PALLIMED

Non-pharmacological pain interventions

A range of complementary techniques and expertise exists in addition to the pharmacological approaches. These techniques are not just an adjunct to medication but are a part of holistic patient-centred care. Not all approaches will be appropriate for every patient, but then there are patients for whom traditional medicine has little to offer either. Pain may diminish in a relaxed patient and many of the therapies listed below aim to promote relaxation.

Complementary therapies	Other non-pharmacological interventions
Acupuncture	Positioning
Reflexology	Catheterisation
Touch therapy	Reassurance
Aromatherapy	Good communication
Art therapy	Diversional therapy
Music therapy	Transcutaneous electrical nerve stimulation (TENS)
	Splinting of a fractured limb
	Psychological support
	Spiritual counselling

Treatment of other causes of poorly controlled pain

Pain	Co-analgesic
Headache due to cerebral oedema	Dexamethasone
Painful wounds	Metronidazole, topical lidocaine/ morphine
Intestinal colic	Hyoscine butylbromide or hydrobromide (Kwells)
Gastric mucosa	Proton pump inhibitor (PPI), eg lansoprazole
Gastric distension	Asilone + domperidone/ metoclopramide (in the absence of colic)
Skeletal muscle spasm	Baclofen/ diazepam/ tizanidine/ dantrolene
Cardiac pain	Nitrates/ nifedipine
Oesophageal spasm	Nitrates