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    Boomer Pain Booming

    Pain management will continue to be an important facet of health care as America's baby boomers age and more of them develop chronic illnesses. If you are fighting pain, tell your doctor. There are many pain treatments that can give you relief, and others

    Changing How We Think About Pain continued...

    Campbel says that for people 50 and older, the best pain management approaches for arthritis and low-back pain start with the idea that pain should be treated according to the intensity and duration of pain, patient expectations, and patient tolerance.

    If pain is severe and sudden, then it might be appropriate to try to control it with an anti-inflammatory drug, such as Advil, Aleve, or Motrin, he says. In April 2005 the FDA asked that over-the-counter anti-inflammatory drugs -- except for aspirin -- revise their labels to include information about potential heart and stomach ulcer bleeding risks. If anti-inflammatory drugs do not work and pain is severe or even disabling, then use of narcotic painkillers should be considered, he says.

    New Treatment Options

    There are many new pain treatments under development, Portenoy says. These include disease-specific treatments, such as procedures that treat compression fractures of the spine to relieve back pain. New drugs called sodium-channel blockers specific for pain cells are under development, as are chemicals isolated from plants, such as hot peppers, that could reduce inflammatory pain that occurs when people have diseases like arthritis.

    For the kinds of severe pain often seen in cancer patients, there are new, more specific narcotic or morphine-like pain medications under development, says Patrick W. Mantyh, PhD, a research scientist at the Minneapolis Veterans Administration Medical Center and a neuroscientist at the University of Minnesota.

    "These new, synthetic opioids may have fewer side effects than the kinds of drugs we now use to fight cancer pain and other severe pain," says Mantyh. "There are numerous other potential targets, as signaling in the pain system has many distinguishing molecular features that might make good drug targets."

    But many pain specialists stress that they already have many good treatment options for pain. A big part of the chronic pain problem in the U.S. comes from reluctance on the part of patients to discuss pain.

    "That's a big reason for the new pain-treatment mandates," says Mantyh. "It isn't that we can't effectively treat pain in most patients. It's that many patients are way too willing to suffer quietly, not knowing that help is available -- that there is no need to suffer sometimes."

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