Oh, My Aching Back
Pain is important not because it disrupts our lives, but because it's a signal that we need to pay attention; something is wrong. And that something wrong can be either acute pain, typically from an injury which disappears when healed or from chronic pain which persists beyond the normal tissue healing time. A standard measure of "normal healing time" is estimated to be three months.

The Over-The-Hill Gang
As people age they're more likely to "grin and bear it" even though pain can interfere with work, daily living and sleep and result in depression, anxiety, social withdrawal and sometimes lead people to deal with pain by using alcohol. Older adults have been known not to follow doctors' orders and take pain medications only "as needed" when pain is severe. Frequently elders are undermedicated for pain because they don't want to complain, are afraid they'll become addicted to the medications or believe everyone they know has pain, "So what's the big deal anyway?" The lesson, according to Dr. Molton is to "speak up" talk to your physician, family and friends and seek help.

Pain and Dementia
According to Dr. Molton those with dementia can usually communicate about their pain. But it's a challenge to try to figure out how much pain the person is experiencing if he can't communicate or remember very well. He suggested changes in activities, walking gait, agitation, wandering, social withdrawal, moaning, chanting and fast breathing all may be indicators of pain.

Two Approaches
For acute pain health care providers focus on physical factors — for instance if you fell and broke your foot, the cause would be your foot colliding with concrete causing physical damage. For chronic pain, providers are identifying psychological, behavioral and social factors and developing treatment plans to address each factor for individual patients. This doesn't mean chronic pain is all in your head. It does mean that the way each person thinks about and behaves with chronic pain can make a big difference in his life. So, if you break your foot follow the doctor's orders, don't go dancing and take your medication as directed. For those experiencing chronic pain follow Professor Molton's easy and reasonable tips.

Pain Tips

• Talk to your doctor
• If possible, take medications on a "scheduled" basis rather than "as needed and as determined by you" — regular schedule over time is the key here!
• Exercise and stretch — it's good for you and will help distract you from the pain
• Use what works for you — hot/cold treatments, massage or acupuncture
• Pace yourself — break big physical tasks up into smaller tasks — take it easy
• Rest on a regular basis not in response to the pain at the moment — regular schedule again is important here
• Talk to others who have pain — maybe a support group or just your close friends
• Try to finish tasks without asking for help in response to pain, unless it's dangerous
• Learn how to communicate with your spouse and family about pain in a helpful way so they can understand how to help and support you
• Don't make a mountain out of a mole hill — negative thoughts are never the best medicine
• Relax

Alternatives to Consider
For chronic pain there are some alternatives that you might consider such as yoga, meditation and guided imagery and some options from the technology age like biofeedback and electrical stimulation. We know that the mind-body connection applies to everyone, but what works for one person may not work for someone else. So be open to exploring what might work for you.

A Great Ending
At the end of the evening participants were able to try the ancient art of meditation and see the technology of biofeedback in action with our very own Linda Asami, Nikkei Concerns Special Projects Manager and Volunteer Coordinator. Those attending left with greater knowledge about pain and an appreciation for how pain can be affected by each person's thoughts and behavior. The program series was funded in part by the Shigeo and Megumi Takayama Foundation.

Learn more about Aging Successfully! in the Fall 2007 Tayori