Cancer Pain : Distraction, Hypnosis, Massage, Vibration, Cold or Heat

by National Cancer Institute

(Page 7 of 8)

Distraction

Distraction means turning your attention to something other than the pain. People use this method without realizing it when they watch television or listen to the radio to "take their minds off" a worry or their pain.

Distraction may be used alone to manage mild pain or used with medicine to manage brief episodes of severe pain, such as pain related to procedures. Distraction is useful when you are waiting for pain medicine to start working. If the pain is mild, you may be able to distract yourself for hours. Distraction can be a powerful way of relieving even the most intense pain for awhile.

How to Use Distraction

Any activity that occupies your attention can be used for distraction. Distractions can be internal, for example, such as counting, singing mentally to yourself, praying, or repeating to yourself statements such as "I can cope." Or distractions can be external, for example, doing crafts such as needlework, model building, or painting. Losing yourself in a good book might divert your mind from the pain. Going to a movie, watching television, or listening to music are also good distraction methods. Slow, rhythmic breathing can be used as distraction as well as relaxation. Visiting with friends or family is another useful distraction technique.

You may find it helpful to listen to rather fast music through a headset or earphones. To help keep your attention on the music, tap out the rhythm. You can adjust the volume to match the intensity of the pain, making it louder for very severe pain. This technique does not require much energy, so it may be very useful when you are tired.

After using a distraction technique, some people report that they are tired, irritable, and feel more pain. If this is a problem for you, you may not wish to use distraction or to be careful about which distraction methods you use and when you use them.

Hypnosis

Hypnosis is a trance-like state of high concentration between sleeping and waking. In this relaxed state, a person becomes more receptive or open to suggestion. Hypnosis can be used to block the awareness of pain, to substitute another feeling for the pain, and to change the sensation to one that is not painful. This can be brought on by a person trained in hypnosis, often a psychologist or psychiatrist. You can also be trained to hypnotize yourself.

During hypnosis, many people feel similar to the state we experience when we begin to awaken in the morning. We can't quite open our eyes, but are very aware. We can hear sounds inside or outside our house. Our eyes remain closed, and we feel as though we either can't or don't want to wake up and open our eyes.

People can easily be taught, by a hypnotherapist, to place themselves in a hypnotic state, make positive suggestions to themselves, and to leave the hypnotic state.

Choose a hypnotherapist who is licensed in the healing arts or who works under the supervision of someone who is licensed. To locate a therapist skilled in hypnosis, contact the behavioral medicine department at a cancer center near you.

Skin Stimulation

In this series of techniques, the skin is stimulated so that pressure, warmth, or cold is felt, but the feeling of pain is lessened or blocked. Massage, pressure, vibration, heat, cold, and menthol preparations are used to stimulate the skin. These techniques also change the flow of blood to the area that is stimulated. Sometimes skin stimulation will get rid of pain or lessen pain during the stimulation and for hours after it is finished.

Skin stimulation is done either on or near the area of pain. You can also use skin stimulation on the side of the body opposite the pain. For example, you might stimulate the left knee to decrease the pain in the right knee. Stimulating the skin in areas away from the pain can be used to increase relaxation and may relieve pain.

• If you are having radiation therapy, check with your doctor or nurse before using skin stimulation.

• If you are receiving chemotherapy, check with your doctor before using hot or cold packs.

• You should not apply ointments, salves, or liniments to the treatment area, and you should not use heat or extreme cold on treated areas.

Massage

Using a slow, steady, circular motion, 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. Depending upon where your pain is located, you may do it yourself or ask a family member, friend, or a massage therapist to give you a massage. Some people find brushing or stroking lightly more comforting than deep massage. Use whatever works best for you.

Precaution: If you are having radiation therapy, avoid massage in the treatment area as well as over red, raw, tender, or swollen areas.

Pressure

To use pressure, press on various areas over and near your pain with your entire hand, the heel of your hand, your fingertip or knuckle, the ball of your thumb, or by using one or both hands to encircle your arm or leg. You can experiment by applying pressure for about 10 seconds to see if it helps. You can also feel around your pain and outward to see if you can find "trigger points," small areas under the skin that are especially sensitive or that trigger pain. Pressure usually works best if it is applied as firmly as possible without causing more pain. You can use pressure for up to 1 minute. This often will relieve pain for several minutes to several hours after the pressure is released.

Vibration

Vibration over and near the area of the pain may bring temporary relief. For example, the scalp attachment of a hand-held vibrator often relieves a headache. For low back pain, a long, slender battery-operated vibrator placed at the small of the back may be helpful. You may use a vibrating device such as a small battery-operated vibrator, a hand-held electric vibrator, a large heat-massage electric pad, or a bed vibrator. Do not use a vibrator on the stomach. Avoid vibration over red, raw, tender, or swollen areas.

Precaution: If you are having radiation therapy, avoid vibration in the treatment area.

Cold or Heat

As with any of the techniques described, you should use what works best for you. Heat often relieves sore muscles; cold lessens pain sensations by numbing the painful area. Many people with prolonged pain use only heat and have never tried cold. Some people find that cold relieves pain faster, and relief may last longer. Also, you can alternate heat and cold for added relief in some cases.

For cold, try gel packs that are sealed in plastic and remain soft and flexible even at freezing temperatures. Gel packs are available at drugstores and medical supply stores. They can be used again and stored in the freezer. You may want to wrap the pack in a towel to make it more comfortable. An ice pack, ice cubes wrapped in a towel, or water frozen in a paper cup also work.

Precaution: If you start to shiver when using cold, stop right away. Do not use cold so intense or for so long that the cold itself causes more pain.

To use heat for pain relief, a heating pad that generates its own moisture is convenient. You can also try gel packs heated in hot water, hot water bottles, a hot, moist towel, a regular heating pad, a hot bath or shower, or a hot tub to apply heat. For aching joints, such as elbows and knees, wrap the joint in a lightweight plastic wrap (tape the plastic to itself). This retains body heat and moisture.

Precautions:

• Do not use a heating pad on bare skin. Do not go to sleep for the night with the heating pad turned on. Also, be very careful, if you are taking medicines that make you sleepy or if you do not have much feeling in the area.

• Do not use heat over a new injury because heat can increase bleeding - wait at least 24 hours.

• Avoid heat or cold over any treatment area receiving radiation therapy and for 6 months after therapy has ended.

• If you are receiving chemotherapy, check with your doctor before using a cold pack.

• Do not use heat or cold over any area where your circulation or sensation is poor.

• Do not use heat or cold application for more than 5 to 10 minutes.

About the Author

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