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Resistant pain

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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80% of cancer patients achieve good pain control using the analgesic step ladder culminating in oral morphine.

The remaining 20% may require alternative analgesic techniques:

  • spinal administration of opioid analgesics
  • local anaesthesia
  • nerve blocks

One should also consider if certain elements such as anxiety, mechanical factors, neurogenic components, inflammatory components or malignant components might be better treated. Some or perhaps combinations of the following treatments is often helpful.

  • amitryptiline
  • carbamazepine
  • bone pain - calcitonin/radiotherapy

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