Other methods of pain control can be used on their own or in combination with painkilling drugs. If your pain is difficult to treat, your doctor may refer you to a doctor who specialises in pain control, or a specialist pain clinic. There are specialist pain clinics in every area of the UK (contact NHS Direct or the nurses at Cancerbackup for further details).

The methods include:

Nerve blocks may help to relieve pain by blocking the pain pathways in the nerves and preventing pain messages from getting to the brain. This can be done with a long-acting local anaesthetic, chemicals, freezing (cryotherapy) or heat (radiofrequency thermo-coagulation). This procedure may be carried out in your local hospital or at a specialist pain clinic.

The aim of TENS is to stimulate the nerves reaching the brain. This makes the body release its own natural painkillers, the endorphins. TENS has been known to relieve cancer pain, especially if it is only in specific parts of the body. It is given at some NHS pain clinics and by many palliative care teams and hospices.

It is thought that acupuncture may work in a similar way to TENS (by stimulating the body to produce endorphins) and may be helpful for some people with cancer. A number of specialist NHS pain clinics and palliative care services offer acupuncture. Your GP or cancer specialist can refer you.

Pain may stop you from using the part of your body that hurts. This can lead to muscle wasting and joint stiffness, which in turn may make pain and disability worse. Physiotherapy can help to treat the problem and lead to an improvement in pain relief.

Hypnotherapy may help to relieve cancer pain, but is rarely effective on its own. However, self-hypnosis can play a part in helping you to relax, in order to help reduce the effect of emotional upset on pain. Your GP may have a list of local therapists who provide hypnotherapy, or you can contact the National Register of Hypnosis and Psychotherapy for further information.

Learning to relax and to let go of your fears and anxieties – even if only for a short time each day – can play a useful part in your overall pain control, especially by reducing muscle tension. A technique called progressive muscle relaxation involves getting to know particular groups of muscles in the body and learning to tense and relax them.

Once you can relax and contract stomach muscles, neck muscles and others individually or together, you can start using the technique during stressful periods to reduce tension, and therefore pain. When you have learnt the basic techniques you can use them to help with pain relief during difficult times. Yoga can help you to train to control your muscles and breathing. You can find a local yoga organisation by contacting the British Wheel of Yoga.

There are many different types of meditation, but they are all aimed at calming your mind and becoming at peace with yourself. You can try meditation by sitting quietly, and being aware of your breathing, without trying to control it. Whenever you become aware that thoughts have come up in your mind, just come back to the awareness of your breathing. Instead of paying attention to your breathing you can put an object in front of you and pay attention to that.

Meditation can be very difficult at first, and you may feel initially that you are getting worse as you become aware of how busy your mind is. However, it will become easier as you practice. It may help you to be able to let go of distressing or depressed thoughts for a period of time once or twice each day. It is helpful to practice meditation regularly and have guidance from an experienced meditator. You can find details of meditation organisations in your local phone book or at your local library. People who have had mental illness should check with their doctor before trying meditation as it can make some types of mental illness worse.

Visualisation (creating mental images) is a technique that helps you to bring happy relaxing pictures into your mind and use them to overcome some of your pain. By 'seeing' and 'hearing' images and sounds that bring you pleasure, you can, to some extent, shut out symptoms of pain and discomfort.

You may find meditation, visualisation, relaxation, or a combination of these techniques helpful in relieving your pain. Methods vary but the overall aim is the same: to reduce stress and other emotional factors that may be making your pain worse. You can either go to classes to learn these techniques or buy tapes, CDs, records or books. Your GP may know of local relaxation classes, some of which are especially suited to the needs of people with cancer.

Meditation, relaxation and visualisation are explained more fully in our section on complementary therapies.

Emotions such as fear, anxiety and depression are common reactions to cancer and can make pain worse. It is important that you are given emotional support. It helps if you acknowledge your feelings and don’t bottle things up. It is natural to feel a whole range of powerful emotions, including depression, when dealing with cancer.

Our section on the emotional effects of cancer discusses ways of dealing with emotions that you might find helpful.

You may have anxious feelings all the time, or they may come and go. Talking through your feelings with your partner, a close friend or relative can be very helpful.

If you don't feel able to talk to someone close to you (perhaps because it upsets you both too much) then you can ask your GP to put you in touch with a counsellor, or contact one of the counselling organisations. You can also speak to the nurses at Cancerbackup, who may be able to give you contact details of local support groups.

Sometimes, a course of drug treatment, with either an antidepressant or a sedative drug such as diazepam, can help your mood or reduce anxiety.

Serious illness can force people to take life more seriously, to question its meaning and to stop taking things for granted. Some people who have religious beliefs may find their faith greatly shaken by their cancer diagnosis. Even people who have never been regular worshippers may experience spiritual as well as emotional pain.

People often ask questions like 'Is there life after death?' and 'Why should the people I love suffer?' Unanswered questions such as these, which relate to fundamental beliefs, can cause great emotional and spiritual pain that can increase the experience of physical pain.

It is often hard to accept or understand why an illness like cancer should happen in someone's life. People often have feelings of anger and guilt, and worry about how the cancer will affect their family now and in the future.

Sometimes the strength of these emotions may make the person feel isolated and frightened and withdraw from family and friends. It can help to talk to someone about these feelings.

Some people find great comfort in religion at this time and it may help for them to talk to a local minister, hospital chaplain or other religious leader. If you do not feel that this is the right sort of support for you, talking with family and friends, a counsellor or someone from a cancer support organisation may help.