I get really sad when I see an elderly patient, and they tell me: I don t usually tell my
doctor about my pain because it is just part of being old or I don t want to ask my doctor
for pain treatment because they will tell me it is all caused by arthritis and will
prescribe me strong painkillers or I know there is nothing to control my pain, so I
just endure it. These statements are all wrong. These are
all myths that people believe. And I know, many doctors also believe these myths.
Today I m going to talk about pain in older adults. I ll debunk some myths about chronic
pain in seniors, and I hope to leave you with a better, more optimistic viewpoint that older
adults do not need to be stoic. Stoic is a person who can endure pain or hardship without
showing their feelings or complaining. Let s talk about pain in older adults today.
I have a copy of this book, co-written and co-edited by my colleague Dr. Thomas Hadjistavropoulos,
from the University of Regina in Canada. You can find the link to purchase this book
on the description of this video. On Page 9 of his book he writes about myths that people
believe regarding pain in older adults: MYTH number 1. Experiencing pain is a natural
part of growing old. The FACT is that although pain accompanies many illnesses that affect
older people, like osteoarthritis or cancer, it is not the result of old age but a consequence
of disease, illness, or injury that needs to be treated or managed. If we think of pain
as a natural part of being old, we may be less inclined to treat it effectively. Persistent
pain needs to be managed regardless of a person s age.
MYTH number 2. Older adults suffer less than younger persons when they have pain problems.
The FACT is that older adults are likely to be affected by pain as much as younger persons.
MYTH number 3. I don t have the right to ask questions about my pain. The FACT is that
you have every right to information regarding your pain and its proper treatment. You can
discuss various treatment options with your physician.
MYTH number 4. Older adults can t tolerate strong painkillers. The FACT is that opioids
or narcotic painkillers, such as hydromorphone or oxycodone, can be appropriate medications
depending on an older person s condition. MYTH number 5. Analgesic pills are the only
means of treating pain. The FACT is that taking analgesic pills is not the only strategy for
pain treatment. I ll talk more about that later. There are many options, some of which
are even better than pills. The truth is that pain affects more than 50%
of older adults, and many doctors and nurses are not properly trained to assess pain, to
ask the right questions, and don t receive enough training on treating pain in older
adults. Many clinicians do not feel competent to tackle
the problem, and they have discomfort asking questions as they don t know what to do with
the answer. So, older adults avoid talking about their
pain, and healthcare professionals avoid asking about it.
But pain does not go away just because you don t talk about it. Actually, if you don
t confront pain sooner the problem gets worse with time. For example, a back pain that is
not treated earlier may cause the person to avoid walking and become sedentary. Then,
osteoporosis will worsen, and the person may have a bone fracture, aggravating the pain
even more. Before I move on, let me remind you that this
video is for educational purposes only. For any individual diagnosis and treatment, please
talk to your doctor. If you have an emergency, go to the nearest emergency department, or
call 911. I know that seniors have many health issues
to discuss with their doctors, and they have many health concerns that they want to get
treatment for, like heart problems, cancer, or dementia. But pain is also a serious issue
that must be brought up at the doctor's appointment. When pain is poorly assessed and treated,
it leads to poor quality of life, physical and emotional suffering.
Pain is a complex experience. It involves not only the body but also the emotions, sleep,
mood and enjoyment of life. Because pain affects so many areas of our lives, we recommend a
multidimensional treatment of pain. I explain this as the 5M IS for the treatment of chronic
pain. People with chronic pain need to have many tools in their toolbox and learn when
and how to use each tool effectively. Pills or medications are only one of the tools
that we have in the toolbox. That is the first M. There are various types of medications
that we use for pain. I explain anti-inflammatory drugs in this video. There are other types
of pills that are vitamins and supplements. I recommend Vitamin D supplements to all of
my patients, you may watch this video about Vitamin D. There are other supplements that
are indicated for some kinds of pain. You may watch my other videos about magnesium,
vitamin B12, curcumin, Coenzyme Q10, Omega-3, glucosamine and chondroitin.
There are other types of pain pills that we can use too. These are opioid analgesics and
some medications like
antiepileptic or anticonvulsants, and antidepressant class of medications that can be used to treat
chronic pain. The second M is for mind-body therapies. I
explain in another video that these interventions are extremely important to fix the pain system.
If the pain system is overactive, the volume of pain is increased, and these mind-body
therapies will work on reducing the pain volume and pain memory. It is interesting that the
majority of older adults with chronic pain do not seek treatment with psychologists.
One of the very effective types of psychological intervention is Cognitive Behavioural Therapy.
This kind of therapy works very well for pain, in any age group.
The third M is for movement. Exercise is essential in the treatment of chronic pain. Actually,
there is a lot of high-quality evidence from scientific studies that the benefits of exercise
are equal or bigger than medications, and not only that but they last longer. If you
take a pill, the effect is usually a couple of hours. if you exercise, initially your
muscles may hurt a bit, that is normal and it is okay. But then, the benefits of the
exercises will last days, weeks or months. I have a couple of videos about exercises
on my channel. If you read the comments on these videos you will see for yourself that
exercises work for a variety of pain conditions: osteoarthritis, tendinitis, bursitis, plantar
fasciitis, lumbar disc disease, sciatica, spinal stenosis, and myofascial pain.
One of my videos of exercises for hip and knee osteoarthritis has more than 2.5 million
views and 3,000 comments. Here is a comment posted by Teresa Ceolin: Thank you so much
for providing these exercises for OA. After 3 days of doing your exercises, I already
feel much less pain and have more range of motion for my hips. I am very grateful to
you and will recommend you. God bless you for all your work for people suffering pain.
Another video of exercises for shoulder pain has more than 1.5 million views and 1600 comments.
Here is a comment posted by Jean Jenkins: These exercises are excellent for my shoulder
problem. I suffer with rotator cuff tear. They have improved the mobility of my shoulder.
Thank you, Dr. Furlan I have many other videos on my channel. So,
press the subscribe button now and the notifications to receive alerts when I post new videos here.
The fourth M is for modalities. These can be physical modalities such as heat, ice pack,
acupuncture, laser or electrotherapies like TENS.
The fifth M is for manual therapies, and they are therapies like massage, manipulation,
and mobilization. The I is for injections or interventional
pain procedures. These include steroid injections, trigger point injections or nerve blocks.
And the S is for surgery, this could be joint replacement like a knee or hip arthroplasty
or the implant of a spinal cord stimulator. In summary, if you are a senior and you are
suffering from chronic, ongoing, persistent pain, talk to your doctor. If your doctor
does not have the resources to help you, ask to be referred to a multidisciplinary pain
clinic, a clinic with a variety of professionals that could include nurses, social workers,
psychologists, physiotherapists, occupational therapists, pharmacists and many others.
Pain is not a natural part of getting old. When a child has pain, the parents will do
anything possible to find the cause and treatment for their child s suffering. It should not
be different just because you are a senior. We have so many strategies to reduce pain,
not only pills, that it is unfair to seniors not to have access to these interventions
just because of their age. Oh, before I forget, you can download a document
that contains the script of this video. Go to the description of this video below and
click on the link. Thank you for watching. Good bye.