.
Mindfulness meditation is a type of meditation technique that aims to help people manage problems such as anxiety, stress or chronic pain.
Mindfulness classes may be available through your hospital, your GP or a cancer support charity. There are also apps and CDs you can use to meditate at home.
Hypnosis is a form of deep relaxation. It may help people to focus thoughts and feelings on something other than cancer pain. You can also be taught how to hypnotise yourself. Hypnotherapy may make other treatments, such as cognitive behavioural therapy (CBT), more effective. If you use hypnosis, it is important to get help from a trained professional. This could be a doctor, nurse or psychologist.
Learning to relax may also help control pain, even if you can only do this for a short time each day. Ask your doctor if there is a healthcare professional who can help you. This might be an occupational therapist, physiotherapist or psychologist.
A technique called progressive muscle relaxation involves learning to tense and relax groups of muscles, individually or together. These could be muscles in the stomach, neck and other areas.
You can also do relaxation exercises to relax your mind. This can be helpful if anxiety is making your pain worse. There are lots of relaxation CDs available to guide you.
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.
Reflexology is a form of foot or hand massage similar to acupressure. Reflexology has been used to try to improve symptoms related to cancer or cancer treatment. These include pain and feeling sick (nausea). There is no evidence to prove that it is effective when used in this way but it may help people to feel more relaxed.
Music or art therapy
This is therapy using music or art to help with anxiety and to relax you. It may help you to express your feelings in a creative way. You do not have to be musical or artistic. Music or art therapists often run classes at hospitals or hospices. Meeting other people while enjoying an activity may also distract you from pain and help you feel better.
Sometimes simple things can help to improve cancer pain and make you feel better. These are things you or other people can do to help you feel more comfortable.
Find a comfortable position
The way you sit or lie down can affect your pain, so try to find a comfortable position. If you have difficulty moving, ask a family member or friend to help you change position. What may be comfortable at first may be uncomfortable 15 or 20 minutes later. Changing position will also reduce the risk of your skin becoming sore because of being in one position for a long time.
Equipment that can help you stay comfortable includes:
- v-shaped pillows or supports that help reduce backache and neck pain
- a bed cradle to keep the weight of blankets off your limbs
- a special mattress and cushions
- equipment to help with moving around and sitting.
Your district nurse can help you get these things, or tell you where to get them.
Use heat or cold
Heat pads and warm baths can help relieve aches and pains. They may help relax muscles and reduce joint stiffness. Ice packs can help with pain relief where there is inflammation and swelling. Some people find that alternating heat with cold helps them.
Be careful to protect your skin from burns when using heat pads and ice packs. Cover them up before you put them near the skin. Do not use heat on areas where you have inflammation or swelling.
Finding ways to distract yourself so you think of something else may help. For example you could watch TV, read a book, play computer games or listen to music.
Talking to family or friends, having visitors for a short time, or taking short walks with someone may also help.
Some types of gentle exercise, such as walking, may help some people with pain management. Exercise can help relieve stress, distract you and give you more energy. If you have sore joints, exercise can help ease pain by building muscle strength and improving flexibility. Weight-supported exercises, such as swimming and cycling, can be a good choice as they put less strain on your joints. We have more information about exercise and cancer.
Below is a sample of the sources used in our cancer pain information. If you would like more information about the sources we use, please contact us at email@example.com
Fallon, Giusti, Aielli et al. Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines. Annals of Oncology. 2018. 29: 166–191.
O'Brien, Christrup, Drewes, et al. European Pain Federation position paper on appropriate opioid use in chronic pain management. European Journal of Pain. 2017. 21: 3-19.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Viv Lucas, Consultant in Palliative Medicine.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.