Overview
Pain is an unpleasant sensory experience associated with an injury or illness. The pain can be steady, throbbing, stabbing, aching, pinching etc.
There are 2 main types of pain:
- Acute (sudden and short term).
- Chronic (ongoing usually lasts longer than 3 months).
Elderly is at higher risk of developing chronic pain conditions. However, pain is not an expected consequence of aging. If the pain is left untreated or undertreated, it may lead to negative consequences such as poor appetite and malnutrition, depression, anxiety, immobility, social isolation and sleep disturbances. Hence, it is important to recognize and treat the cause of the pain.
Causes
- Burn
- A cut
- Bee sting
- Infection
- Broken bone
- Surgery
- Dental work
- Childbirth
- Arthritis
- Cancer pain near a tumour
- Neuropathic (nerve related)
- Musculoskeletal muscle sprain.
- Headache
Common causes of pain in elderly:
- Burn
- A cut
- Bee sting
- Infection
- Broken bone
- Surgery
- Dental work
- Childbirth
- Arthritis
- Cancer pain near a tumour
- Neuropathic (nerve related)
- Musculoskeletal muscle sprain.
- Headache
- Arthritis
- Cancer pain near a tumour
- Neuropathic (nerve related)
- Musculoskeletal
- (muscle sprain)
- Headache
Detection & Treatment
1. Injection Treatment
- Reduce swelling, irritation,
- muscle spasms and abnormal nerve activity that can cause pain.
2. Nerve Block
- Block a group of nerves that causes pain to a specific organ or body region.
3. Physical and aquatic therapy
- A physiotherapist may suggest
- an exercise programme
- tailored for you that will
- decrease your pain and
- increase your daily functioning.
4. Electrical stimulation
- Transcutaneous electrical nerve stimulation (TENS) consists of a small, battery-operated device which can diminish pain by stimulating nerve fibres through the skin.
5. Psychological support
- Support and counselling combined with a comprehensive pain treatment programme may be useful in managing pain.
6. Surgery
- Your doctor will recommend it when necessary.
7. 3 types of pain medicine
- Simple analgesia(e.g. Paracetamol, Tramadol): It works by decreasing the sensitivity of the nerves to pain and reducing inflammation. Usually given for mild to moderate pain. For severe pain, they may be given in conjunction with opioids.
- Opioids: These works by blocking pain sensation in the spinal cord and the brain. Can be administered orally, intravenously or through the skin. Usually given for moderate to severe pain and requires a prescription.
- Drug Enhancing Medicines: Some medicines such as antidepressants and anti-convulsants, have pain relieving properties and may be useful in treating specific types of pain.
Care Management
Speak up: Tell your doctor if you are suffering from chronic pain such as joint pain, back pain or headache.
Recognise & report: If the patient is cognitively impaired, caregiver needs to assess the pain by:
- Asking direct questions that only require a yes/no response such as "Are you in pain?" or "Where is your pain?"
- Observing non-verbal cues such as increase agitation, restlessness, change in behaviour, low mood, facial grimacing and social isolation.
Taking pain medication:
- Take the prescribed painkillers timely.
- Take painkillers 30 minutes before activities such as showering, exercise or walking.
- Tell your doctor if there are any side effects of the medications such as nausea, vomiting, giddiness, constipation or confusion
Gentle reposition: To reposition the patient gently and regularly.
Heat or cold pack: Heat or cold pack may help with some pain (depending on the cause of the pain) but use with caution asprolonged heat/cold may damage the skin. To consult a specialist if needed.
Essential oils (Aromatherapy): There are some essential oils that you can apply topically to ease muscle and joint pain, tension and swelling. Some of these oils can also be used as inhalation for a calming effect. To consult a specialist if needed.
Use of walking aids: Use of appropriate walking aids (such as walking stick/frame) may help to reduce pain (i.e.: reduce pressure on painful knees on walking) and help in maintaining daily activities.
Massage therapy: Therapeutic massage may relieve pain by relaxing painful muscles, tendons and joints; relieving stressand anxiety. To consult a specialist if needed.
How to manage chronic pain naturally?
- Self-management is encouraged especially after the underlying causes of pain have been treated or managed adequately.
- Learning deep breathing and meditation.
- Doing exercise without high impact (regular exercise helps release endorphins which help to reduce pain). Pacing yourself.
- Eating a balanced diet.
