By Joseph Maroon, MD
Chronic pain is a common problem but especially in seniors. Greater than 60% of community-dwelling older adults and up to 85% of those in assisted nursing facilities suffer from chronic pain. Most pain complains with aging are joint and arthritis related. Untreated or poorly treated pain can lead to depression, social withdrawal, sleep disturbance, decreased mobility, falls, increased hospitalizations and unwanted side effects of narcotic medications.
There has recently been reported an ominous increase in prescription pain pill abuse and deaths. In 2015, the last full year of reporting, Pennsylvania saw an overall 20% rise in overdose deaths, but very few were reported in those over 65 years. Despite this, many physicians have reduced or even stop prescribing pain medications to seniors who have chronic pain.
What Can be Done?
For most types of chronic inflammation and joint pain many people can get relief using non-steroidal anti-inflammatory medications (NSAIDs), like ibuprofen or acetaminophen. However, these medication can have serious side effects including liver and kidney disease and deterioration.
Long-term pain control is generally not as simple as taking a pill. It should involve not only your healthcare practitioner but also lifestyle changes, therapists, bracing and mobility aids to name but a few. Weight loss, appropriate footwear and insoles, knee bracing, physical therapy and exercise to strengthen the joint surrounding muscles, are important first steps to reduce the need for pain medications.
Topical treatments, like capsaicin, NSAIDs and lidocaine ointments generally have fewer side effects and can provide relief for hours or even days. In my practice, seeing thoses with chronic spine pain, I also routinely recommend dietary changes. A low inflammatory diet, with reduced saturated fats, rich in fiber and fish can help to reduce inflammation. Anti-inflammatory phytonutrients found in fruits, vegetables, and other whole foods provide critical antioxidants. I routinely recommend a high quality fish oil (omega-3) supplement which may eliminate the need for NSAIDs in some cases. Don’t let pain control you! There are more options than discussed here, ask your healthcare provider today.
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