A recent large study suggests that more than 25 million Americans suffer from some degree of pain on a daily basis, and that nearly 40 million experience severe pain. When it comes to easing that pain, many of us reach for over-the-counter (OTC) painkillers. However, Mount Sinai geriatrician Patricia Bloom, MD, recommends caution when it comes to using them regularly. “Many people think these medications are without risk simply because they are easily available,” she observes, “but they have many side effects, some of which are potentially life threatening for seniors.”
Vital to Treat Pain
In the study (Journal of Pain, August), women and the elderly were among those more likely to report relatively severe pain, and people in the two most severe pain groups were likely to have worse health status and suffer from more disability than those with less severe pain. “Pain impairs the body’s ability to heal, and can actually make you sicker,” Dr. Bloom confirms. “Unrecognized or undertreated pain can lead to loss of physical functioning, depression, decreased socialization, insomnia, and falls due to weakness and gait instability.” Delirium can be another complication (see our cover page for more on this serious condition).
Unfortunately, pain-relieving drugs carry risk factors for seniors—in fact, the Food and Drug Administration (FDA) recently strengthened the warning labels for widely used NSAIDs like ibuprofen (Advil®, Motrin®) and naproxen (Naprosyn®, Aleve®), noting that they can increase the risk of heart attack or stroke. Another widely used painkiller—acetaminophen—is safe if used correctly, but its presence in many OTC cold and flu medications means it is easy to overdose (it’s recommended that older adults take no more than 3 grams a day of the drug).
If you are looking for non-pharmacological ways to mitigate chronic pain, these complementary health approaches may help:
Yoga: This involves gentle stretching designed to improve the postural issues that can underpin pain, strengthen muscles, and preserve flexibility. “Studies suggest that gentle hatha yoga can decrease pain and improve your ability to carry out activities of daily living if you suffer from back pain,” Dr. Bloom says.
Tai chi: This ancient Chinese martial art consists of slow, gentle movements called “forms.” These movements involve rotation and flexion of the torso, extension of the hips and knees, weight shifting, postural control, and alignment, with and without arm coordination. The different forms improve strength, flexibility, and balance, and can help ease pain and stiffness, as well as reduce the risk of falls.
Pilates: This is a system of strengthening and stretching exercises designed to develop the core muscles (the muscles around your trunk and pelvis) that support your spine. “Many people who take part in Pilates exercises confirm that it has improved their range of motion, as well as helped decrease back, neck and joint pain,” says Dr. Bloom.
Massage: Studies suggest that massage is an effective treatment strategy for reducing muscle tension and pain, and it also can help boost your mood if chronic pain is causing anxiety and depression. Stick to Swedish massage, since it is a more gentle form.
Acupuncture: This form of traditional Chinese medicine involves the insertion of very fine needles into certain areas in order to clear “blockages” in the flow of energy through the body. “Several studies indicate that acupuncture may be effective in easing pain, and few risks are associated with the practice,” Dr. Bloom says, “although you may experience a slight burning sensation when the needles are inserted.”
Mindfulness: A form of non-religious meditation, mindfulness consists of simple practices to train the mind’s attention in ways that have been shown to reduce stress and the impact of pain, and also to alleviate many medical and psychological conditions.
Dr. Bloom is a certified Mindfulness-Based Stress Reduction (MBSR) teacher, and has been involved in studies concerning the use of mindfulness for post-operative pain and chronic pain. “There is quite a significant body of scientific research concerning the use of mindfulness for pain,” she notes. “Data indicates it may help to reduce the intensity of pain, and improve people’s function and ability to engage with life despite pain.” Many community and senior centers now offer courses in mindfulness.
While Dr. Bloom frequently recommends that her patients consider non-pharmacologic interventions for the treatment of chronic pain, she cautions that if you have a specific condition, there may be some exercises that you should avoid. “For example, if you have osteoporosis or osteopenia, both of which weaken the bones, don’t do exercises that require flexing of the spine,” she says. “If you decide to try yoga or pilates, be sure to let the instructor know about any joint pain you have, so that the poses can be modified if necessary to avoid exacerbating the problem.”
Always use qualified practitioners—visit the National Center for Complementary and Integrative heath (www.nccih.org) for links. Finally, if you are considering (or already use) complementary approaches, let your doctor know. Another recent study (American Journal of Managed Care, July 20) of patients suffering chronic pain from common complaints including back pain, joint pain, arthritis, and headaches suggested that 35 percent of those who used acupuncture didn’t inform their healthcare providers.