Other therapeutic interventions

Breakthrough pain is a heterogeneous condition. Non-pharmacological interventions include: rubbing/massage, application of heat, application of cold, distraction techniques, relaxation techniques, hypnotherapy/hypnosis, transcutaneous electrical nerve stimulation (TENS), and acupuncture. But most of these have not been subject to rigorous study. Anaesthetic interventions are usually utilized in patients with uncontrolled background pain, but they are sometimes used in patients with uncontrolled breakthrough pain. A variety of different techniques are available. Peripheral (local anaesthetic) nerve blockade and neuraxial analgesia delivery may be used. Non-surgical stabilization, surgical stabilization, corticosteroid instillation, alcohol instillation, phenol instillation, cryoablation, radiofrequency ablation, laser ablation, cementoplasty/vertebroplasty, balloon kyphoplasty, and MR-guided focused ultrasound surgery are other strategies, most of which have not been subject to rigorous scientific investigation. Non-opioid analgesics are a diverse group of drugs. Non-opioid analgesics may have a role in the management of breakthrough pain. Data on the use of most non-opioid analgesics is limited.