Pain in the elderly
HAS your doctor told you that your pain is to be expected because you’re over 60? Pain in the elderly, so the myth goes, is a normal part of aging, something to be expected and treated passively with a grin-and-bear-it attitude. True, you may experience more pain syndromes than most, but much of the pain associated with old age is not inevitable or unmanageable.
The prevalence of chronic benign pain among the elderly is virtually unknown. But sampling can be drawn from recent studies such as “A survey of Chronic Pain in an Elderly Population,” printed in the Canadian Family Physician. It reported that from among 132 elderly subjects, 83 percent had some form of pain related problem. Physicians report that headaches seem to be the most common pain complaint. This chronic pain may be related to aging and caused by vision changes and vascular changes in general. Neuralgia (pain in the distribution of a sensory nerve) and myalgia (pain from skeletal muscle) also commonly cause pain problems not only for the elderly but even to young adults, along with arthritis and lower back pain. Other pain syndromes known to affect the elderly population disproportionately include herpes zoster and cancer. Some of these conditions have an organic origin and others stem from psychogenic roots but in either case, the pain is real and the suffering should not be chalked up to being old.
Knee pain
It breaks my heart seeing people, especially the elderly, limping when they walk or holding a cane to support their body from falling. Some of these people are still in their 50s and 60s but due to their pain suffering, they look 90. Is there a chance to rehabilitate and bring them back to their normal walking? My answer is 95 percent yes. But it also depends on how severe the damage of the ligament or cartilage.
What are common causes of knee pain?
• For knee pain following an injury, possibly popping and the inability to bear weight or move the knee: Something is wrong with your ligament or cartilage. Call your doctor. Apply ice. Physical therapy is usually needed. Severe knee pain after an injury may also indicate a dislocation or fracture.
• Knee pain in athletes or active people or after you bang or twist your knee; possibly swelling: Overuse of the knee like extreme jogging, jumping, sudden twist, or there’s water in the knee (synovitis). Try RICE—rest, ice (cubes wrapped in a thin cloth), compression (not too tight bandage), elevate your knee while resting with pillow. Therapeutic massage like acupressure, myotherapy, physical therapy can be helpful. Runners should run on soft surfaces and wear quality running shoes to prevent overuse injuries. Start a strength training program to strengthen your knees.
• Pain and swelling below the kneecap in an active adolescent undergoing a growth spurt: Rest the affected area and avoid exercise that strains the knee such as jumping and squatting. Muscle strength training, stretching exercises, ice may be helpful. Ask your doctor if you need anti-inflammatory painkillers. You may feel a tender bump below your knee cap. If pain is severe, your doctor may recommend taping. Knee stretching may ease the pain. See a physical therapist.
Get an X-ray and let an orthopedic doctor diagnose how severe the damage is. Seek for another option like a therapeutic massage. Surgery must be the last resort.
• Pain warmth and stiffness in your knee, like when frequently kneeling on a hard surface and pain is felt upon bending your knee: See a physiotherapist. If you want an alternative medicine, seek the help of a chiropractor, acupressurist, acupuncturist. The pain may be alleviated and may help restore active range of motion.
Exercise
Lack of physical activity is a major problem affecting pain management in the elderly.
Behaviors such as excessive bed rest and limited physical movement increase the occurrence of pain and contribute to physical deterioration. In addition, loss of muscle mass associated with the aging process may by itself be the basis for some pain. Other elders may experience pain related to problems affecting their posture and manner of walking.
Fortunately, exercise is a highly effective therapeutic approach to these problems. Exercise releases endorphins, which can raise your pain threshold. It also contributes to improved physical functioning, strength, flexibility and range of motion. And it has a positive effect on sleep, appetite, mood and general health. The kind of exercise program most appreciate for individual pain conditions vary. A program focusing on stretching and strengthening specific muscles and joints may be useful in managing musculoskeletal pain and enhancing functional activity. For aerobics, the degree of physical activity must be tailored to your level of physical fitness.
Calixto S. Paquiao, A.B; B.S.E;P.E was the national coach of the Philippine weightlifting team from 1977 to 1985, based in Rizal Memorial Stadium and Sports Complex, Metro Manila. He is a Certified Coach of International Coaching and Refereeing Course and a U.S certified Fitness Trainer by Nautilus U.S.A specializing in personal fitness training, sports nutrition and weight management. He was enshrined in the Cebu Sports Hall of Fame in 2002. He was trained and certified by The PUM Netherlands Senior Experts based in Hague on International Therapeutic Massage and Pain Control. He specializes in natural therapy: chronic and acute back, shoulder, knee, sciatic nerve pain, sports injuries (no fracture), migraine. He is currently fitness director of Coach Pacquiao Fitness and Wellness Center.
