Chronic Pain Syndrome
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Age Appropriate Pain

At some point in life, many people just don't feel the way they used to. The run that once cleared your head now just makes you uncomfortably aware of your knees. Or you've got achy joints that make you feel "old."

Although it is not uncommon with age to experience new aches, it isn't normal to be in pain; that's a sign that something is amiss.

No two pains are alike, and it's hard to predict what you may feel as you age. But there are certain pains that are more common at certain ages. Here's a look at the types of pain that sometimes accompany aging -- and what to do about it.

4 Golden Rules for Pain

No matter what your age or ailment, heed these guidelines when you feel pain:

Deal with it head on. "Sucking it up" or denying pain is never a good idea, says Michel Dubois, MD, director of research and education and professor of clinical anesthesiology at the NYU School of Medicine.

Acute pain -- the kind that comes on suddenly -- should be treated as quickly as possible to prevent it from becoming a chronic pain condition, which is defined as pain lasting more than three months. In other words, CALL YOUR DOCTOR IMMEDIATELY.

Check on vitamin D. Ask your doctor to check your vitamin D levels to make sure you're not deficient. According to Sam Moon, MD, MPH, associate professor in the division of occupational and environmental medicine at Duke University Medical Center, vitamin D can be helpful in preventing micro fractures and alleviating pain that stems from fractures associated with osteoporosis.

Avoid obesity. Extra pounds put tremendous strain on the body, increasing your chances of experiencing chronic joint and lower back pain.

Get enough sleep. A lack of sleep can worsen pain and contribute to muscle tightness and depression. If you aren't sleeping well, and changes like going to bed earlier and developing good sleep habits don't help, check with your doctor to see if you have a sleep disorder and find out what can be done to help you get a good night's rest.

Watch for depression. Chronic pain is often accompanied by depression, which often goes unrecognized. Depression not only makes it more difficult to deal with physical pain, it magnifies it. If you have chronic pain, tell your doctor how you're feeling emotionally. 

In Your 30s

Pain problem: Headaches

Headaches are one of the most common types of pain experienced by people in their thirties, Moon says.

Although headaches can plague people throughout their lives, they seem to be more common in midlife, Moon says.

Studies have shown that migraines, which are two to three times more common in women than in men, tend to peak between ages 35-45. Tension-type headaches -- the most common type of headache -- feature constant (rather than throbbing) pain and pressure, and may increase with age.  

The fix: Seek solutions.

The cause of many headaches is unknown, which can make treatment tricky. So if one treatment hasn't worked, persist and try another.

"Work with someone you trust to get a diagnosis," Dubois says. "There are treatments for each of these [headache] conditions," he says. "But don't expect instant reward."

If you get migraines, Moon suggests identifying your migraine triggers. "Many people are sensitive to lights, foods, wines, or cheese. "Sometimes not eating regularly or caffeine withdrawal can be the trigger," Moon says.

Acupuncture and mind/body techniques, such as yoga, mindfulness stress reduction and relaxation training, and cognitive behavioral therapy (CBT) can be helpful for headaches, as well as for chronic pain of any kind.  Your first step would be to ask your doctor to refer you to a Board Certified physician specializing in Chronic Pain Management.

Pain problem: Straining the Body

In your 30s, you may start paying -- in pain -- if you push yourself physically the way you did when you were younger.

Overuse syndromes such as muscle pain and tendonitis -- an inflammation of the tendons, which attach bone to muscle -- are also common during the 30s. Lower back pain may start for some people at this age, along with problems with the rotator cuff (shoulder) and tennis elbow in the late 30s and early 40s, Moon says.

The bottom line: Your margin of error is shrinking. You're less likely to get away with repetitive motions done with bad joint alignment.

The fix: Get your body in sync.

"You must learn the proper way to use your body that takes full advantage of how the body is designed," Moon says.

That means being mindful of things like using your legs when you lift to avoid putting pressure on your back and avoiding working with your arms above your head, which puts too much pressure on your neck and shoulders.

