People of any age can be susceptible to chronic pain. Pain does not discriminate. Pain sees no gender, no ethnicity, and no age. But pain can have a different impact on people of varied ages. For example, someone in their early twenties can respond to pain much differently than someone who is past retirement age.
Treatments and pain management may also vary depending on an individual’s age. Someone who is relatively young may require different treatments and different methods of pain management versus someone who is over the age a 65.
With age often comes a variety of changes to the body. Muscle mass may decrease. The fatty tissue over the body may increase. The amount of water that the body carries can also decrease with age. The once spongy, cushioning cartilage that lined the joints of the body may now be thinned and fragile. Our organs change over time too and may function slower and perhaps even less efficiently than they did in years before.
With all these changes happening as we age, it is clear to see that the risk of chronic pain developing in the elderly population is higher than their younger counterparts. For this reason, it is important to understand how chronic pain can impact the elderly population, and what can be done to help.
There is a societal misconception that pain as we age is a somewhat rite of passage. This is untrue. Pain is a communication signal that our bodies send to our brains to notify us that something is wrong. Pain should not simply be expected by a certain age. Because of this misconception, many older adults are not seeking the proper diagnosis and treatments for their pain and sadly many older adults suffer silently with the pain.
It is vital to communicate any changes to your body that you are experiencing to your primary care physician. The earlier on the pain is identified and diagnosed, the more likely both you and your primary care physician are to find a treatment that works best for you.
Changes to your body include, but are not limited to joint and bone pain, swelling of any sort, back pain, any pain or numbness or weakness in the arms or legs, difficulty grasping objects, difficulty or pain when walking, sitting or standing for any amount of time, as well as any facial pain and/or headaches.
Early detection of the source of the pain as well as a confirmed diagnosis early on increases your chance of successfully managing your pain.
Due to the constant physical changes to the body as we age, resolving the pain is not always possible. For example, when cartilage wears down, and arthritic changes begin to take place, it is not possible to reverse these changes. We can however, better manage the condition by implementing a multidisciplinary course of action that includes changes to diet, physical activity, pain interventions, medications and regular follow-ups with your doctor to evaluate your condition. By taking these preemptive steps, you are effectively increasing you chances of leading a high quality of life during your senior years, despite the pain you may be experiencing.
It is also important to note that as our body ages, as do our internal organs. This means that certain medication can impact us in different ways. There are a number of pain medications and dosages that may be suitable for a younger patient, would not be suitable for an elderly patient. This is again because of the changes that are happening to our bodies as we age.
For example, our kidney function tends to change as we age. The primary job of our kidneys is to filter out what our bodies have no use for. Because our kidneys tend to shrink in size as we age, they are not always able to filter out the medications at optimal level.
Another example would the changes to the liver that happens with age. The liver tends to shrink in mass and have a somewhat decrease in blood flow as we age, this makes the breaking down of the medication a more difficult task for the liver to carry out.
The changes to the acid levels in the stomach as we age can also alter the way that the medications are absorbed into the body.
It is for this reason that physicians will often start older patients on the lowest possible dosage of medication, and very slowly taper up. It is also for this reason that many physicians will not exceed a certain dose of a medication for older patients, which can often leave the patient frustrated and with pain that is still not fully under control. It is important to understand that your physician is trained in the safe limits of medications, and that sometimes, the risk does not outweigh the benefits. That being said, if your physician feels that you have reached the maximum safe dosage of any particular medication, hope is not lost. As a team, both you and your doctor are able to collaborate and hit the ground running to find an alternative to help you maintain a good quality of life.
Chronic pain affects everyone on mental and emotional level. Sometimes, the effects of chronic pain on the mental health of a patient are much more detrimental than the physical impact may be. This is especially true for the elderly population. As our bodies change naturally with age, we may find that we have new limitations that we did not have in the years of our youth. Our social lives start changing, and we may not interact with family and friends as often as we once did. Children grow and start families of their own. Friends retire and move away. Often with older age also comes periods of silence in our homes.
When chronic pain is thrown into the mix, this can take the normal and tolerable sense of quiet in the home up to full blown isolation. Chronic pain limits our mobility. It also can create a pain memory which can develop into a fear of moving painful parts of the body, which in turn can amplify the pain. Pain can also affect sleep. Poor quality sleep can have a significant impact on our mood, our memory, and our ability to concentrate.
These sudden and unpleasant changes that result from chronic pain can lead to a variety of mental health concerns such as depression and anxiety. The elderly population is more susceptible to isolation in general, but is at a much more increased risk when they are living with chronic pain.
For this reason, treating the psychological effects of chronic pain is equally as vital as treating the physical effects. Talking to your primary care physician about your mental health as well as discussing your pain will help to maintain a social and active quality of life. While chronic pain is a more complex condition in the elderly population, it is not unmanageable. With the proper treatments and by working as a team with your primary care physician, you can maintain an active and social lifestyle well into your years.