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How to manage chronic pain

Created date

June 22nd, 2016

The strongest of pain medications, opioids/narcotics, have recently made headlines because abuse, misuse, and resulting side effects are rising at an alarming rate. In Massachusetts alone, opioid-related hospital visits nearly doubled from 2007 to 2014. Nationwide in 2009, over 400,000 visits to emergency rooms involved nonmedical uses of these painkillers. These numbers are indeed troubling, but rather than simply dismiss these medicines as unsafe, it is important to remember that they can be part of a balanced approach to pain relief. This particularly applies to seniors because of all age groups, they have the highest prevalence of pain and the lowest risk for abusing opioids.

Over half of seniors suffer from chronic pain with the majority reporting that pain affects their physical or emotional functioning. Research shows that despite these problems, approximately 80% of seniors do not discuss pain with their doctors. Some believe that pain, even significant pain, is a natural part of aging. Others have concerns that treatment (especially medication) may not be effective, or that intolerable side effects may occur with pills.

Range of treatment options 

In fact, there are many treatment options for seniors who have persistent pain. First and foremost, work with your doctor to determine if you have an underlying condition that can be diagnosed and treated. If that is not the case, there are many nonmedication options. Physical therapy and guided exercise is often a mainstay of pain management. Mindful meditation was recently shown to significantly reduce chronic low back pain. Cognitive behavioral therapy has been shown to reduce neck pain, and complementary medicine, including chiropractic care and acupuncture, can be helpful.

Several classes of medications can be useful, including opioids, but a carefully balanced approach weighing benefits, side effects, and risks must be the rule and not the exception. Opioids are sometimes the only safe and effective option, but studies show that over half of seniors who begin an opioid regimen decide to reduce their dose, take it less frequently, or stop altogether. One-fourth of seniors say that side effects such as constipation, nausea, and dizziness are the reasons they discontinue the drugs, and over half cite fear of addiction. 

If medication is to be a part of your pain management plan, discuss all the risks and benefits with your doctor. Be sure you provide a complete list of your current medicines, including supplements such as multivitamins and any herbal preparations to check for interactions. Once you fill your prescription, count the pills and inspect them to confirm they fit the description on the accompanying printed material. After you begin your medicine, report all new symptoms and side effects to your doctor promptly.

While chronic pain may not be cured, you and your doctor can certainly come up with a treatment plan that will likely reduce your pain and improve your overall functioning. None of this can happen, however, unless you tell your doctor about the pain’s impact on your life. Please don’t be a stoic; rather, use your courage to persist until you find the right combination of therapies.