Of the many symptoms experienced by those at the end of life, pain is one of the most common, feared, and often undertreated,

Dr. Perry Fine from the University of Utah in Salt Lake City reviews the treatment options, including CAM. Here’s a summary.

Rehabilitation/physical therapy

  • Physical, occupational, and speech therapy are potentially beneficial in managing pain.
  • Strengthening, stretching, and the use of assisting devices may improve mobility.


  • Family members can be taught simple, safe techniques of massage.
  • Hospice programs can often provide trained, certified massage therapists.

Percutaneous electrical nerve stimulation (PENS)

  • Evidence supports PENS for persistent low back pain and knee pain.


  • Popular for patients with cancer and other end-stage pain.
  • Several researchers have found acupuncture to be an effective antidepressant.
  • Has a positive effect on COPD (chronic obstructive pulmonary disease), shortness of breath associated with end-stage cancer, and asthma.

Cognitive interventions

  • Might improve mood and increase coping behaviors.

Music therapy

  • Low-cost
  • Reduces anxiety and improves mood for medical, surgical, and ICU patients, and for patients undergoing procedures.
  • Useful in children and adults.
  • For caregivers, music therapy might improve empathy, compassion, and relationship-centered care without interfering with technical aspects of care.

11/16/07 16:24 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 www.Vicus.com, a complementary and alternative medicine website.