The Management of Pain in Metastatic Bone Disease

Sorin Buga, MD; Jose E. Sarria, MD


Cancer Control. 2012;19(2):154-166. 

In This Article

Psychotherapeutic Management

Relaxation Techniques

Relaxation techniques include simple focused-breathing exercises, progressive muscle relaxation, pleasant imagery, meditation, and music/art-assisted relaxation. These techniques are easy to learn and do not require special training. They could reduce symptoms such as fatigue and nausea/vomiting and could improve mood, sleep, and quality of life in cancer patients.

Mindfulness-based Stress Reduction

Mindfulness-based stress reduction has been shown to improve not only chronic pain, including cancer pain and low back pain, but also a patient's mood and level of stress.


Hypnosis can be used in palliative cancer care mainly to control nausea, particularly anticipatory nausea related to chemotherapy. It can also be used to increase the pain threshold, by decreasing either the annoying sensation or the attention given to the pain, and to improve both overall and mental well-being. Only a few small randomized controlled trials have been conducted to explore the effects of hypnosis on the pain associated with cancer.[11–14]


Psychotherapy should be offered to patients who have a history of psychiatric illness or who develop clinical signs of depression. Psychotherapy can also be used as an adjuvant to medical treatment for patients with a history of addiction; this condition makes pain management in these patients a challenging task.


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