Illustration by Sara Andreasson for HuffPost
This story is part of Pain in America, a nine-part series looking at some of the underlying causes of the opioid addiction crisis and how we treat pain.
With age comes pain. Whether caused by injury, arthritis, cancer or any number of conditions, persistent pain affects up to four out of every five people age 65 and older.
While many turn to opioids and other medications, their risks, including the potential for abuse and overdose, are well known. Less well known (at least among the general public) are the added issues older adults can face when taking these drugs.
The older you are, the more likely you are to develop an adverse side effect from a pain medication, said Cary Reid, associate professor of medicine in the division of geriatric and palliative medicine at Weill Cornell Medicine and director at Cornells Translational Research Institute on Pain in Later Life (TRIPLL).
Those side effects, such as confusion and a heightened risk of falls, can be severe and can make doctors hesitant to prescribe pain medications to older adults. These drugs can also take longer to metabolize with age, meaning they can be more potent or stay in an elderly persons system longer than expected. And because many older adults take other medications too, theres also the risk of problematic drug interactions.
With the number of American seniors expected to almost double by 2060 to nearly a quarter of the population this all adds up to a growing need to find alternative treatments.
Thats where researchers like those at TRIPLL come in. One of 13 Roybal Centers that the U.S. governments National Institute on Aging has funded to improve the lives of older Americans, TRIPLL focuses on nondrug approaches to managing and preventing chronic pain.
Its casting a wide net, looking into alternatives that range from acupuncture and meditation to physical therapy, cognitive behavioral therapy and even mobile technologies.
Reporting Pain With Digital Health Technology
In one TRIPLL-funded project, Elizabeth Murnane, a postdoctoral scholar in the computer science department at Stanford University, and a team of researchers developed smartphone-based technology that adults 55 and older can use to self-report the intensity of chronic pain. The idea is to capture information about pain as it happens without burdening the patient, while serving as an alternative to pen-and-paper and verbal self-reporting measures commonly used in clinical settings or at-home methods that often suffer from low adherence or misreporting.
The test used nine different measures to capture the patients experience of pain, including a circle that fills with color when the interface is touched, and a widget for reporting pain with a numerical range of 0 to 10 that can be adjusted by tapping the screen. Early testing revealed some usability issues for older adults with low digital skills or motor, cognitive and visual impairments, so the researchers changed the design to be more touch and pressure-oriented, in part motivated by how wed sometimes observe our participants instinctually grasping the hand of a loved one or a chair or other object nearby in moments of pain, Murnane explained.
Now Murnane and her collaborators are working on a pain assessment tool that examines rhythms of pain intensity.
Many factors can influence the experience of pain age, gender, genes and how much sleep a person needs (and how much they actually get), Murnane said. Healthy functioning and synchronization of the circadian system is known to deteriorate with age, contributing to a vicious cycle of sleep disruption and exacerbated pain in older adults.
The researchers hope the data can be used to advance the basic understanding of pain and how it manifests in everyday life behaviorally, psychologically and physiologically as well as to design new tools for pain monitoring and management. For example, they hope to discover digital biomarkers of pain, which are bits of data collected with digital devices and wearables like smartwatches that can be used to explain or predict the presence of illness or disease. In Murnanes case, these markers could be someones degree of forward flexion or how far theyve walked on an inclined path, which researchers expect would correlate with pain severity, she said.
Emotion Regulation Therapy
Negative emotions are also associated with chronic pain typically, the more depression, anger, negativity and irritability that a patient feels, the more pain they report experiencing, Reid explained.
Weill Cornell Medicine psychologist Dimitris Kiosses and a multidisciplinary team of researchers have been working on a psychosocial treatment called problem adaptation therapy that aims to provide elderly patients suffering from chronic pain with techniques like deep breathing, relaxation and changing their perspective on a situation to decrease the impact of negative emotions and increase the impact of positive ones.
The goal there is to have people recognize the kinds of emotions they experience and to develop strategies to minimize negative emotions, because research has demonstrated a strong link between negative emotions and increased pain and pain-related disability, Reid said.
