Some people think that pain is natural with aging, or that when older people are not clear in explaining the cause or nature of their pain that they are “just complaining.” Both of these views are wrong. There is almost always a real problem behind pain.
Arthritis is said to be the most common cause of pain in people over the age of 65. Circulatory problems, shingles, and other types of nerve damage, certain bowel diseases, and cancer are other common reasons for pain in older people.
Muscle pain is also quite common. Conditions that contribute to muscle pain in older people are fibromyalgia (especially in older women) and myofascial pain (which can result from trauma, nerve damage, and arthritis). These conditions are treated differently than other types of pain, and may get better without taking any medicine at all (that is, they may be best treated with physical therapy).
Pain can lead to other problems such as losing the ability to move around and do everyday activities. The sufferer may have trouble sleeping, experience “bad moods,” and develop a poor self-image. In addition, people with pain often become anxious or depressed. They may be at greater risk for falls, weight loss, poor concentration, and difficulties with relationships.
On the positive side, most pain can improve with treatment that usually consists of a combination of medicine and non-medicine strategies. Treatments such as physical therapy, massage, application of heat and/or cold, exercise, and relaxation may be tried first. If these treatments are not successful alone, pain pills should be prescribed along with them and the person closely observed for side effects. Since all medicines have side effects, pain pills should be prescribed with care.
Pain among older adults is too frequently left undiagnosed and untreated. Statistics show that 25% to 65% of older adults living on their own or with family, and up to 80% of seniors in long-term care facilities, have pain. Conditions such as dementia or Alzheimer’s disease further complicate an older adult’s ability to seek and receive adequate care for his or her pain.
There are many reasons why older adults may suffer pain, from chronic disease to infection to joint and bone conditions. The National Pain Foundation has compiled a list of common pain conditions among this population. Click on the links to find out more specifics about the diagnosis and treatment of some of the diseases and conditions listed below.
Abdominal Pain
Causes include gallstones and other biliary tract diseases, appendicitis, bowel obstruction, peptic ulcer disease, abdominal aortic aneurysm (AAA), malignancy or gastroenteritis. Indeed, up to 10% of severe abdominal pain in the older population is caused by a vascular condition. Older adults can help limit stomachaches by eating smaller meals that include plenty of fiber, drinking plenty of water, exercising regularly and limiting the intake of food that causes gas.
Arthritis
While there are over 100 types of arthritis, osteoarthritis is the most common. It affects up to 80% of older adults, and can seriously hamper daily activities and overall well being. Other diseases and conditions that cause joint pain include osteoporosis, ankylosing spondylitis, rheumatoid arthritis, gout and fibromyalgia. Arthritis is the leading cause of disability in the United States.
Back and Neck Issues
Back and neck pain can be caused by a number of issues, including sprain or strain, past fractures, swollen or herniated disks, sciatica, arthritis and spinal stenosis, which usually affects older adults.
Cancer
Though cancer affects people of all ages, the older you get – the more likely you are to develop cancer. Pain is one of the most common symptoms of all types of cancer. It is usually classified as one of two types: nociceptive pain, which is described as sharp, aching and throbbing and neuropathic pain, which is described as a burning or numb sensation.
Circulatory Problems
Symptoms include muscle cramps, fatigue and aching, chest pain, leg pain, itchy skin, vein pain or varicose veins, and sores that heal slowly or not at all. Circulation issues frequently affect those with diabetes, a condition that affects nearly one out of five Americans over the age of 60.
Complex Regional Pain Syndrome (CRPS)
CRPS is an extremely painful condition that develops after an illness or injury and often affects the leg, arm, foot or hand. Patients frequently describe an intense, searing pain that includes skin sensitivity, swelling and color changes.
Fibromyalgia
Fibromyalgia is characterized by intense and widespread pain. People with fibromyalgia report muscular pain, tenderness, fatigue, headaches, numbness and sleep disorders. Patients over 60 frequently cite fatigue, swelling, headaches, anxiety and depression as their most severe fibromyalgia symptoms.
Headache
Headaches unrelated to underlying diseases are classified in three different types: cluster, tension and migraine. Tension headaches are, by far, the most common type, affecting up to 90% of women and 70% of men.
Neuropathic Pain/Peripheral Neuropathy
Neuropathic pain is usually caused by damage to the body nerves. It is often characterized as burning, tingling and “electrical” feelings in the feet or other extremities. Common causes include diseases such as diabetes and kidney, liver and thyroid disorders or a specific physical injury. Researchers believe more than 20 million people suffer from peripheral neuropathy.
Orofacial Pain
This condition is related to pain in the face, mouth and teeth, and may include severe headaches, jaw tenderness and aching, muscle spasms and strain, dry mouth and toothaches. Older adults may have pain from cancers and precancerous formations, periodontal diseases, tooth loss, other bodily diseases and medication side effects.
Pelvic Pain
Chronic pelvic pain affects up to one out of 10 women and can be related to a number of different conditions, including infection, uterine fibroids, vulvodynia, kidney stones, pelvic inflammatory disease (PID) or sexually transmitted diseases, among others. The pain can be dull and aching or, as in the case with an infection, burning and sharp, and can also include a feeling of pressure or heaviness.
Post Herpetic Neuralgia
Shingles are an outbreak of rash or blisters on the skin that is caused by the varicella-zoster virus, the same virus that causes chicken pox. One of the main symptoms of shingles is a burning or tingling pain in or under the skin. The pain associated with shingles can be intense and is often described as “unrelenting.” Approximately 20% of people diagnosed with shingles develop post-herpetic neuralgia, a chronic pain condition that affects the nerve fibers and skin. Post-herpetic neuralgia can be even more painful than shingles and can last for months or even years. The condition occurs more often in older adults.
Post-surgical Pain
Post-surgical pain is a complex condition caused by damage or trauma to the tissues and nerves during surgery. The body responds to the invasion by sending the central nervous system into a sort of overdrive. This means that pain is often felt in areas not operated on during the surgery.
Thoracic Outlet Syndrome
This relatively rare condition, which results in neck and shoulder pain and finger numbness, is caused by damage to the blood vessels and nerves in the thoracic outlet (the area between the lowest vertebrae of the neck to the upper rib). Damage can be caused by trauma (such as an automobile accident), poor posture, the presence of an extra rib, and joint pressure.
