The initial approach to pain treatment is usually with medications taken by mouth, or using a skin patch. But these approaches to therapy do not always provide adequate pain relief. Alternative methods are available in such cases – ones that either deliver medication by other means or that take a different approach to blocking pain signals from reaching the brain.
Injections
We tend to think of an injection as giving a single shot into a muscle (intramuscular). But when speaking of pain medications, the preferred method is to use a needle and tube to drip medication into the vein (intravenous) or into the fatty tissue just under the skin (subcutaneous) over a period of time. Both of these methods of administration can include the use of a button-activated pump controlled by the patient for additional pain relief when needed.
Infusion pumps
Opioids and other pain-relieving medications can be administered through a catheter into the space around the nerves in the spine. The catheter is connected to a programmable pump that is either external or surgically implanted. When medication is infused directly into the central nervous system in this way, much smaller amounts are needed and side effects are lower than in other routes of administration.
Nerve blocks and neurosurgery
Nerve blocks and neurosurgery can be used in some cases to block the message of pain as it travels through the nervous system to the brain. Nerve blocks are usually performed with an injection through a tube or needle: temporary blocks that last for hours or days use a local anesthetic, and longer lasting blocks of three to six months can be achieved by using chemicals that destroy a portion of the nerve. Neurosurgery is not commonly used in the treatment of Cancer Pain, but it may be helpful in unusual situations.