Barbara Chase, an 81-year-old New York City resident, learned valuable techniques for managing chronic back and nerve pain she experiences from Parkinsons disease by participating in this program. Shes never liked taking medicine, she said, and is amazed by how helpful some nondrug alternatives like listening to music and relaxing her body and mind can be in managing pain. Chase now likes to go to the gym, turn off the lights, and listen to music through her phone while stretching and doing other movement exercises, which she says takes her to another place.
It makes me relax and I just forget, Chase said. I dont think about it.
Relaxing by lying on the floor, closing her eyes, and spreading out like a bird has a similar effect, she said, adding that she can often feel her pain coming on ahead of time, and now knows to use these emotion-regulation techniques to get rid of it.
Its amazing, she said. And its free.
Behavioral Treatment For Older Adults With HIV
Older adults with HIV are a growing population with high rates of chronic pain and substance use, and decreased physical function. To address these issues, researchers supported by TRIPLL developed an eight-week behavioral pilot study in 2016 that incorporated weekly tai chi and cognitive behavioral therapy sessions and used text messaging to facilitate behavior change.
Results from a small randomized control trial were positive participants who took part in the CBT, tai chi and texting program experienced more pain relief, reduced substance use and improved physical performance compared to a control group who received standard care. Now the researchers are trying to obtain funding from the National Institutes of Health to support a similar but much larger trial.
Looking To The Future
Because many clinicians were trained to manage pain primarily with medication, educating them about nondrug approaches to pain management can be difficult, Reid said.
Another challenge is getting insurers to cover nonpharmacological pain management techniques, and without insurance coverage, many treatments become inaccessible for patients who cant afford the out-of-pocket costs.
Even finding places that offer those alternatives can be tough. Its often difficult in New York City, and if its difficult in New York City, imagine what it must be like if youre living in a very rural state, Reid said. Weve got to enhance the availability and dissemination of these kinds of tools.
Read more from the original source:
These Alternative Treatments May Be The Answer To The Pain Of Aging - HuffPost
- Ed's Guide to Alternative Therapies - pathguy.com - December 8th, 2016 [December 8th, 2016]
- Complementary and Alternative Medicine Guide | University ... - December 8th, 2016 [December 8th, 2016]
- Complementary and Alternative Medicine (CAM) Overview - December 26th, 2016 [December 26th, 2016]
- Alternative Medicine, Holistic Doctors,Naturopathic ... - January 5th, 2017 [January 5th, 2017]
- Alternative Medicine Degrees - Excite Education - January 13th, 2017 [January 13th, 2017]
- Alternative Medicine | Category | Fox News - January 13th, 2017 [January 13th, 2017]
- Alternative Medicine - Disabled World - January 13th, 2017 [January 13th, 2017]
- Alternative Medicine Degree, BS - Everglades University - January 23rd, 2017 [January 23rd, 2017]
- Alternative Medicine | Duke University Press - January 23rd, 2017 [January 23rd, 2017]
- Bill to rein in alternative medicine practitioners - Bangalore Mirror - February 8th, 2017 [February 8th, 2017]
- Peroxide ingestion, promoted by alternative medicine, can be deadly - Science Daily - February 8th, 2017 [February 8th, 2017]
- Can Peroxide Kill You? Yes, Say Doctors About This Alternative Medicine Favorite - Medical Daily - February 8th, 2017 [February 8th, 2017]
