Some people have pain that is not relieved by drugs or non-medical methods. When this happens, other treatments can often be used to reduce pain.
Stopping pain impulses from going through the nerves
Surgery
Pain cannot be felt if the nerve pathways that carry pain impulses to the brain are interrupted. To block these pathways, a neurosurgeon may cut nerves, usually near the spinal cord. When the nerves that relay pain are cut, feelings of pain, pressure, and temperature can no longer be felt. Only surgeons with special skills, who are also experts in pain management, should do this kind of surgery. These surgeons normally work with other pain specialists to explore other methods of pain control before they cut nerves.
Nerve block
A nerve block is a procedure where a local anesthetic (a numbing drug), which may be combined with a steroid, is injected into or around a nerve or into the space around the spinal cord to block pain. After the injection, the nerve is no longer able to relay pain so the pain is relieved for some time. For longer-lasting pain relief, phenol or alcohol can be injected. A nerve block may cause muscle paralysis or a loss of all feeling in the affected area.
Spinal analgesia
Low doses of pain medicine may be injected into the fluid around the spine (called intrathecal injection). If this works, a tube and a pump may be placed to deliver the pain medicine right into the spinal fluid to control the pain. Morphine is often used for this purpose, and you can still have side effects like itching and constipation. Surgery is done to put the small pump into your body.
Epidural
Certain kinds of pain may respond to pain medicine that is injected into the space around the layers of the spine. If this works, a pump can be implanted so that you can get pain medicines right around the nerves. This may cause numbness or weakness of the treated area.
More cancer treatment may be given to shrink the tumor.
Sometimes, even when cancer treatment cannot cure the cancer, it can shrink the size of a tumor that is pressing on nerves and organs and causing pain. Chemotherapy, hormone therapy, or radiation may be used in this way. Radioactive injections are sometimes used when the cancer has spread to many places in the bone -- the radioactive drug settles in the bones near the cancer and helps to stop its growth and relieve pain. In a few cases, other treatments like radiofrequency ablation can be used in certain areas of the body. In this treatment, electrodes are put in near the tumor to heat and destroy the cancer.
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