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.
To comment on this article, contact
editor@uspharmacist.com.
Published May 15, 2006