Chronic Pain in Older Adults: Strategies for Managing Discomfort

Chronic pain is a relentless adversary, especially for adults aged 50 and over. According to a 2021 report by the Centers for Disease Control and Prevention (CDC), an estimated 20.9% of U.S. adults experience chronic pain, with the prevalence increasing with age. This persistent discomfort significantly impacts daily life, affecting sleep, mobility, and overall well-being. Pain is uncomfortable for everyone, even impacting our daily lives, but for older individuals, including those needing long-term care, effectively managing chronic pain becomes even more critical.

A significant portion of the older population experiences increased pain as they age and grapple with chronic health conditions. The research shows pain prevalence rises across multiple age groups, with adults aged 45-64 experiencing a higher percentage (25.8%) of chronic pain compared to younger adults (14.6%), and this prevalence climbs even higher (30.8%) for those 65 and over. This trend suggests that pain management becomes an increasingly crucial aspect of health care as we enter our later years.

The Challenge of Chronic Pain in Later Life

As we age, our bodies naturally experience wear and tear. Arthritis, osteoporosis, and other age-related conditions can contribute to chronic lower back, knees, and hip pain. Past injuries or surgeries often compound these issues, making pain management a complex challenge. 

Furthermore, chronic pain can lead to social isolation and depression, further diminishing the quality of life.

Fortunately, there are various approaches to address chronic pain and improve function, even for older adults. Here are some key strategies to consider:

• Exercise Therapy:  Regular physical activity, tailored to individual needs, can significantly improve pain management. Low-impact exercises such as swimming, yoga, or gentle stretching can increase flexibility, strengthen muscles, and improve mood. A 2020 study published in the Journal of the American Geriatrics Society found that exercise therapy effectively reduced chronic low back pain in older adults. Those with chronic back pain may find relief through knee rolls and pelvic tilts. Leg stretches like knee extensions may be helpful for chronic knee pain. Remember that it's essential to do these continuously for them to have a positive overall impact. 
• Addressing Underlying Conditions:  Chronic pain can sometimes be a symptom of an underlying medical condition, such as arthritis, fibromyalgia, or even depression. Chronic pain may have some related conditions, including mental health disorders like anxiety and depression. Diagnosing and treating these conditions can significantly alleviate pain. 
• Pain Management Techniques:  A combination of therapies can be highly effective. These might include:

• Medications: Over-the-counter pain relievers, prescription medications, or topical creams can offer relief. However, discussing options with a doctor is crucial to avoid potential side effects.

• Heat or Cold Therapy: Applying heat or cold packs to the affected area can provide localized pain relief.

• Mind-Body Therapies: Techniques like meditation, relaxation training, and cognitive behavioral therapy can help manage stress and improve coping mechanisms for chronic pain.

• Lifestyle Modifications:  Maintaining a healthy lifestyle is crucial in pain management. This includes:

• Healthy Diet: Eating a balanced diet rich in fruits, vegetables, and whole grains can improve overall health and reduce inflammation.

• Weight Management: Excess weight can put additional strain on joints, exacerbating pain. Losing even a modest amount of weight can make a significant difference.

• Adequate Sleep: At least seven hours of sleep per night can improve pain tolerance and overall well-being.

The Role of Long-Term Care Facilities in Pain Management

Creating a pain management plan is essential for older adults requiring long-term care. Ideally, this plan should be individualized and developed collaboratively between the care recipient, their family, and medical professionals at the facility. Here are some key considerations:

• Comprehensive Pain Assessment: A thorough evaluation should be conducted to identify the source and severity of the pain.
• Individualized Treatment Plan: The plan should incorporate a combination of therapies best suited to the resident's specific needs and preferences.
• Medication Management: Caregivers should ensure medications are administered correctly and monitored for potential side effects.
• Non-Pharmacological Interventions: Techniques like massage therapy, acupuncture, or physical therapy can be incorporated into the plan to optimize pain relief.
• Regular Monitoring and Communication: Regularly assess the resident's pain levels and adjust the plan as needed. Open communication with family members regarding the resident's pain management is crucial.

Alternative Treatments

Sometimes, people with chronic pain don't respond well to the typical treatments, opening the door to alternative therapies – those that you'll often need to seek out yourself. Specific retreats can be beneficial for those with chronic pain and mix a community environment with alternative medications. 

One good example is Daydream MD, a supportive, healing community that provides a safe place to heal using ketamine therapy or psychedelic medicine. It's safe, and the unique treatments have been carefully chosen thanks to their proven effectiveness. It may be something to consider if you have struggled with more traditional medicine. 

