British medical bulletin
-
Successful treatment of sympathetic pain is directed at the restoration of normal function. This can be achieved in the majority of cases with a combination of appropriate sympathetic or somatic nerve block, usually coupled with aggressive physiotherapy. ⋯ Other non-invasive techniques such as stimulation-produced analgesia and pharmacology, particularly the use of adrenergic blocking agents, hold some promise of future benefit. Here too, more effort should be made to carry out properly designed studies, as there is scepticism about the place of permanent or potentially destructive therapy in any painful condition.
-
British medical bulletin · Jul 1991
ReviewOpioid-responsive and opioid-non-responsive pain in cancer.
Cancer pain in general responds in a predictable way to analgesic drugs and drug therapy is the mainstay of treatment, successfully controlling pain in 70-90% of patients. The two major problem areas are pain associated with nerve damage, and 'incident' (movement-related) bone pain. Nerve damage pain tends not to respond well to morphine or other opioids. ⋯ The patient may then experience excessive side-effects at rest, but still have pain on movement. Other examples of pain which may be resistant to treatment with opioid analgesics are bladder and rectal tenesmus, pancreatic pain, and pain associated with decubitus ulcers or other superficial ulcers subjected to pressure or shearing forces. Management of non-opioid-responsive pain may include a variety of treatments involving adjuvant analgesic drugs and non-drug measures.