Pain can signal disease progression, the emergence of adventitious infection, or some significant complication of treatment. Therefore, patients who choose to have acupuncture for pain management should be encouraged to report new pain problems to their health care team before seeking palliation through acupuncture. Maintaining an open and accepting relationship will make it easier for the patient and the practitioner to discuss negative as well as positive experiences and situations where acupuncture might be contraindicated.
When a patient seeks TENS therapy or acupuncture, clinicians should listen for clues that would indicate that the pain is uncontrolled. If the patient is seeking these modalities because of poorly managed pain, the clinician, in cooperation with the patient, should revise the pain management plan by:
Correcting misconceptions the patient might have concerning the use of analgesic drugs, especially the phenomena of addiction and tolerance with opioids.
Escalating an analgesic dosage.
Adding an adjutant drug to manage a specific pain complaint or to counteract a side effect.
Prescribing a psychotropic drug to manage coexisting anxiety or depression.
Providing training in the use of cognitive-behavioral strategies.
Controlled studies are needed to test the effectiveness of counterstimulation in the treatment of cancer-related pain.
Physical Modalities
Counterstimulation
TENS
Psychotherapy and Structured Support
Hypnosis
Peer Support Groups
Pastoral Counseling
Neuroaugmentation
Index