Various other alternative therapies can offer a complementary and sometimes more natural approach to managing discomfort. Here are some promising options to consider:

• Acupuncture: This traditional Chinese medicine practice involves inserting thin needles into specific points on the body. Studies have shown acupuncture to be effective in managing chronic pain conditions like osteoarthritis, low back pain, and headaches. The National Institutes of Health acknowledges that while the exact mechanism isn't fully understood, acupuncture appears to stimulate the nervous system and may also help release endorphins, the body's natural painkillers.
• Massage Therapy:  Massage can be highly beneficial for chronic pain, particularly for muscle and joint conditions. Different massage techniques, such as deep tissue or Swedish massage, can help improve circulation, reduce muscle tension, promote relaxation, and decrease pain perception. A 2015 review published in the journal Cochrane Database of Systematic Reviews found massage therapy to be effective in reducing chronic low back pain.
• Mind-Body Therapies:  Techniques like meditation, yoga, and tai chi can be powerful tools for managing chronic pain. These practices combine physical postures, breathing exercises, and focused attention to cultivate relaxation and mindfulness. Studies have shown that mind-body therapies can help individuals cope with chronic pain and improve their overall well-being.
• Nutritional Therapy:  Certain dietary modifications can significantly affect pain management. A diet rich in fruits, vegetables, and whole grains can help reduce inflammation, while limiting processed foods and added sugars may be beneficial. Additionally, some individuals find that specific supplements, like fish oil or curcumin, can offer pain relief. However, consulting a medical professional before starting any supplements is crucial.

Chiropractic Care: An Option to Consider 

Sore, achy muscles and joints impact everyone; these can worsen as we age and suffer from additional chronic health and aging issues. Andrew Bang, DC, a Cleveland Clinic chiropractor, suggests three ways to ease common aches and pains. Heat is one of the first things to try.

If we can get the heat to help penetrate those areas where you have pain, you have increased blood flow; those ligaments, tendons, connective tissue loosen up back to a lengthened state instead of a tightened state. So, you tend to have less pressure on a joint, then you tend to feel better.

Dr. Bang recommends using heat treatments such as heating pads, warm rice socks, or a paraffin wax dip to deeply penetrate joints, enhance blood flow, and alleviate discomfort. He advises gently stretching tight muscles, such as those in the neck, to restore blood circulation and relieve tension. 

Additionally, Dr. Bang suggests strengthening overstretched muscles to help ease aches and pains, enhancing overall muscle balance and comfort.

I find that the body loves, it craves, a couple of things. It craves movement. It craves a variety of movement. Repetitive movements tend to lead to pain and irritation. Whereas with a variety of movements, you tend to have relief in pain and increase in blood flow.

Dr. Bang likes to tell the people he treats that 'motion is lotion' – if you keep moving, you'll have less pain.

It's important to remember that these alternative therapies are often most effective when used in conjunction with traditional medical approaches. Consulting with a doctor or licensed practitioner is essential before starting any new treatment, especially for those with existing health conditions. Open communication with health professionals allows for a personalized approach to pain management, incorporating the most effective strategies to improve the quality of life for adults over 50.

Being Careful with Pain Meds

While pain medication can be a valuable tool for managing chronic pain, it's essential to be aware of potential risks, particularly for older adults receiving long-term care. Certain medications, like opioids, can have serious side effects that can significantly impact well-being and even increase vulnerability in those with pre-existing health conditions.

Opioids, while effective for acute pain, can lead to dependence and addiction over time. This is especially concerning for older adults, who may be more susceptible to these effects due to changes in metabolism. 

Senada S. Malik, a medical researcher at the University of New England, says research shows the rising use of opioids is having a devastating impact on the lives of many Americans.

The rise in opioid-related cardiac arrests during the study period was significant. By 2018, opioids were related to a similar number of cardiac arrests as all other reasons put together.

Additionally, opioids can cause drowsiness, constipation, and confusion, all of which can increase the risk of falls and accidents in seniors. Furthermore, opioids can negatively impact the function of vital organs like the kidneys and liver.

The kidneys and liver process and eliminate medications from the body. As people age, their function naturally declines. Regular use of opioids can further strain this function, potentially leading to liver damage or kidney failure. This can create a dangerous cycle, as reduced kidney function can lead to a buildup of the medication in the body, further increasing the risk of side effects. 

For these reasons, a cautious approach to pain medication is necessary, especially for anyone with chronic health or aging issues. Caregivers and medical professionals should carefully evaluate the risks and benefits of each medication, considering the impact on kidney and liver function. 

Prioritizing non-pharmacological pain management strategies whenever possible can help minimize these risks and optimize the well-being of older adults in long-term care.

Pain is a Big Challenge, Especially with Age

Chronic pain is a significant challenge for older adults, but it doesn't have to define their lives. By implementing a multifaceted approach that combines exercise therapy, addressing underlying conditions, pain management techniques, and healthy lifestyle choices, you or a loved one can experience significant improvement in their well-being. 

For those requiring long-term care services, a personalized and comprehensive pain management plan, developed in collaboration with health professionals, family, and the care recipient, is essential for optimizing the quality of life.