Strong pain medications can prevent and ease breakthrough pain but they don’t always work and are not necessarily the best option. So what is someone to do?
Relaxation therapy is an alternative option to managing breakthrough pain.
What is Breakthrough Pain?
Breakthrough pain is temporary and usually occurs in moderate to severe flare-ups, and happens even through you are taking medications on a daily basis. This kind of pain, according to the International Association for the Study of Pain, is often abrupt, acute and intense. It breaks through a patient’s normal pain levels despite daily medications. Having breakthrough pain does not mean that pain is not controlled or that medications are not working.
Breakthrough pain can either be incident related, spontaneous or come at the end of a dose of medication. Incident related pain increases due to over activity while spontaneous pain has no reason or pattern of occurrence. End of dose pain occurs just before you are scheduled to take your medication and can be managed through adjusting medication dosages.
Pain Medication is Not Always the Best Option
Persistent pain, or pain that is continuous and always present, is best controlled when that pain is properly treated through medication and other therapies. Breakthrough pain, on the other hand, is more complex to treat and while narcotics can be prescribed, they are not necessarily the best option.
Further, doctors are hesitant to prescribe them because they can be habit forming and cause adverse side effects. Moreover, many patients prefer non-medicinal options for treating breakthrough pain. An alternative to pain medication is relaxation therapy.
Benefits and Risks of Relaxation Therapy
A 1996 study reported by the Journal of the American Medical Association found that relaxation therapies are effective in reducing pain related to a number of medical conditions. Other benefits included reduced muscle tension and the ability for patients to increase activity levels. Therapists and psychologists are generally the best people to teach you about relaxation techniques so ask your doctor for a recommendation.
Mind and body relaxation therapies are generally not associated with any medical risks but there are been some rare incidents. People with cardiovascular disease are often advised to avoid progressive muscle relaxation because of the possibility of increased pressure on the chest cavity, this according to National Institutes of Health. Further, people with epilepsy should speak with their doctors before trying meditation due to reported episodes of deep and prolonged meditation.
Types of Relaxation Therapies
Relaxation therapy works to help the body reduce its reaction to stress. The major types of relaxation therapies are:
Meditation: Mediation uses awareness to quiet the mind and relax the body. A study published by the National Institutes of Health reported that meditation can help to increase a person’s pain tolerance and self-esteem while decreasing anxiety, stress levels, depression and pain. The most common types are transcendental meditation and mindfulness meditation. In transcendental meditation, the patient repeats a mantra to allow negative feelings and thoughts to pass through the mind and body. In mindfulness meditation, the focus is on stress reduction through attention to thoughts and physical sensations. This type of meditation has been known to reduce pain and improve mood for patients suffering from chronic pain.
Progressive Muscle Relaxation: Progressive muscle relaxation involves techniques that tense specific muscle groups and then relax them to create tension awareness and relaxation. It is labeled as progressive because it includes all the major muscle groups, starting from the toes and moving upward. By relaxing the muscles one at a time, the participant should eventually experience total muscle relaxation.
Autogenic Training: Autogenic training or AT teaches your body to respond through visual imagery and body awareness to achieve deep relaxation and reduce stress. You can practice these on your own or with the help of a therapist. Once you have learned AT techniques, you can practice them whenever you need or want relief from stress or pain.
Breathing: While there are different breathing techniques, they all aim to bring about relaxation. In general, the goal is to shift from upper chest breathing to abdominal breathing. Find a quiet and calm place where you cannot be disturbed for at least ten minutes and set alarm to keep track of your time. Sit comfortably and place one hand on your chest and the other on your belly. Pay attention to how your chest and belly move while you breathe normally and concentrate on each breath. Now, try to breathe gently in and out through your nose. Your chest and belly should be still and your diaphragm should be doing all the work. With each breath, allow the stress and tension to escape from your body. As you slow your breathing, sit quietly and pay attention to how relaxed your body feels.
Remember to keep your doctor updated on your specific condition and what alternative therapies you have tried. Relaxation therapy is intended to balance out your treatment plan and not replace any recommendations made by your doctor.
 Ali, G. and Kopf, A. (n.d) “Breakthrough Pain, the Pain Emergency and Incident Pain.” International Association for the Study of Pain Guide to Pain Management in Low Resource Settings. Retrieved from http://www.iasp-pain.org/AM/Template.cfm?Section=Guide_to_Pain_Management_in_Low_Resource_Settings&Template=/CM/ContentDisplay.cfm&ContentID=12199
 “Integration of Behavioral and Relaxation Approaches Into the Treatment of Chronic Pain and Insomnia.” (1996, Jul. 24) The Journal of the American Medical Association. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=405834
 Victors, A. and Zollman, C. (2001, Oct.) “Hypnosis and relaxation therapies.” National Institutes of Health. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071579/
 Kabat-Zinn, J. and Burney, R. (1981) The clinical use of awareness meditation in the self-regulation of chronic pain. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/3897551.