There are many ways to address pain without drugs, surgery or other medical interventions. Some may work, some won't. Some will work for others but not for you. But all should be discussed with your physician. Here is a sampler ...

Relaxation or meditation techniques relieve pain or keep it from getting worse by reducing tension in the muscles. These techniques include simple breathing exercises, progressive muscle relaxation, and visualization that reduce tension and anxiety. They can help you fall asleep, give you more energy, make you less tired, and possibly make other pain relief methods work better. Some people, for instance, find that taking a pain medicine or using a cold or hot pack works faster and better when they relax at the same time.

Distraction involves focusing your attention on something other than your pain. Many people use this method without realizing it when they watch television or listen to the radio to "take their mind off" the pain. Reading, cooking, or talking to family and friends can all work just as well.

Distraction may work better if pain is sudden and intense or if it is brief, lasting only 5 to 45 minutes. It may also be useful during procedures that may be brief but painful or when you are waiting for pain medicine to start working. If pain is mild, you may be able to distract yourself for hours.

Imagery for pain control is a method of allowing your mind and powers of concentration to focus on soothing images. It is a way of further extending the benefits of relaxation and distraction for your own benefit. Imagery can be thought of as a deliberate daydream that uses all of your senses-sight, touch, hearing, smell, and taste. Some people believe that imagery is a form of self-hypnosis, but the way imagery relieves pain is not completely understood.

Skin stimulation includes massage, heating pads, ice packs or other similar methods to alleviate pain. It is usually done either on or near the area of pain. For pain relief, massage is most effective when using slow, steady, circular motions. You can massage over or near the area of pain with just your bare hand or with any substance that feels good, such as talcum powder, warm oil, or hand lotion. However, if you are having radiation therapy, avoid massage in the treatment area.

Exercise can help relieve tension, depression and fatigue. Exercise such as swimming or walking can be comforting, can increase your energy level, and can provide a welcome, healthy distraction from your pain. An exercise program should only be started after your doctor gives you the go-ahead.

Drs. Kerry Courneya of the University of Alberta and Christine Friedenreich of the Alberta Cancer Board in Canada, writing in the Annals of Behavioral Medicine, noted that physical exercise can improve cancer patients' quality of life by reducing pain, fatigue, nausea and other side effects. They analyzed 24 studies of exercise in cancer patients published between 1980 and 1997 and found that "the studies have consistently demonstrated that physical exercise following cancer diagnosis has a positive effect on quality of life, including physical, functional, psychological, and emotional well being."

Biofeedback involves learning to voluntarily control certain body functions such as heart rate, blood pressure and muscle tension. How people use biofeedback to control pain is not understood, but some researchers believe that imagery helps. Cancer patients sometimes use biofeedback techniques to reduce anxiety and help them cope with their pain, but results are mixed. Biofeedback usually is used with other pain-relief methods.

Hypnosis is a technique in which an individual's susceptibility to suggestion is heightened. To relieve pain, the hypnotist may suggest that pain will be gone when the person "wakes up." Some cancer patients have learned methods of self-hypnosis that they use to control pain. The role of hypnosis in treating chronic pain is uncertain, however. Some studies have shown that 15 to 20 percent of hypnotizable patients with moderate to severe pain can achieve total relief with hypnosis. Other studies report that hypnosis reduces anxiety and depression; by lowering the burden of emotional suffering, pain may become more bearable.

In the News

According to researchers at Beth Israel Deaconess Medical Center in Boston, patients who used self-hypnotic relaxation techniques during surgery needed less pain medication, left the operating room sooner, and had more stable vital signs during the operation. Writing in the British medical journal The Lancet, Dr. Elvira Lang called the self-hypnosis "a simple method that decreases pain and anxiety and makes the invasive procedure safer and faster."

Results from a pilot study at Cedars-Sinai Medical Center in New York showed that inpatient treatment with massage, acupuncture or guided imagery reduces pain associated with bypass surgery. According to lead researcher Dr. Gregory Fontana, the results were so promising that 60 percent of the massage group, 70 percent of the acupuncture group and 100 percent of the guided imagery group said they would have been willing to pay for the therapy out-of-pocket. Fontana suggested that these techniques might be equally successful for other surgeries as well.

Another study by researchers at the University of California, San Francisco found that over 70 percent of breast cancer patients are combining traditional medical treatments with alternative therapies such as acupuncture, herbs, prayer, or nutritional supplements. But the same study noted that two-thirds of these women did not inform their physicians of their use of such therapies. This is worrisome because, while many complementary treatments can be beneficial, some can have interactions with conventional treatments, mask test results, or possibly even cause direct harm.

SOURCES:
National Cancer Institute (http://www.nci.nih.gov)
National Center for Complementary and Alternative Medicine (http://www.nccam.nih.gov)
The Lancet, April 29, 2000; 355:1486-1490
British Journal of Urology International, 2000; 85:481-485
Annals of Behavioral Medicine, Sept. 1999
The Journal of Family Practice, June 1999