Do you suffer with chronic pain? If you do, you’re far from alone: according to the CDC, roughly 50 million Americans are chronic pain sufferers, with “chronic” defined as pain lasting three months or longer. The CDC report warns that “debilitating” pain “has been linked with depression, Alzheimer’s disease and related dementias, higher suicide risk, and substance use and misuse.” For one American adult in five, chronic pain is a serious health crisis.
For that reason, we were intrigued to read this recent article on chronic pain published by NextAvenue. According to author Meg Lambrych, a health reporter who is also an RN and health trainer, recent medical research has revealed that the best cure for chronic pain may not be what you think. “While surgery and pain medications can have impact,” says NextAvenue, “it turns out that regular physical activity is the most potent and least invasive pain reliever available.” Let’s take a deeper look at this important topic.
Chronic Pain is Not an Inevitable Part of Aging
There are certain traits and conditions that we take for granted as being part and parcel of the aging process, Lambrych says, and since life-disrupting chronic pain is experienced by 85 percent of adults over 60 it often falls into that category.
“However,” she writes, “you may be shocked to learn that there is no inevitable physiological process that older people experience that is guaranteed to cause pain. Studies show chronic pain conditions lessen with age, and your ability to perceive pain may diminish with time.”
To begin the article, Lambrych poses the following, thought-provoking questions:
“If pain isn’t inevitable, what separates older adults who suffer from chronic pain from those who don’t?” and “How can someone with chronic pain lessen their symptoms and improve their quality of life?”
Chronic Pain Can Have Many Causes
While we all have some idea of what chronic pain is, it helps to have a clear definition. “According to the Cleveland Clinic,” Lambrych explains, “chronic pain is pain that lasts over three months and negatively impacts your life. Untreated chronic pain is a huge issue for older adults and can lead to falls, injuries, a loss of independence, depression and anxiety.”
The societal idea that pain is a normal part of aging makes it less likely for older people to seek treatment, which can lead to a lot of unnecessary suffering. Lambrych lists these as the most-common pain culprits for people over 60:
*Musculoskeletal conditions
*Neuropathy
*Arthritis
*Fibromyalgia
*Connective tissue disorders
Treating Chronic Pain in Seniors Presents Challenges
There’s a certain “stiff upper lip” mentality among older people, which Lambrych calls a “stoic approach”, that often combines with the pervasive fear of opioid medication addiction to create a lot of needless and silent suffering.
“Yet the actual risk of older adults becoming addicted to opioids is low, only 3 percent, according to a study published in the Pain Medicine journal,” Lambrych writes. “So, while there certainly are some medications that older people should avoid, traditional medical treatments, including surgery and pain medication, are safe and effective ways to treat some causes of chronic pain and should not be overlooked.”
One Powerful Weapon Against Chronic Pain: Exercise
It’s no secret that, here on the Blog, we are big proponents of regular physical activity. Moreover, according to Lambrych, you can add “pain relief” to the long list of benefits that regular exercise can provide for you. In fact, she calls it “the most potent and least invasive pain reliever available.”
Melissa Koehl, a physical therapist with over two decades of experience, specializes in helping patients with connective tissue disorders treat their chronic pain. “I have worked with a lot of older adults who would greatly benefit from lifting (weights) but are afraid to start. It takes some work to get them on board,” Koehl says.
Lambrych asked Koehl for her top pain management tips for older adults. Here’s what she said.
Releasing Endorphins: Feel Better, Hurt Less
“Regular exercise, such as cardio or strength training, can reduce chronic pain symptoms in two ways,” Lambrych explains. “First, it releases special chemicals called beta-endorphins, which act as natural opioids in the body. These endorphins not only produce that happy post-exercise haze, but they treat pain directly by acting like morphine on affected pain receptors.”
This is one of the reasons why regular exercise is such an excellent way to manage chronic pain, increase overall pain tolerance, and boost mood and energy levels. Koehl highlighted strength training, in particular, which releases the most endorphins; she calls it “crucial” for people over 60.
“I can’t think of a single situation where I would not encourage my patient to participate in strength training,” says Koehl, in large part because it helps to fight off bone and muscle loss and strengthens tendons, all vital benefits for older adults.
“All of these adaptations will keep you moving with less pain for longer,” Lambrych writes. “But no matter what type of exercise you choose, regular activity releases endorphins, improves mobility and effectively treats chronic pain symptoms.”
Getting Started on an Exercise Plan to Reduce Chronic Pain
Koehl notes that there is no “one-size-fits-all” approach to exercise, and every person needs to choose the right program that will address their holistic health best. And while strength training already has lauded benefits, older adults with connective tissue disorders (such as hypermobile Ehlers-Danlos syndrome, or hEDS) should seek proper supervision while they slowly build up their exercise routine.
Here are Koehl’s five best tips for treating chronic pain with exercise for adults over 60:
Get medically evaluated first. Koehl is clear that exercise is vital for older people, but it’s still important to know what your “baseline” is before you jump into a new routine. She suggests getting “evaluated by your health care professional to understand the source of your pain and to get cleared for physical activity” before you begin.
Consult a physical therapist if possible. If it’s within your budget and ability to do so, Koehl encourages older adults to seek out a physical therapist, calling them “movement experts”.
“Depending on your state and insurance status, you may need to see a doctor to get a referral first. Check with your insurance company for their services and the best care access,” Lambrych adds.
Work with a qualified and experienced fitness professional. We all know how important it is to learn a new skill from someone who is more experienced than we are, and exercise is no different. However, Koehl urges caution: personal training has a relatively low barrier to entry, and does not require advanced training or education, so it’s important to be discerning in your selection. Lambrych explains, “It’s crucial then that you vet your trainer and make sure they are certified with a reputable training body such as the International Sports Science Association (ISSA), National Academy of Sports Medicine (NASM) or American Council on Exercise (ACE). In addition to being certified, your trainer should have ample experience working with older adults with complex medical histories. They should thoroughly intake and adjust your training program to your current needs and goals.”
Go slow. It’s tempting to want to see results right away, but Koehl says that progression with exercise is going to be based on your own unique exercise history and current level of fitness. “If you’re a former competitive athlete, you will likely progress faster than someone who has never touched a weight,” Lambrych writes. Koehl advises us to remember that exercise is not a race. When in doubt, progress slowly. Lambrych adds, “Older adults with complex medical conditions will likely require more rest between sessions as they adjust, so you must listen to your body and rest when needed.”
Movement is play, so have fun! Koehl understands that when you’re in pain, the last thing you want to do is get up and move. But try to remember that all exercise releases endorphins, and this will reduce pain and give you more energy. “Keep trying different types of movement until you find one you love,” she says.
Lambrych concludes with this note on motivation, “If you’re struggling with motivation, try a fitness class or a walking group for added company and accountability. Sometimes, the only thing that gets us moving is knowing someone is counting on us, and that’s ok. All movement is good; there’s no better time to start than now.”
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(originally reported at www.nextavenue.org)