- Marijuana tension between clinical, alternative medicine ... - Washington Times - February 9th, 2017 [February 9th, 2017]
- Cannabis providers feel tension between clinical and alternative medicine - The Cannabist - February 11th, 2017 [February 11th, 2017]
- Happy Healthy YOU - Tillsonburg News - February 15th, 2017 [February 15th, 2017]
- Health dept cracks down on alternative meds containing sildenafil citrate - NYOOOZ - February 18th, 2017 [February 18th, 2017]
- Alternative Medicine Conferences | Traditional Medicine ... - February 24th, 2017 [February 24th, 2017]
- American Institute of Alternative Medicine - February 24th, 2017 [February 24th, 2017]
- Alternative medicine to treat pain and other ailments on the rise locally - Rockford Register Star - February 25th, 2017 [February 25th, 2017]
- Alternative Medicine Career Information and Education ... - February 27th, 2017 [February 27th, 2017]
- Why is alternative medicine so popular? - Alternative ... - February 27th, 2017 [February 27th, 2017]
- Potential dangers and dubious history of alternative medicine are often unknown to its consumers - MinnPost - February 28th, 2017 [February 28th, 2017]
- New form of alternative medicine comes to OU - Oaklandpostonline - March 1st, 2017 [March 1st, 2017]
- OPENING THE PLAYBOOK ON ALTERNATIVE MEDICINE - Dope Magazine - March 2nd, 2017 [March 2nd, 2017]
- Ask a Doctor: Is there an alternative medicine treatment for constant pain? - Chattanooga Times Free Press - March 7th, 2017 [March 7th, 2017]
- Alternative medicine grows in Sugar Land, Missouri City - Community Impact Newspaper - March 7th, 2017 [March 7th, 2017]
- Medicine with a side of mysticism: Top hospitals promote unproven therapies - STAT - March 7th, 2017 [March 7th, 2017]
- Abstracts: Obamacare Replacement, Alternative Medicine, and More - Undark Magazine - March 8th, 2017 [March 8th, 2017]
- For Prairie Village practitioner, personal experience led to interest in alternative medicine techniques - Shawnee Mission Post - March 8th, 2017 [March 8th, 2017]
- Financial Planning + Alternative Medicine - March 8, 2017 ... - KHTS Radio - March 9th, 2017 [March 9th, 2017]
- Premier U.S. Hospitals Are Selling Unproven Alternative Therapies ... - KQED - March 11th, 2017 [March 11th, 2017]
- Speakers lay stress on use of alternative medicine - The Nation - March 11th, 2017 [March 11th, 2017]
- Top U.S. hospitals promote unproven medicine with a side of ... - PBS - PBS NewsHour - March 11th, 2017 [March 11th, 2017]
- Medical cannabis expert discusses treatment options - Herald-Whig - April 8th, 2017 [April 8th, 2017]
- 5 ALTERNATIVE MEDICINES EVERY MAN SHOULD BE AWARE OF - TORO Magazine - June 6th, 2017 [June 6th, 2017]
- CID unearths fake 'council of alternative medicines' in Behala - Millennium Post - June 11th, 2017 [June 11th, 2017]
- Parents who believe in 'alternative nutrition' convicted after baby dies of malnutrition - Telegraph.co.uk - June 14th, 2017 [June 14th, 2017]
- Times of Malta Alternative medicine - Times of Malta - June 16th, 2017 [June 16th, 2017]
- Suffering from severe pain? Experts say THIS form of alternative medicine will work just as well as drugs! - Zee News - June 20th, 2017 [June 20th, 2017]
- IBAM Indian Board of Alternative Medicine - June 20th, 2017 [June 20th, 2017]
- Alternative medicine practitioner charged with sexual assault in Burlington - Hamilton Spectator - June 20th, 2017 [June 20th, 2017]
- Mind, body, spirit: Nurse opens holistic health store to promote overall wellness - Muscatine Journal - June 21st, 2017 [June 21st, 2017]
- Four of the Most Misused Terms in Alternative Medicine - ATTN: - June 24th, 2017 [June 24th, 2017]
- How cupping therapy helps athletes like Michael Phelps as an alternative medicine - Sport360 - June 26th, 2017 [June 26th, 2017]
- Calimesa Alternative Medicine - Weedmaps - June 26th, 2017 [June 26th, 2017]
