Non-pharmacological management

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Cancer pain management in adults > Non-pharmacological management
Contents Introduction Recommendations Overview Patient-centred care Screening Assessment
Self-management Pharmacological Mx Non-pharmacological Mx Practice improvement Resources Opioid formulations References

Information on authorship and revision

Page last modified: 18 March 2016 12:29:43

Author(s): Australian Adult Cancer Pain Management Working Group

Non-pharmacological management

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N1. Consider referral to a physiotherapist for assessment of functional ability and potential suitability of non-pharmacological pain management strategies. (NCCN, NHS, SIGN)


Note Consider complementary therapies (see table below)

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N2. Provide support for any psychosocial and spiritual concerns identified during comprehensive assessment.

(NCCN)


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N3. Consider referral to an occupational therapist for assessment and management. (NCCN, NHS)


Note Occupational therapists can assess activities of daily living, energy conservation, anxiety management, relaxation and lifestyle impact management, and assess potential benefits of diversional therapy, splints, role support, advice on functional ability, positional and seating assessment and advice, wheelchair, and assistive equipment.

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N4. Consider referral to a clinical psychologist for psychological therapies and support:

• Cognitive–behavioural therapy (NCCN, SIGN)

• Relaxation techniques (NCCN)

• Distraction techniques (NCCN)

• Guided imagery therapy. (NCCN)


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N5. Consider music either prerecorded or with a music therapist (Consensus) expand arrow
Systematic review by Bradt et al (2011): Bradt J, Dileo C, Grocke D, Magill L. Music interventions for improving psychological and physical outcomes in cancer patients.Cochrane Database Syst Rev. 2011 Aug 10;(8):CD006911. doi: 10.1002/14651858.CD006911.pub2.


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N6. Offer to discuss any complementary therapies the person may wish to consider, and provide reliable information about the evidence for their effectiveness. (Consensus) expand arrow

Principles of holistic management; Potential for drug–drug interactions

info Complementary therapies for cancer pain management
Modalities recommended in international guidelines
Modality Source(s)
Bed/bath/walking aids NCCN
Cognitive–behavioural therapy SIGN, NCCN
Distraction therapy NCCN
Heat/ice therapy NCCN
Imagery/hypnosis NCCN
Massage NCCN, SIGN
Transcutaneous electrical nerve stimulation (TENS) NCCN
Reflexology SIGN
Reiki SIGN
Relaxation NCCN

References

Bradt J, Dileo C, Grocke D, Magill L. Music interventions for improving psychological and physical outcomes in cancer patients.Cochrane Database Syst Rev. 2011 Aug 10;(8):CD006911. doi: 10.1002/14651858.CD006911.pub2.

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Adult cancer pain. Version 2.2015: NCCN; 2015. Available from: http://www.nccn.org

National Health Service Quality Improvement Scotland. Best practice statement. The management of pain in patients with cancer. Edinburgh: NHS Quality Improvement Scotland; 2009. Available from: http://www.palliativecareguidelines.scot.nhs.uk/documents/PAINCANCERREV_BPS_NOV09.pdf

Scottish Intercollegiate Guidelines Network. Control of pain in adults with cancer. A national clinical guideline [Version amended 18 July 2011] Edinburgh: SIGN; 2008. Available from: http://www.sign.ac.uk/pdf/SIGN106.pdf

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