I’ve been chair-bound for the last few days, nursing a pulled muscle in my lower back, acquired when I too eagerly embraced some early-season gardening.
I’m experiencing irritating but temporary pain. On a 0 to 10 scale, with zero being no pain at all and “10” the most intense pain imaginable, I am never more than a spasmodic 6. With continued and caring attention from my husband, select over-the-counter remedies — and if I continue to roll a tennis ball between the wall and my painful back muscle — I will get beyond this moment.
But the experience is prompting me to think a lot about pain management.
“The elderly are more likely to have arthritis, bone and joint disorders, cancer and other painful chronic conditions. And the elderly are often untreated or under-treated for pain,” according to the Journal of the American Osteopathic Association (2002). Through the decades, the finding has been supported by other geriatric experts.
“Why is it that seniors don't get the pain treatment they need?” I ask, as I re-position my store-bought pain patch and sip ginger tea. The reasons are both not surprising and yet unexpected. There’s the frequently heard and highly stoic sentiment from your favorite older adult, “I can handle this.” There’s the fear of over-use of narcotic medications and the potential for addiction to opioids, which is increasingly worrisome to health care providers and public health officials.
And there’s this. Sometimes we, as older adults, do not even report having pain because pain it's considered to be an expected aspect of aging. Perhaps we’re fearful pain pronouncements will lead to invasive or unaffordable diagnostic testing. Maybe we worry any prescribed pain medications will be expensive — and constipating. Many do not want the dry mouth or sedated feeling that can go with pain medications.
We process medications differently as we age, and medication side effects or interactions with our other prescribed (and unprescribed) medications can be substantial and further debilitating. Some foods eaten while you are taking certain medications can also have less-than-desirable impacts. We worry about that too. The challenges are many.
Pain is sometimes called the “fifth vital sign.” If you are hospitalized for any reason, your vital signs will be regularly checked (temperature, pulse, respiration and blood pressure). Increasingly, especially for elders with suspected cognitive issues, you will also be shown a series of expressive faces depicting moods (the Faces Pain Scale).
The face on the far right of that scale clearly depicts excruciating pain; it’s probably the kind of pain experienced by Norman Cousins, author of "Anatomy of an Illness,” who suffered from a degenerative and notoriously painful condition, Ankylosing Spondylitis.
He self-prescribed “diversionary laughter.” And he discharged himself from the hospital and into a hotel across the street, where he took high doses of Vitamin C and arranged for continuous exposure to humorous films and videos. His finding was, “laughter is a natural body anesthesia.”
In search of a happy face on any pain scale you may be using right now, this is a strategy worth considering. LOL.
— Sharon Johnson is a retired Oregon State University associate professor. Reach her at Sharon@agefriendlyinnovators.org.