Breakthrough pain is a worsening or flare of pain that occurs in patients whose pain is otherwise controlled.

Dr. Neal Slatkin, who is director for the Department of Supportive Care, Pain & Palliative Medicine at the City of Hope has reviewed the treatment options — including CAM.

Here are options that “should be incorporated into the management strategy and integrated with pharmacologic therapy as needed” and as appropriate depending on the source of the pain.

He lists these options first ahead of pharmacologic treatments.

  • Application of cold or heat
  • Braces
  • Counter-irritant creams, or bandage wraps
  • Limitation of activity
  • Correction of poor posture
  • Reconditioning
  • Exercise
  • Massage therapy
  • Transcutaneous electrical nerve stimulation (TENS)
  • Behavioral therapy
  • Acupuncture
  • Nerve blocks

The bottom line?
Dr. Slatkin advises, “While the perception of decreased pain is essential, enhancements in function and quality of life are legitimate and quantitative outcome measures, which in some patients may precede a reported decrease in pain.”

“Anxiety and depression can interfere with the success of treatment, especially when it takes longer than anticipated to reach treatment goals, and counseling can be helpful for such patients.”

4/8/08 21:12 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.