Pay attention to how you use your body during hobbies, cooking, driving, and other daily activities. By changing the tools you use, the way you sit at your desk -- anything that can pull your body out of proper alignment -- you will protect yourself from future injury and pain.

 In Your 40s and 50s

Pain problem: Arthritis and Back Trouble

"This is [the age] when osteoarthritis and degenerative disk disease commonly begin to show themselves," Moon says.

Degenerative disc disease causes the disks -- which act as shock absorbers for the spine and allow it to flex, bend, and twist -- to dry out and become brittle. This can cause pain, limit range of motion, and irritate muscles or tendons. Chronic back or neck pain, as well as pain in the hands, knees, and hips may also begin during these years.

The two most likely groups of people to experience arthritis pain at this age are the very fit who injure themselves in midlife by overdoing exercise, and "those who do nothing to keep their bodies fit," Dubois says.

A total lack of exercise can cause stiff joints, shoulder pain, and hip pain.

The fix: Take a conservative approach to treatment.

When it comes to treating short-term joint and lower back pain, nonsteroidal anti-inflammatory medications (NSAIDs) such as aspirin and ibuprofen may help, but people often make the mistake of giving up too quickly, Moon says.

"It may take 10-14 days of regular dosing for the full anti-inflammatory benefit [from NSAIDs] to kick in. Often, people abandon them too early," Moon says. The same is true of prescription medications with side effects that cause people to stop taking them before they have a chance to make a difference.

When dealing with chronic back pain, many people in the U.S. rush too quickly to surgery, Dubois says.

"People think that something is mechanically wrong and [that the back] should be fixed like a car," he says. But it's not that easy; the back pain often returns, worse than before, after two years, Dubois says. "It's not the miracle cure."

He suggests finding a Pain Management physician who can determine the best course of action. It may be trying massage therapy, physical therapy, spinal and muscle injections of corticosteroids (which reduce inflammation), local anesthetics, or a combination of both to relieve pain. Acupuncture has also been shown to be very effective. He encourages people to be persistent and try various treatments until they get some relief.

Fix: Develop strength and balance with the help of your Pain Management doctor.  Make sure that you donít try new exercises or strengthening techniques that will make it worse.

Strengthening your core muscles, which include your abs, is also important for low back pain. Your lower back is better supported when your abdominal muscles are strong.

Also work on strengthening the quadriceps muscles -- which are between your hip and knee cap on the front of your upper leg -- during your 40s and 50s.

"I think quad strengthening helps in fall prevention. It helps people who have back pain to learn to use their legs more so they don't have to use their back so much. It helps prevent knee pain as well," Moon says.

And if you haven't already started working on your balance, now is the time, because as you age, you're more likely to fall. Moon recommends the martial arts Tai Chi or Qigong to strengthen the quadriceps and improve balance. These practices involve meditation, slow graceful movements, and controlled breathing.

In Your 60s, 70s, and Beyond

In your 60s, 70s, and beyond, arthritis and degenerative spinal disc disease become more common and can become a significant source of pain. Again, medications and holistic treatments such as acupuncture and yoga can be very helpful.

Broken bones from falls become a greater concern, as does pain associated with diseases such as cancer.  With serious medical conditions, sometimes pain isn't prioritized because the focus is on the disease.

That's a mistake. "If pain stays too long in a cancer patient, it by itself can become a major aspect of the disease," Dubois says. Not addressing pain also hampers quality of life.

The fix: Make pain care a priority.

Pain that keeps you awake at night and impacts social and family life often causes a patient's condition to worsen quickly, which is why it must receive its own treatment so it doesn't take over your life.

Effective pain management will reduce the pain, increase your quality of life and improve your overall daily outlook.


Fiaz Jaleel, MD
106 Boston Avenue, Suite #205
Altamonte Springs, FL 32701

Phone: 407-673-8999
Fax:  407-678-1246

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