A trend toward patient-centered pain management

Created date

December 30th, 2019
Dr. Narrett leads the medical team at all Erickson Living communities. A graduate of Harvard Medical School, he has been providing care for seniors for over three decades.

Pain is the source of great human suffering and disability. About 130 million Americans and more than one in four seniors report chronic long-term pain. Pain’s impact can be devastating and often results in poor sleep, low energy, depression, and worsening health.

While pain is debilitating, there is much you and your medical providers can do to help address and manage your symptoms. The first step is to diagnose the source of the pain and work toward treatment of the underlying cause. Chronic pain in seniors is most commonly related to diseases that affect the bones, muscles, and nerves. Common examples are arthritis and peripheral neuropathy (nerve damage) resulting from diabetes or poor circulation. Chronic pain can also occur with cancer and cancer treatment and in the later stages of chronic diseases such as congestive heart failure, kidney disease, and chronic obstructive pulmonary disease. 

Once the cause of the pain is established, or even if the source of the pain is never clarified, there is much that can be done to alleviate discomfort and its impact. Treatment options are vast and range from medication and physical and behavioral therapy to complementary health approaches or more invasive techniques such as nerve blocks and surgery. Take the time to review your options and have the conversation with your health care provider. 

Medication can play an important role in pain management, but it is just one option and often comes with side effects. Determining the cause of the pain is often helpful in selecting the best medicine, and there is a long list to choose from. Be an informed consumer and understand the benefits and risks of pharmaceuticals, especially for seniors.

Even more options 

Since medication often comes with risk, what other options do seniors have to manage chronic pain? Last year, the U.S. Department of Health and Human Services assembled a panel of experts to investigate best practices for pain management. The task force was convened to make recommendations about ways to control pain without using addictive opioids such as oxycodone, hydrocodone, and morphine. They found that pain managed with multiple modalities was most effective, and that sometimes pain control measures could be effective without any medication at all.

One important example of a successful nonpharmacologic approach is cognitive behavioral therapy (CBT), which is typically administered by a therapist in one-on-one sessions. CBT helps you come to an understanding of the triggers of your pain, the role stress and emotional factors play, and how to develop coping and adaptive strategies such as relaxation and controlled breathing. It has been shown in multiple studies to be very effective in reducing low back pain, headache, fibromyalgia, and arthritis pain. CBT can also be delivered successfully over the phone or computer.

Other nonpharmacologic pain management approaches include physical therapy, regular exercise, acupuncture, acupressure, massage, chiropractic care, and spirituality. Additional approaches include nerve blocks and more invasive procedures. 

There is much you can do to take control, manage your pain, and feel better in mind and body. Consider all your options and make a plan with your doctor that works for you.

In good health,

Dr. Narrett