Pain management in the elderly is a very effective and required segment, as this is very commonly faced among people ageing. When you become older, the prevalence of severe pain syndromes increases in intensity and at times it becomes excruciating. Pain in elderly is a very diverse subject, as there are different types of pains experienced. When people reach a certain age they usually think that it’s okay to experience this type of pain due to their age. However, there could be something more life-threatening behind the pain felt.
This is why it is important to visit a healthcare professional to know the reason behind the pain and mange it effectively. There are many ways to manage pain in elderly. At the same time, it is worth keeping in mind that pain can derive from many things. Read further to learn more about pain management in the elderly.
Types of Pain Mechanisms in the Elderly
There are different types of mechanisms that lead to an increase in and sensitivity in elderly. Mentioned below are the two types of pain mechanisms:
Physiological Changes
Physiological changes in the elderly cause a decrease in the neurotransmitters such as the gamma-aminobutyric acid (GABA), no adrenaline, serotonin, and acetylcholine. This in turn leads to a decrease in the number of increased pain thresholds, peripheral nociceptive neurons, and reduced endogenous analgesic response leading to an increase in pain.
Aging Homeostenosis
Homeostenosis in aging is the loss of homeostatic reserve of different organ system shown as a renal and live function decline. This also includes a decrease in the muscle mass, low appetite, depression, agitation, and increase in vulnerability leading to more falls, sleep disturbances, and much more.
Treatment Options for Managing Pain in Elderly
There are different treatment options available for the elderly when it comes to managing pain. Before you go with a certain treatment plan, it is always best to first consult a health professional, and they will tell whether the treatment will help and suit the patients taking other things into account. When going for a treatment option, it is important to take in to account other issues faced by the elderly as well.
Pain Management in Elderly Using Medications
There are different medications out there for treating pain in elderly, but it can get very complicating choosing a specific course as almost 75% of people who are 65 or more have 2 or more other chronic conditions, and this has to be taken into account when prescribing a specific medicine. No matter how much pain prevails in the elderly, sometimes the pain is untreatable.
In a study conducted by Maxwell, it was found that in 21% of adults, the pain felt remained untreated in different nursing homes. Untreated pain is most likely to happen in patients suffering from Alzheimer’s, as it become difficult for them to communicate or express the pain felt.
When using medication as a treatment for managing pain in the elderly, each person must have a separate evaluation. This way, professionals can come up with an effective strategy on what to prescribe that will come with the least amount of side effects.
There is no doubt that this is difficult to strategize, as there are so many health issues and challenges faced by the elderly. Issues such as physical limitations make it hard to receive treatment such as physical exercise, physiotherapy, stretching and other physical activities.
Physical therapy is one of the best ways to relieve pain in muscles and become more flexible. However, this isn’t the best form of treatment for the elderly individuals who are physically impaired. This is why medication treatments are more common in elderly as compared to alternative treatments.
Researchers have also found this in a study conducted by Macfarlane et al. However, the side effect sometimes get worse with medications, especially when you’re not sure of the other chronic conditions the elderly may be dealing with.
According to a report in 2008, around 31% of the 65 elderly patients were hospitalized because of an adverse drug reaction. Elderly patients become more prone to a higher drug risk if they have natural, physiological changes in the body, and this usuallyhappens with age. If there is slow movement in the gastro intestinal tract, then that indicates the absorption of a few drugs, and even a liver oxidation rate can interfere with the timing of the drug.
Risks of Using Medication as Pain Management in Elderly
As mentioned earlier, there are different types of medications prescribed to the elderly when it comes to managing pain. However, many risks that come with different types of medications, and you should be well aware of them. Mentioned below are a few of the common drugs prescribed to the elderly for pain management and the risks that come with it:
NSAIDs
NSAIDs are one of the most common types of drugs used to treat musculosketal pain in the elderly. These types of medications are usually used for the elderly when it comes to pain management. However, these medications come with a significant amount of side effects. If an elderly patient is facing other health issues such as heart problem, blood disorders, renal problems or more, the medication could interact with these conditions and make them worse.
According to a study, gastrointestinal toxicity becomes very prevalent in adults taking NSAIDs. NSAIDs usually have a negative interaction with other prescribed medications such as aspirin, anti hypertensive meds and certain serotonin receptor inhibitors (SSRIs). Most of the time, this leads to hospitalization. This is why it is important to take your medical history into account, especially when taking strong drugs as this puts you at a higher risk of \an intense drug reaction.
Opioids
Opioids are another type of medication recommended by the World Health organization (WHO). It is recommended to use this type of medication after the use of NSAIDs .Opioids consist of fentanyl, methadone, oxycodone, and morphine, which are commonly prescribed to elderly patients for the treatment of pain. However, Opioids are said to be very addictive, and not the best forms of medications. There are many risks associated with Opioids, especially when elderly patients take them.
Some of the common type of risks elderly patients may experience are nausea, constipation, more falls, sleep disturbances, respiratory depression, and gastro intestinal complications. Many elderly patients are advised not to consume alcohol when on an Opioid-based treatment as well as sedatives like benzodiazepines, as these increase the risk of respiratory depression in elderly patients. Opioids also may lead to unhealthy body consumption changes which could lead to a decrease in bone mass, muscle, and fat which increases the risk of an overdose.
Alternative Approaches to Managing Pain in Elderly
As pain management in the elderly is becoming more and more common, people are looking towards other alternatives to medications considering the side-effects. It is best to talk to physical therapists, yoga instructors, and chiropractors when wanting to look for alternative treatments.
Most of the elderly are physically impaired, making it difficult to use physical therapy as a treatment plan. However, it is best to discuss the different ways that can still attain physical therapy. This will involve tailoring treatment plans so that the elderly can benefit from it and use it easily. Mentioned below are a few therapies for pain management in the elderly:
Chiropractic Care
Chiropractic care is the fourth most used alternative methods in according to a survey conducted by the National Health Interview. What’s more, chiropractic treatment is one of the most effective outpatient treatments when it comes to improving flexibility and pain disability in the elderly.
There is a high chance of experiencing side-effects from chiropractic care such as a spinal manipulation, which involves temporary discomfort in the treated area. This also depends on the skills and efficiency of the chiropractor. So you have to make sure you get in touch with the best chiropractor near you to attain effective treatment.
Acupuncture
Acupuncture is another well-known alternative treatment for managing pain in the elderly. This type of treatment could help relive certain types of pains such as neck pain, knee pain, low back pain, headaches, migraines, and osteoarthritis. These are some of the common types of pains usually experienced by the elderly.
Final Thoughts
Pain management in the elderly is quite a challenging thing, especially when it comes to treating the pain. You have to be very careful as to what treatment option you should opt for. It would be best if you consulted with your healthcare professional before starting any treatment. There are many things to consider when managing pain in the elderly, and hopefully this article has given you some idea on the essential things to take into account.