(stimulation sensory nerves)
(direct nerve involvement) e.g.
Dysaesthesia: superficial burning pain
• Tumour-associated oedema, e.g. raised intracranial pressure
Bony metastases and other tissue destruction
Muscle spasm pain
Viscus (hollow organ) obstruction, e.g. colic, tenesmus
Metabolic effects • Hypercalcaemia
Skin infiltration/ulceration aspirin opioids antidepressants antiepileptics e.g. carbamazepine antidepressants corticosteroids aspirin
NSAIDs aspirin diazepam clonazepam baclofen antispasmodics biphosphonates (APD)
aspirin opioids opioids corticosteroids radiotherapy antidepressants neurosurgery NSAIDs spinal morphine local anaesthetic opioids opioids opioids opioids local anaesthetic TENS
radiotherapy neurosurgery radiotherapy (the most effective)
hormones orthopaedic surgery opioids chlorpromazine corticosteroids palliative surgery radiotherapy corticosteroids treat infection dressings palliative surgery radiotherapy
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