Thursday, May 2, 2019

Pain and the Older Adult

As we age, aches and pains tend to occur more frequently, last a little bit longer, and hurt a little bit more than they used to. A sore or stiff joint or muscle that we may not have thought twice about 5 years ago is now preventing us from living our lives to the fullest. As physical therapists, we are often asked by older adults in the clinic about various medical interventions that they hear about: “My sister told me viscosupplementation for her knee did wonders, should I go get it done?”, “My doctor told me I have arthritis, do I need a knee replacement?”, “I have diabetes, should I sleep upside down to reverse my neuropathy?” The reason we get so many questions is that there is such an influx of information from various sources that it becomes difficult to discern rubbish from solid medical advice.
One common source of health information older adults turn to for information is AARP’s monthly magazine. Its own editor-in-chief describes it as “the best-read magazine in America according to latest total audience stats.” Questions that I received regarding a particular article in April’s edition titled “The Latest Gains in Pain” led me to wish to summarize this article and offer any insights that I may.

The article states that many older adults live with chronic, daily pain without a specific cause or condition, because pain, as it explains, is its own disease. It is also incredibly common-about 1 in 2 individuals over the age of 65 suffer from chronic pain. It differentiates acute pain (which has the
purpose to avoid tissue damage) from chronic pain (which no longer has any physiological or survival purpose and hangs around after tissue healing ceases). Seemingly unrelated findings including stress, obesity, and anger can actually exacerbate symptoms, making what would be a minor ache feel like a major debilitating event. Lastly, the article supports the stance that often opiates are less effective than exercise and other non-pharmacological methods.

The statement that chronic pain can take place in the absence of an identifiable cause (having pain despite having no muscle tears or joint breakdown) is groundbreaking. This means you can have pain without a direct mechanical cause. Just because your arm hurts doesn’t mean your rotator cuff is torn; simply because your back hurts does not mean the degenerated disc found on your MRI (which could have been there for years without causing any problems) is directly causing your back ache. This finding gives hope for those who are living with daily OTC or prescription-pain killers for chronic pain just because your disc may still be affected does not mean your pain also has to stick around forever.

There is a plethora of new information coming out regarding pain science which aides to drive treatment and help those who are in pain every day of their lives. To those of us who may have seen this article in a widely distributed magazine, talk to your nearest healthcare provider (including the wonderful folks at one of the nearby 9 PTW locations) to get you back to living your best life.

PTW’s Matt Brennan PT, DPT is a Clinical Director at our Hatfield clinic. For an initial evaluation, call Matt at 215.855.3359 today!