Is Chronic Pain on the Rise?

Chronic pain relief becomes critical as baby boomers age.

From the WebMD Archives

As the first baby boomers hit their 60s, many are finding life hurts a bit more than it once did. Whether playing tennis, lifting a basket of laundry, or just getting out of bed, pain -- for some, chronic pain -- is a new companion.

"We have an aging population," says Robert Bonakdar, MD, director of pain management at the Scripps Center for Integrative Medicine in La Jolla, Calif. "As the baby boomers get older, we're going to have more and more people with chronic back pain, osteoarthritis" and other painful conditions.

But while previous generations may have been more willing to accept pain as an inevitable consequence of aging, experts say many baby boomers won't stand for it.

"I think that baby boomers are less likely to accept the status quo," says Steven P. Cohen, MD, an anesthesiologist in the division of pain medicine at Johns Hopkins School of Medicine. "They have a sense of entitlement. Living the rest of their lives in chronic pain is just unacceptable."

The good news is that they're right. Just because some painful illnesses become more common as you get older doesn't mean you're doomed to suffer. You should not accept living in chronic pain -- not when plenty of treatments offer pain relief.

Chronic Pain: Why Are We Hurting?

The causes of pain aren't so surprising. As people age, their sins catch up with them. A lifetime of minor injuries -- a stress fracture from jogging in your 30s, a bad back from lifting a couch in your 40s -- can add up to serious pain.

"You see a lot of back pain, neck pain, knee pain, joint pain, and pain from falls, and tears and other injuries in baby boomers," says Christopher L. Edwards, PhD, assistant professor of psychiatry and medical director of the Biofeedback Laboratory at Duke University School of Medicine.

The boomer generation can be stubborn about fitness, says Edwards. "Some baby boomers have the same exercise regimen at age 60 that they had thirty years before," Edwards tells WebMD. "Their bodies can't keep up with them."

And while keeping active is important at every age, unfortunately bones weaken and muscles atrophy over time. These are facts of life. If you push yourself too hard, you can get hurt. Sometimes, that injury becomes a source of chronic pain.

Disease can play a hand, too. Pain can stem from arthritis, diabetes, and cancer. Pain after surgery can become chronic. Painful syndromes, like fibromyalgia and irritable bowel syndrome (IBS), also cause suffering.

"With almost every medical condition, the incidence of pain increases with age," says Cohen.

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Is Chronic Pain More Common Now?

As baby boomers age, the number of people with painful conditions like osteoarthritis will rise. Current estimates of those living with chronic pain range from 50-65 million. But is the average person more likely to be in pain than he or she used to be? Experts aren't sure.

"If I had to guess, I'd say that the incidence of pain is probably about the same as it's always been," says Edwards. "What has changed is our way of talking about it."

Cohen argues that this new perspective on pain has had a big effect. He says that 40 years ago, pain after a mastectomy was reported to be about 5%. Now, some studies show it to be as high as 50%. Obviously, surgery wasn't less painful forty years ago. But where people in the past may have simply struggled through potentially debilitating pain, now we ask for help.

"As health care has improved, the whole medical profession has focused more on quality of life rather than just life," says Cohen. Chronic pain relief has become an important goal in its own right.

And people gain that relief differently, often taking one -- or several -- approaches, including:

Prescription Drugs and Chronic Pain Relief

Narcotic painkillers like OxyContin, Percocet, and Vicodin are widely associated with chronic pain relief -- and with addiction. However, experts generally say the dangers of abuse are overstated.

"The fact that there is a potential for abuse of these drugs doesn't diminish their value in treating pain," says Edwards. "There just needs to be a balance." Every medication has drawbacks, and deciding to use one is always a matter of weighing the benefits and risks.

And with some medications there are potentially grave risks. Painkillers called Cox-2 inhibitors -- like Bextra, Celebrex, and Vioxx -- were heralded as wonder drugs a few years ago. Then research showed that for some they posed a risk of heart attacks and strokes. (Bextra also posed a risk of serious skin reactions).

Of these drugs, only Celebrex is still available, and the FDA requires it to carry a strong risk warning.

Surgery or implanted devices -- like pain pumps -- are sometimes helpful for severe chronic pain, though of course surgery has its own risks. If you feel you need a new approach to managing your chronic pain, talk to your doctor.

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Over-the-Counter Drugs: Do-It-Yourself Pain Management?

Many people prefer finding pain relief with over-the-counter drugs rather than seeing a doctor. "We're a do-it-yourself culture," says Penney Cowan, executive director of the American Chronic Pain Association. "And it's obviously a lot easier and cheaper to buy a bottle of painkillers than it is to see a doctor."

That's usually OK, so long as you're only using over-the-counter drugs occasionally and as directed on the label.

But pain is sneaky. It can worsen so gradually you don't notice. It starts with an occasional ache you treat with a couple of painkillers. But over a few years it can become relentless. And your "occasional" use of a nonprescription painkiller has turned into a daily ritual of downing a handful of pills. That's a cause for concern.

"People severely underestimate the dangers of over-the-counter painkillers," says Cowan.

Some of the most problematic are NSAIDs (nonsteroidal anti-inflammatory drugs) like aspirin, Advil, Aleve, and Motrin. Taken regularly, they can result in serious gastrointestinal bleeding and may also raise the risk of cardiovascular problems. What's worse, the older you are, the more likely you are to have complications from these drugs, says Cohen.

A Holistic Approach to Chronic Pain Relief

But drugs and other medical treatments aren't the only solution. Some baby boomers are turning to unorthodox new techniques -- or very old ones - for chronic pain relief.

Complementary medicine is designed to work alongside conventional medical treatment and includes options like:

Bonakdar says baby boomers are more open to these approaches to pain relief than previous generations. And some approaches, like acupuncture, biofeedback, and massage have been shown to help ease pain in scientific studies.

And while other approaches may not have the same evidence backing them up, your doctor might still encourage you to try them if they have no risks.

However, supplements -- like vitamins, herbs, and botanicals -- can have serious side effects and interact with other drugs. Make sure your doctor knows about all the ones you use.

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Taking Control of Your Health -- and Chronic Pain Management

Getting older is inevitable. And as your body ages, the likelihood of illness increases. But that doesn't mean you have to accept chronic pain passively.

Baby boomers have a reputation for being demanding about their health care. Yet plenty of people in their late 50s and early 60s are in pain but aren't getting relief. If you're one of them, speak up. You deserve to have your pain managed, says Cowan.

"There's a saying that while pain is inevitable, suffering is not," says Cowan. "We do not have to suffer." No matter your age, you never need to settle for living with chronic pain.

WebMD Feature Reviewed by Ephraim K Brenman, DO on August 15, 2007

Sources

Published Nov. 6, 2006.

SOURCES: American Academy of Pain Medicine, press release, "Pain Facts." American Cancer Society web site: "Biofeedback." Robert Alan Bonakdar, MD, director, integrative pain management, Scripps Center for Integrative Medicine, La Jolla, Calif. Steven P. Cohen, MD, associate professor, department of anesthesiology and critical care medicine, division of pain medicine, Johns Hopkins School of Medicine, Baltimore. Corbin L. Cancer Control, July 2005; vol 12: pp 158-164. Penney Cowan, executive director, American Chronic Pain Association, Rocklin Calif. Christopher L. Edwards, PhD, assistant professor, psychiatry; medical director, Biofeedback Laboratory, Duke University, Durham, N.C. National Cancer Institute web site: "Acupuncture PDQ." Stewart WF. The Journal of the American Medical Association, Nov. 12, 2003; vol 290: pp 2443-2454.

© 2006 WebMD, Inc. All rights reserved.

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