- Homeopathic Health Center | Columbus, OH - (614) 890-2589 - June 26th, 2017 [June 26th, 2017]
- Alternative Medicine | What Is Alternative Medicine? - June 26th, 2017 [June 26th, 2017]
- Quotes About Alternative Medicine (30 quotes) - June 26th, 2017 [June 26th, 2017]
- Alternative Medicine That Doctors Recommend | Reader's Digest - June 26th, 2017 [June 26th, 2017]
- Alternative Medicine Schools - Excite Education - June 26th, 2017 [June 26th, 2017]
- Medical journal takes aim at natural remedies - CBC.ca - June 26th, 2017 [June 26th, 2017]
- Healing through alternative medicine: Winona locals choose acupuncture as a cure - Winona Daily News - June 26th, 2017 [June 26th, 2017]
- Patrick Noel, DC: Restoring the body's innate ability to heal through chiropractic care - Colorado Springs Gazette - June 27th, 2017 [June 27th, 2017]
- Back Pain? Try Yoga - New York Times - June 29th, 2017 [June 29th, 2017]
- Jerusalem: Alternative healer indicted on rape charges - The Jerusalem Post - June 29th, 2017 [June 29th, 2017]
- Does Pink Himalayan Salt Have Any Health Benefits? - TIME - June 29th, 2017 [June 29th, 2017]
- Not all wellness is bullshit - Quartz - June 30th, 2017 [June 30th, 2017]
- What's happening in your body during acupuncture? - The Verge - July 1st, 2017 [July 1st, 2017]
- Natural and Alternative Medicine against Asthma - Radio Cadena Agramonte - July 3rd, 2017 [July 3rd, 2017]
- Alternative Medicine in Halacha: a Review - Yeshiva World News - July 3rd, 2017 [July 3rd, 2017]
- West Bengal's top doctors turn out fakes, arrests blow lid off thriving scam - Hindustan Times - July 5th, 2017 [July 5th, 2017]
- Sudbury woman chooses alternative treatments for stage 4 cancer - CBC.ca - July 6th, 2017 [July 6th, 2017]
- Unbiased reporting can help call time on pseudoscience - EuroScientist - July 6th, 2017 [July 6th, 2017]
- Holistic therapy for pets? Traditional vet care being blended with reiki, acupuncture - Georgia Voice - July 7th, 2017 [July 7th, 2017]
- A Memoir of Chronic Fatigue Illustrates the Failures of Medical Research - The New Yorker - July 10th, 2017 [July 10th, 2017]
- Valtrex after expiration - Alternative medicine for herpes simplex 2 - Van Wert independent - July 11th, 2017 [July 11th, 2017]
- Sacred Space, University of Miami partner to educate community on wellness - Miami Herald - July 11th, 2017 [July 11th, 2017]
- One FDA About-Face Doesn't Mean an Orphan-Drug Bonanza - Bloomberg - July 12th, 2017 [July 12th, 2017]
- 'Bridging medicine with nature' - The Torrington Telegram - July 12th, 2017 [July 12th, 2017]
- Gwyneth Paltrow's Goop posted a defense of its jade eggs for vaginas. It's a mess. - Vox - July 14th, 2017 [July 14th, 2017]
- Acupuncture for pets? Yes, it's a thing - MyDaytonDailyNews - July 15th, 2017 [July 15th, 2017]
- Create Ministry for traditional, alternative medicine - Association - Graphic Online - July 17th, 2017 [July 17th, 2017]
- Native American healing class sparks unique health textbook - ABC News - July 18th, 2017 [July 18th, 2017]
- Rav Elyashiv ZTL On Alternative Medicine By R. Yair Hoffman - Yeshiva World News - July 18th, 2017 [July 18th, 2017]
- Expedite action on the passage of the alternative medicine bill ... - GhanaWeb - July 18th, 2017 [July 18th, 2017]
- Is Gwyneth Paltrow's pseudoscience winning? - Vox - July 20th, 2017 [July 20th, 2017]
- Salt Therapy Gaining Popularity in Alternative Medicine Circles - Newsmax - July 22nd, 2017 [July 22nd, 2017]
- Vargas: Weeding out herbal remedies for our pets - News Chief - July 24th, 2017 [July 24th, 2017]
- Patients recognise over-worked GPs as majority agree to see alternative medical professionals - Herald Series - July 25th, 2017 [July 25th, 2017]
- Cancer controversies and traditional medicines - Regina Leader-Post - July 26th, 2017 [July 26th, 2017]