Pain Control

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Skin stimulation

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

What you should know about skin stimulation

If you’re getting radiation therapy, check with your doctor or nurse before using skin stimulation. You shouldn’t put ointments, salves, menthol, or liniments on the treatment area, and you shouldn’t use heat or extreme cold on treated areas. If you’re getting chemotherapy, check with your doctor before using hot or cold packs.

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 on where your pain is, 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.

    Precautions: If you’re getting radiation therapy, avoid massage in the treatment area as well as in any red, raw, tender, or swollen areas. Check with your doctor as noted above.

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 test this 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 very sensitive or that cause more pain. Sometimes gradual pressure on the trigger points is helpful to relieve pain. Pressure usually works best if it’s 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 many hours after the pressure is released.

Vibration: Vibration over and near the area of the pain may bring short-term 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 can use a vibrating device such as a small battery-operated vibrator, a hand-held electric vibrator, or a large heat-massage electric pad.

    Precautions: If you’re getting radiation therapy, avoid vibration in the treatment area. Do not use a vibrator on the stomach or over red, raw, tender, or swollen areas.

Cold or heat: As with any of the techniques described, you should use what works best for you. Heat often relieves sore muscles. Cold can lessen the feeling of pain by partly numbing the painful area. You can also switch back and forth between heat and cold for added relief in some cases.

For cold, try gel packs that are sealed in plastic and stay soft and flexible even when frozen. You can get them 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, frozen peas, or water frozen in a paper cup also work.

    Precautions: 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.

    Avoid cold over any area where you are getting radiation treatments and for 6 months after it has ended.

    If you’re getting chemotherapy, check with your doctor before using a cold pack.

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

    Do not apply cold for more than 5 to 10 minutes at a time.

To use heat for pain relief, a heating pad with a moisture option is handy. You can also try gel packs warmed in hot water; hot water bottles; a hot, moist towel; a regular heating pad; a hot bath or shower; or a hot tub. You might want to try one of the heat patches you can buy at the drugstore. 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 fall asleep with the heating pad turned on. Be very careful if you are taking medicines that make you sleepy or if you don’t 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 over any area where you’re getting radiation treatments and for 6 months after treatment has ended.

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

    Do not apply heat for more than 5 to 10 minutes at a time.

Menthol: Many menthol preparations – creams, lotions, or gels – are available for pain relief. When they’re rubbed into the skin, they increase blood circulation to the affected area and produce a warm (or sometimes cool), soothing feeling that lasts for several hours.

To use menthol, test your skin by rubbing a small amount of the substance in a circle about the size of a quarter in the area of the pain (or the area you want to treat). This will let you know whether menthol is uncomfortable to you or irritates your skin. If the menthol does not create a problem, rub some more into the area. The feeling from the menthol slowly increases and remains up to several hours. If you are concerned about the odor bothering others, you can use the menthol when you are alone, perhaps in the evening or overnight.

    Precautions: Do not rub menthol near your eyes, over broken skin, a skin rash, or mucous membranes (such as inside your nose or mouth, or around your genitals and rectum).

    Make sure you do not get menthol in your eyes. Wash your hands well with soap and warm water after using menthol.

    Do not use menthol on the skin of the treatment area during radiation therapy.

Transcutaneous electric nerve stimulation (TENS): This is a technique in which mild electric currents are applied to some areas of the skin through electrodes attached to a small power pack. The feeling is described as a buzzing, tingling, or tapping feeling. The small electric impulses seem to interfere with pain sensations for some people. The current can be adjusted so that the sensation is comfortable or even pleasant. Your doctor or a physical therapist can tell you where to get a TENS unit, and how to use it.


Last Medical Review: 08/29/2013
Last Revised: 08/29/2013