US Pharm. 2006;5:8.       

Everyone feels pain once in a while--a stiff neck, a sinus headache, a cut or burn--but many patients experience persistent pain. Recurring pain may be due to accidental injuries, musculoskeletal problems, migraine or neuropathic pain syndromes, psychological stress and tension, for example. We know that individuals perceive pain differently; what is tolerable pain to one person may be intolerable to another. Assessing the patient's pain is an important function of the clinician treating older adults who have cognitive impairment. Pharmacists should be familiar with common behaviors that are associated with pain (see the Senior Care article, page 30).

This month's editorial focus is pain and its treatment. Joint pain is one type of health problem that may have several causes and may result in significant interference with one's activities. The knees and back are prime targets for arthritis, especially in overweight individuals. Over time, skeletal misalignment--such as one leg being slightly shorter than the other--may cause pain. Persistent pain often leads to loss of sleep and depression.

More and more Americans are choosing complementary and alternative medicine (CAM) strategies to ease their pain (see TrendWatch, page 11). Over two thirds of the U.S. population use CAM therapies, including herbal remedies, homeopathic products, and nonpharmacologic approaches such as massage. Other techniques used to reduce pain include electromagnetic therapy, hypnosis, light energy, and aromatherapy. The growth rate in the number of people using CAM is 15% per year. In my surrounding communities, there are increasing numbers of integrative medicine centers, lectures and workshops on antiaging medicine, yoga/tai chi centers, and older people walking briskly around the neighborhood. There's also an independent pharmacy specializing in natural and alternative products and nutritionals.

Even the youngest of the 1946-1964 baby boomers are now over age 40 and eager to try any means to relieve their pain. In an article published last spring,* University of Pennsylvania School of Medicine, Philadelphia, researchers Katz and Rothenberg discuss the usual prescription and over-the-counter drugs to treat arthritis pain and add, "Nonpharmacologic therapies such as exercise, physical ther apy, and psychologic counseling may also diminish pain and improve outcome in patients with rheumatic diseases. One may also consider yoga, acupuncture, biofeedback, massage, relaxation techniques, and other alternative therapies."

The fitness craze has not reached everyone. For the young and old alike, when pain becomes a part of daily living, the motivation to seek relief runs high. Think about what you recommend to your patients seeking pain relief. Do you ask what methods they have tried and if it works? E-mail me at LSimonsen@jobson.com and list what your patients are doing to be free of pain.

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