Chevy Chase, MD (PRWEB) May 12, 2011
Pain affects everyone. Not only can it be emotionally and physically debilitating for patients, but their families, and the economy at large, suffers as well. Studies show the annual cost of chronic pain in the United States, including healthcare expenses, lost income, and lost productivity, is estimated to be $100 billion. Pain management has become a personal and economic priority as 75 million baby boomers approach retirement age.
But diagnosing and treating pain in older adults can be challenging. Those 65 and older often have multiple medical and nutritional problems, take multiple medications and have many potential sources of pain.
Older patients can also harbor certain beliefs about pain that can stand in the way of successful treatment. This article is meant to help dispel some well-worn myths while giving practical examples of pain management techniques that have been very effective for many senior patients.
Myth #1. Expect pain.
It comes with age and you must learn to live with it. Myths about pain, and an individual’s predisposition for enduring it, tend to increase with age no matter how fit or otherwise healthy the patient. Call it inherited attitudes about aging or a lack of facts, some patients begin to exhibit a “pain acceptance” attitude as early as age 50.
While pain is often a symptom that something is askew in the body, that something can often be easily corrected and in many cases prevented by simply staying fit. For example, an increasingly idle patient in his 60s experienced acute lower back pain after playing touch football with his old Army buddies. The retired soldier knew he was going to be active at the reunion, but didn’t prepare for it by gradually increasing his cardiovascular activity or participating in a weight training regimen. He didn’t adequately stretch his muscles before or after the football game. Instead, after straining his back he waited for two weeks to call his doctor and in the meantime became increasingly more inactive. His inactivity confounded the problem and slowed his recovery.
Acute pain caused by temporary circumstances can largely be prevented by keeping the body fit and by preparing for activity. Acute pain can also be lessened by taking charge of it immediately instead of hoping it will go away on its own.
Myth #2. Over-the-counter or prescription medications are the only real way to alleviate pain.
Johnson & Johnson (or Bayer, or GlaxoSmithKline, or “fill in the brand”) knows best when it comes to safe and effective pain relief. Pain relievers from the most well-known brands have been around since we were kids and in some cases, for more than a century. They must be safe and effective, right?
Not always. While prescription drugs have been used and prescribed with caution because of many known and serious side effects, traditional OTC medications, such as Tylenol, Motrin, and a host of others have become embroiled in controversy because of their side effects, adverse affects on the heart and other vital organs, and for questionable manufacturing practices.
What we once took for granted as “very safe” OTC medications compared to prescription painkillers, has now made us wary. Parents are now encouraged to forego giving OTC medications to children below a certain age. Older people and those with pre-existing chronic conditions are making doubly sure they don’t ingest more of an OTC painkiller than what is recommended.
Before reaching into the medicine cabinet, consider stepping out of the OTC box by experimenting with these alternative methods of pain relief. Information about alternative pain relief therapies can be found at the National Center for Complementary and Alternative Medicine, which is part of the National Institutes of Health (NIH), which include:
- Yoga, Medication and Acupuncture. These mind-body practices focus on the interactions among the brain, mind, body and behavior, with the intent to use the mind to affect physical functioning and promote health. Yoga and medication include focused breathing techniques, specific postures and balance exercises to increase calmness and relaxation.
- Massage. Massage therapy can relieve pain, rehabilitate sports injuries, reduce stress, increase relaxation, address anxiety and depression, and aid in general well-being.
- Natural Pain Relievers. Natural herbal medicines made from centuries-old ingredients used in Ayurvedic medicine that provide pain relief without side effects are becoming increasingly popular in the West.
Myth #3. Natural pain relievers don’t work and are a waste of money.
With sales of pain management products expected to grow to $47 billion by 2011 and an aging baby-boomer population that strives to live longer and live better, retailers have recognized the importance of carrying a wide variety of over-the-counter pain management products—particularly effective products without any known adverse side effects.
While natural pain relief products, either in topical form or provided as an oral dietary supplement, are becoming more mainstream in the US, many older Americans doubt their effectiveness, even if they haven’t yet tried them. This may be due to a misunderstanding about the ingredients in natural pain relievers or a low expectation of relief.
Effective natural pain relievers contain ingredients that are proven painkillers, such as turmeric, a powerful healer recognized for its anti-inflammatory properties; ginger, known to alleviate muscle strains, arthritis and rheumatism; rosemary, which can be used for joint or musculoskeletal pain, and other botanicals that have a well-documented pain reduction effect.
Since topical natural pain relief products don’t contain laboratory-created pharmaceuticals, they won’t generally make the skin feel “icy hot,” smell like medicine, or cause clothes to stain. Effective natural pain relief products alleviate inflammation, muscle aches and nerve pain without side effects, perfumes, or gimmicks.
A 97-year old patient recently became a convert to topical natural pain relief products. She had been suffering from chronic arthritis pain for decades and had tried every OTC and prescription drug suggested to her by her doctors over those many years. She also had surgery to try to correct some issues. Last year she tried a natural pain relief cream that has changed her life tremendously. She was extremely doubtful about the product’s efficacy at first. But after continued use she became a natural pain relief believer and today, for the first time in years, she is nearly pain-free. Natural Pain Relief products may be a viable option for older Americans, no matter their age or previous pain management experience.
Myth #4. Surgery may be the most radical option – but it works.
As an interventional pain specialist, I always advocate surgery as the last resort. As we age, we don’t recover as quickly from surgery. Surgery can also produce complications that can hinder pain relief or make matters worse. Importantly, surgery can be an expensive step to take if insurance coverage isn’t adequate.
Modern technology has given us viable alternatives to surgery. In my practice I have many patients who suffer from every type of back pain. Many are debilitated by the pain to the point where it has drastically affected their quality of life. Among other surgery alternatives, I have recommended spinal cord stimulator implants to patients who suffer from neuropathic pain and have found no other outlet for relief. The procedure has been quite successful for the vast majority of them.
A spinal cord stimulator (SCS) uses electrical impulses to relieve chronic back pain, arm or leg pain. It is believed that electrical impulses prevent pain signals from being received by the brain. After a trial implantation process where the patient provides the doctor with feedback to determine pain relief effectiveness, the SCS device is implanted near the base of the spine, using local anesthesia with sedation in an out-patient setting. Then, after implantation of a battery and following programming, the patient can control their level of pain relief using an external control unit according to their needs.
The SCS is but one of many out-patient procedures that can provide a high level of pain relief without surgery. Before resorting to surgery, I encourage you to talk to your doctor about this procedure and others if you have found no relief using any other method.
Myth #5. The doctor always knows best.
Too many older patients try to please their doctors by downplaying their level of pain or the effectiveness of the prescribed treatment. Only you know the severity of the pain you’re experiencing, which treatments are actually working for you, and the pain management techniques you’re truly comfortable trying.
Be your own best advocate. Be honest with your doctor about how you’re feeling and if treatment is really working. He or she wants to find a solution that works for you. Don’t be afraid to ask questions, or to voice your opinion about a procedure or a medication if you have any reservations. An open dialogue will bring about the best results – and the most relief for you.
Dr. Reza Ghorbani, MD, ABIPP, FIPP, is an interventional pain management specialist and president of the Advanced Pain Medicine Institute in Chevy Chase, MD, as well as the director of pain management services at the Dimensions Healthcare System. He is also founder of Truceuticals LLC, makers of Noxicare Natural Pain Relief products. Visit Noxicare at http://www.noxicare.com.
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