Guide to Pain Management in Low-Resource Settings: Complementary Therapies for Pain Management



Barrie Cassileth, Jyothirmai Gubili - International Association for the Study of Pain

Publication Identity

International Association for the Study of Pain


Both acute and chronic pain may be treated with prescription pharmaceuticals, but they also may be controlled by complementary therapies such as acupuncture, massage therapy, and other modalities discussed in this chapter at less cost and typically with fewer side effects.

Each year about nine million cancer patients worldwide experience moderate to severe pain most of the time. Thirty percent of newly diagnosed cancer patients and 70–90% of patients with advanced disease suffer significant pain. Pain experienced by cancer patients can be chronic, caused directly by tumor invasion or by cancer treatment itself, or acute pain, such as following surgery. Pain in terminal stages of disease has its own characteristics and special issues. The World Health Organization (WHO) recommends use of analgesics for pain starting with nonopioid drugs followed by opioids for uncontrolled and persistent pain. But, pharmacological interventions, although effective, do not always meet patients’ needs, and they may produce difficult side effects. They are also costly and may be difficult to obtain. These issues pose a great challenge for patients requiring long-term pain management, often forcing them to choose between living in pain or living with undesirable side effects. Complementary therapies have an important role to play everywhere, and especially in low-resource setting.