Most of us believe that aging and pain go hand-in hand.
Here to explain why that doesn’t have to be the case is Dr. Ankur Patel, an interventional pain physician with Novant Health Pain Management -Lexington and Thomasville.
We spoke with Patel about how we can prevent pain while we age – and address pain if we’re already experiencing it.
If you take away nothing else remember this much:
- Staying active can make a huge difference as we age.
- If pain sets in, start tracking it so you have a good record if you seek care from a doctor.
- You don’t have to settle for a life with pain – get help.
Are you hurting? Ask your doctor about a referral to a pain management specialist.
What are the most common causes of pain that you see in your practice?
The most common causes are muscle injuries or spasms, joint pain (especially in the neck), disc pain, pinched nerves (sciatica), pain from cancer or cancer treatment, or diabetic pain (neuropathy).
Are any of these causes of pain preventable?
Most of these are preventable, especially if we treat the underlying conditions. For example, for diabetes, if your blood sugar is controlled, you will be less likely to have neuropathy.
We can prevent muscle injuries and spasms and joint pain through regular low-impact exercise, being physically active and maintaining flexibility, strength and a healthy weight.
Are there particular exercises to do—or not to do—to prevent pain and injury?
Core strengthening is hugely important because our spine takes the load from our entire body, so if we strengthen our core, it protects the spine and reduces the risk of back pain. Planks, bridges, and leg lifts can help strengthen your core.
Maintaining proper posture can go a long way. So can stretching daily and being aware of how we are working, especially if we are working at a desk. This can prevent back and neck pain.
Lifting incorrectly causes a lot of injuries. The further away the object you’re lifting, the more pressure you’re putting on your back. Instead, keep things close to you and your body, and bend your knees and hips as you lift items.
Also, stay hydrated, quit smoking, avoid prolonged sitting, and have regular checkups with your physician.
Everyone knows we’re supposed to do all the things. But I’ve never heard anyone say, “Hey, if you do these, you’ll have less pain as you age.”
You don’t know what’s good for you until you see the consequences down the road. It’s hard to put it into perspective for patients. But trust me, basic steps like these are a huge investment in your quality of life as you get older.
I’m 37. What can someone my age do to prevent pain as they age?
Sometimes it can be a chore to exercise, so I say, find something you like to do. If you like to swim, if you like to do Pilates, if you like to cycle—make that your exercise so you’re more likely to do it. It’s a really great way of preventing these chronic conditions in the future.
If you do develop an injury or chronic pain, there’s a lot of things we can do. Many are not invasive, like medications, physical therapy, acupuncture, massage and more—so see a specialist like myself or one of my partners so we can try to help you break out of the pain cycle early.
The majority of patients in their 40s and 50s will have back pain, but 90% of those will resolve on their own or with a short course of physical therapy. The worst thing you can do is ignore recurring pain – so if you throw out your back every few months, don’t ignore it. That can cause more damage down the road.
Do your recommendations change at a certain age? Is there an age where you say, “no more lifting,” or “hang up your hiking boots?”
My goal is to keep patients functioning and doing everything they want to do. It’s my job to help them figure out how to do that.
I don’t like to restrict patients, but maybe we have to adjust the way they lift or play a certain sport or do a modification. I have golfers all the time who have hip pain when they swing, so we adjust how they’re swinging to prevent further hip inflammation and keep them golfing. My job is to help you work toward your goals.
Are there vitamins or supplements that can help prevent pain as we age?
There’s a big push now for an anti-inflammatory diet and supplements. Some things that come to mind are Omega 3 fatty acids, turmeric and curcumin, which are good anti-inflammatories. Collagen supplements can help with collagen formation. Glucosamine can help with cartilage health. They’re definitely an option to consider, but we have to be very careful.
These supplements and foods aren't highly regulated, so a lot of them can affect your current medications if you have chronic conditions. Before adding any supplements into your routine, talk with your physician and see if the benefits would apply to you.
Beyond the physical toll of pain, what else do you see with patients?
Pain is not just physical. There are emotional and psychological components to how we perceive pain and what our body does with that pain.
When patients get into a chronic cycle of pain, it becomes an emotional and psychological cycle. This leads to a heightened perception of pain, and they can’t break out of the cycle. It’s surprising to patients how complex it is.
So, what should we do if we feel pain, and when should we notify our doctor about it?
If the pain isn't getting better, if it feels worse, if you’ve tried and exhausted other therapies like medication, and if you’ve worked with your primary care clinician and tried what they recommend, then it may be appropriate to ask your primary care provider for a referral to a pain specialist.
How can I make it easier for you to diagnose and treat my pain?
Keep a pain diary. Write down your symptoms on a bad day. Where is the pain located? How long does it come and go, or is it constant? Describe it in words—is it sharp, pain, burning, electrical, aching?
These words tell us what may be causing it and help us clue into what medications may work best. What makes the pain better and what it makes it worse? Is it better when you stand or sit? How far can you walk? What are you not able to do in your normal daily life? What have you tried already to address it? Diagnosis comes from history, so if you can help us get a great history, we can better know what is causing the pain.
If you’ve had imaging done (X-rays, MRIs, etc.), make sure we have access to it, so we have more information during our first appointment.
Patients come in to see me thinking they have to live in pain for the rest of their life. That's not accurate. It's not just “surgery” or “live in pain in the rest of your life.” There are lot of things in the middle that we can help you with.
What’s a common example of patients you help?
I had one gentleman in his late 60s whose pain was so bad he couldn’t sit with his family for dinner, go to his grandkids’ games, or spend time with friends. He was not a candidate for surgery. In our consult, I asked him what was important to him, and he said, “All I want to do is be able to go on walks with my wife.”
We were able to get him walking more with some minimally invasive procedures, which really went a long way toward his quality of life. The small things in life are what really matter to a lot of patients.
If you’re in pain, discuss your options with a specialist early so we can help you work toward your goals. Whether your goal is playing with grandkids, golfing, hiking, or going for walks with your wife — those are things we can help you with.
What is a pain specialist?
According to the American Academy of Pain Medicine, pain specialists prevent, evaluate, treat and rehabilitate people who are in pain.
Pain specialists have completed medical school, residency and board certification in a medical specialty before completing additional training and certification on pain and how to treat it. They may work as part of a team along with a primary care physician and/or other specialists, or act as the main clinician.
You may be referred to a pain specialist when:
- You are in pain, but there is not an obvious cause for the pain after extensive testing completed by your primary care clinician.
- You have tried many of the initial treatments for pain recommended by your doctor and are still in pain.
- You are experiencing pain that lasts longer than the expected time of healing — also known as "chronic pain.”
- You need a minimally invasive procedure or a surgical procedure to reduce or manage pain.
- You need pain medication management.
Each pain specialist will approach pain management uniquely depending on their background and the procedures and treatments they have been trained to provide. It’s important to make sure you get matched with the right pain specialist for your needs and goals. For example, are you open to surgery, or are you hoping to avoid it? Are you open to taking pain medication, or not?
