Steroids as pain relief adjuvants.

Mr. C. is a married, 80-year-old man with a straight posture and a sharp wit. Ten years ago he was diagnosed with a pancreatic carcinoid tumour and underwent a Whipple procedure. Since then, his symptoms have been well controlled with intermittent chemotherapy despite his known liver and multiple spinal metastases.One year ago, Mr. C. developed bony pain from his cervical spine disease and was started on hydromorphone. Despite escalating doses, he presents to your office with increasing pain. The pain is moderate in severity and described as aching and constant in his neck, with intermittent, sharp, shooting pain through his left upper back and shoulder. You consider adding a corticosteroid as an adjuvant analgesic to Mr. C.'s hydromorphone regimen.