The Continuum of Chronic Pain and Aging
What are the statistics for the elderly population?
As our bodies age in later life, things begin to slowly but surely break down. You may find that more medications begin to enter your day-to-day life, or more therapies may look to aid in relieving nagging aches and pains. That is why taking a preventive lifestyle towards the natural process of aging can help avoid the myth that pain is a foregone part of growing older. Here, it may be beneficial to build solid relationships with caregivers or pain specialists to explore your options—medications, devices and physical therapy – are effective ways to manage pain later in life.
Here are some statistics on chronic pain in older populations:
- Pain is a very common problem for older persons (ie, those age 65 and over), with persistent pain affecting more than 50% of such individuals persons living in the community setting and more than 80% of those living in nursing homes.
- Along with a greater prevalence rate of chronic medical comorbidities in later adulthood, the most frequent pain complaints among elderly patients are osteoarthritic back pain, especially in the low back or neck (around 65%), musculoskeletal pain (around 40%), peripheral neuropathic pain (typically due to diabetes or postherpetic neuralgia, 35%), and chronic joint pain (15% to 25%).
- 75% of people age 65 or older have two or more chronic conditions—such as heart disease, diabetes, chronic lung disease, or arthritis.
- Approximately 30% to 50% of people with dementia are likely to also experience chronic pain.
- Older persons with dementia or communication problems are even more at risk of under-treatment of pain, due to difficulties communicating their pain. They are known to receive fewer analgesics than others of similar age and pathology.
- Individuals with chronic pain had on average a 9.2% faster memory decline and a 7.7% faster increase in dementia probability.
- Among elderly veterans, 50% report suffering from chronic pain. In a survey, approximately 65% percent of US Veterans reported having pain in the three months prior to being surveyed, with approximately 9% classified as having severe pain. Severe pain was 40% greater in veterans than non-veterans, especially among those who served in recent conflicts.
- Interestingly, older military veterans who were not prescribed opioids were shown to have improved pain intensity over time than those who were prescribed opioids.
With more and more people entering their retirement years, expansion of geriatric programs to accompanying the onset of chronic pain remains an important factor as this population reaches their twilight. Older patients with chronic pain need better access to the healthcare they need, and a continuous effort between patients, families, and providers need to be made together to meet this goal.
Chronic Pain Is Not a Normal Part of Aging
Let me cut to the chase: Chronic pain is not a normal part of aging! You should not have daily pain just because you are over 50.
I can’t tell you how many patients I have who believe that aches and pains are what one should expect once you become middle age. Now, it is true that occasional aches and pains come with aging — typically in our knees, hip, and feet. This is due to wear and tear of our bones — they start to deteriorate over time, and joint spaces narrow. That can cause pain and stiffness. And most of us experience a headache at least once a year. I’m not talking about these instances. Chronic pain is pain that exists every day for at least six months. And if you have such pain, you need to get a proper diagnosis and care plan.
Take for example a recent patient I saw in clinic last year. “Bernice” (not her real name) is 60 years old, and her husband suffers from kidney failure and recently needed to go on dialysis. Bernice has become a caregiver shuttling back and forth to medical appointments. She opted for early retirement to help with his care. A few months prior to her clinic appointment, his condition had deteriorated. Bernice came to clinic complaining of a headache and general muscle aches. “I hurt all over” was her comment to me. Her labs results were normal, and her X-rays didn’t show anything out of the ordinary. Her primary doctor had been prescribing ibuprofen but according to Bernice, “it doesn’t seem to work and it upsets my stomach. I guess I’m just getting old and it’s something I just have to l live with.”
Bernice is not typically a patient of mine so we ended up spending much of the visit talking about her family situation. She remarked how she isn’t getting enough sleep, she barely finds time to eat, and she states, “I can feel the stress in my body.” “I have to do it all myself — no one helps me.”
It turns out Bernice is depressed and that is causing her generalized pain. The headache is a classic tension headache. With the proper dosing of an antidepressant, involvement of social work, and referral to behavioral health experts on stress-reduction strategies, Bernice is doing much better. At a visit a few months ago, the headache is gone, and her pain is now infrequent. And she understands why she gets pain, and knows when to seek help.