Contrast bath therapy for neuropathic pain due to spinal nerve root compression by myeloma: a case report

Abstract

Introduction: Although common in individuals with cancer as well as nerve root compression, neuropathic pain can be difficult to prevent and manage due to the complex pain mechanisms involved in its pathophysiology. Although contrast baths have a long history of use for pain management, there is little known about their efficacy in the acute rehabilitation setting or in patients with cancer related neuropathic pain. Case presentation: A 54-year-old man with multiple myeloma presented with progressive lower extremity weakness and 8/10 neuropathic pain intensity in both feet due to extensive myelomatous involvement of his lumbar spine. The patient’s pain limited his participation in physical therapy despite an extensive pain medication regimen. At the discretion of the patient’s physical therapist, contrast bath therapy for this patient was initiated with a reduction in pain intensity to 3/10. This analgesic effect lasted for a period of up to 10 h, which allowed the patient to participate in 3 h of therapy daily and to sleep comfortably. Discussion: Contrast baths are a simple and cost-effective therapy that can be performed independently. As demonstrated in this case, they can potentially provide marked improvement in neuropathic pain and, in the acute rehabilitation setting, may enable patients to better participate in intensive physical therapy.