Older Adults and Pain Medication
New guidelines recently released said that nonsteroidal
anti-inflammatory drugs (NSAIDs), which include ibuprofin and Alleve, and COX-2 inhibitors like Celebrex, should be virtually
eliminated as analgesics in older adults’ medicine cabinets under
updated geriatric pain management guidelines. Although the American
Geriatrics Society once recommended these agents before consideration
of opioids for patients 75 and older with persistent pain, it now calls
this strategy too risky.
Persistent pain is common
among seniors, and if
ignored or incorrectly treated, pain may cause falls, functional
impairment, disruptions in sleep, depression and anxiety, and increased
healthcare costs. However, the
cardiovascular risk and gastrointestinal toxicity of NSAIDs usually
outweigh the benefits of using them.
For most seniors,
acetaminophen (Tylenol, Excedrin) should be considered as “initial and
ongoing pharmacotherapy in the treatment of persistent pain,
particularly musculoskeletal pain,” the guidelines said. They noted that the
presence of liver disease and/or chronic alcohol use can be contraindications to these drugs.
Journal of the American Geriatrics Society
Spinal Degeneration: an aging process?
By age 30, about one-third of the population will show osteoarthritic
changes on spinal X-rays, and by 70 years of age degenerative joint
disease is almost universal. However, the process of spinal degeneration may not be an inevitable part of
aging. This is evident from the fact many older people have healthy,
well-preserved discs and no sign of disc or joint degeneration. Yet
severe degenerative change can be seen in young adults if there has
been trauma or prolonged, abnormal spinal stress, such as the result of
postural distortion and misalignment.
In most individuals, spinal degeneration is still considered largely a “wear and tear”
condition. In simplest terms, the spine is comprised of vertebra separated from
one another by discs (analogous to cushions or sponges). As we age,
these discs undergo subtle biochemical changes resulting in a loss of
thickness and cushioning ability.
Evidence suggests these alterations in the disc may be the result of chronic
undernourishment due to faulty spinal mechanics, rather than an
inevitable part of the aging phenomenon. Faulty spinal mechanics
is primarily the result of accidents, microtrauma and postural
distortions. Trauma and abnormal posture produces misalignment of the
spine, further contributing to spinal wear and tear.
Chiropractic care can
significantly benefit osteoarthritis sufferers by gradually improving
movement in dysfunctional joints and through restoring normal spinal
curves and alignment. In addition to pain relief, chiropractic care
may also assist in preventing further degeneration from occurring. The most important contribution chiropractic care can have to spinal health, however, may lie in prevention. Through
maintaining optimum joint movement and spinal alignment, regular
chiropractic care can help prevent spinal degeneration from starting in
the first place.
Structural Integration, is a form of soft tissue manipulation and
movement education, which has the ability to dramatically change your posture
and structure. It aims to align and balance all the components of your body by
addressing the soft tissue, known as the fascia, within the context of how your
body relates to gravity. If your interested in learning more or have always wanted to try Rolfing, I suggest Cody Smolik
practices in Black Rock
Physical Therapy/Pilates on 2889 Fairfield Avenue. Her numbers are 917-544-4412 or 203-345-7573. She is available to work with specific issues or introduce
you to the series that Structural Integration has to offer.