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Chronic pain in elderly

Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
October 14, 2016: Clinical Therapeutics
Chandra Prakash Pal, Pulkesh Singh, Sanjay Chaturvedi, Kaushal Kumar Pruthi, Ashok Vij
BACKGROUND: Among the chronic rheumatic diseases, hip and knee osteoarthritis (OA) is the most prevalent and is a leading cause of pain and disability in most countries worldwide. Its prevalence increases with age and generally affects women more frequently than men. OA is strongly associated with aging and heavy physical occupational activity, a required livelihood for many people living in rural communities in developing countries. Determining region-specific OA prevalence and risk factor profiles will provide important information for planning future cost effective preventive strategies and health care services...
September 2016: Indian Journal of Orthopaedics
Jennifer Greene Naples, Walid F Gellad, Joseph T Hanlon
When possible, chronic noncancer pain (CNCP) in older adults should be managed by nonpharmacologic modalities in conjunction with nonopioid analgesics. If moderate-to-severe pain persists despite these approaches, however, nonparenteral opioids may be considered as adjunctive therapy. This article reviews the epidemiology of opioid use and their effectiveness for CNCP in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly...
November 2016: Clinics in Geriatric Medicine
Tammy Vu Bach, Jonathan Pan, Anne Kirstein, Cindy Joanne Grief, Daphna Grossman
Palliative care clinicians are increasingly involved in the care of elderly patients suffering from chronic malignant and nonmalignant illnesses, of which neuropathic pain is a prevalent problem. As a person becomes more frail, pain medications such as opioid analgesics and adjuvant pain medications can result in unwanted effects such as sedation, confusion, and increased risk of falls. Treating pain in patients with advanced dementia or neurodegenerative diseases that can affect swallowing is particularly challenging because most adjuvant pain medications used to ameliorate neuropathic pain must be taken orally...
October 11, 2016: Journal of Palliative Medicine
Paweł Kleczyński, Maciej Bagieński, Artur Dziewierz, Łukasz Rzeszutko, Danuta Sorysz, Jarosław Trębacz, Robert Sobczyński, Marek Tomala, Maciej Stąpór, Dariusz Dudek
PURPOSE: Restoration of quality of life (QoL) and improvement of clinical outcomes is crucial in elderly patients undergoing transcatheter aortic valve implantation (TAVI). We sought to evaluate changes in QoL and all-cause mortality 12 months after TAVI. METHODS: A total of 101 patients who underwent TAVI were included. Patients were followed for 12 months. QoL was assessed at baseline and at 1, 6 and 12 months after TAVI using EQ-5D-3L with a visual analog scale (VAS)...
October 10, 2016: International Journal of Artificial Organs
Benjamin D Elder, Timothy F Witham
Low back pain is highly prevalent, affecting a vast majority of the adult population at some point in their lifetime. Thorough history and physical examination is critically important in evaluating these patients and screening for potentially serious conditions. Imaging should be guided by the history and physical examination, particularly when there is concern for serious conditions and/or a focal neurological deficit present. Adequate treatment of patients with low back pain often requires a multidisciplinary approach, involving several medical specialties...
October 2016: Seminars in Neurology
M K Nicholas, A Asghari, F M Blyth, B M Wood, R Murray, R McCabe, A Brnabic, L Beeston, M Corbett, C Sherrington, S Overton
This study compares the outcomes, from pre-treatment to 1 year follow-up, of an outpatient, CBT-based pain self-management program (PSM) that included exercises, pain education, and pain coping strategies, with a control condition (EAC) that included exercises and a control for the attention of the treatment team. We previously reported short-term results (to 1 month follow-up) from the same study. This new paper considers the important issue of maintenance of treatment-related gains. The participants (n = 141) were a heterogeneous sample of ambulant, community-dwelling older adult chronic pain patients (mean age: 73...
September 24, 2016: Pain
M Stravinskas, P Horstmann, J Ferguson, W Hettwer, M Nilsson, S Tarasevicius, M M Petersen, M A McNally, L Lidgren
OBJECTIVES: Deep bone and joint infections (DBJI) are directly intertwined with health, demographic change towards an elderly population, and wellbeing.The elderly human population is more prone to acquire infections, and the consequences such as pain, reduced quality of life, morbidity, absence from work and premature retirement due to disability place significant burdens on already strained healthcare systems and societal budgets.DBJIs are less responsive to systemic antibiotics because of poor vascular perfusion in necrotic bone, large bone defects and persistent biofilm-based infection...
September 2016: Bone & Joint Research
José-Luis Barnay, Andre Cabie, Sylvie Abel, Emilie Javelle, Odile Troisgros, Patrick René-Corail
Arboviruses cause very recurrent epidemics, the oldest Dengue, known especially outside the flu-like syndrome with high fever mainly impacting vulnerable populations, may be responsible for severe hemorrhagic fevers, but also a few cases of Guillain-Barré syndrome. In 2014, the French Antilles occurred an outbreak of Chikungunya, following that of the Reunion's outbreak. During this period have been described, the articular and musculo-squellettic lesions, responsible for loss of autonomy in populations already carriers of chronic inflammatory joint damage or mechanical, but also a heavy impact on the autonomy of elderly and frail people...
September 2016: Annals of Physical and Rehabilitation Medicine
Eduardo E Rocha, Erika M Suzigan, Joao Ep Almeida, Mauricio A Luz
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Golnar Alamdari, Luciana Laganà
BACKGROUND: Physical pain is very common in older age and is often accompanied by depressive as well as PTSD symptomatology. Many conceptualizations of the comorbidity of pain with depression and with PTSD exist, but they need to be tested on older adult populations. PURPOSE: This article covers existing literature on the relation between depression and pain in older age, as well as between older adults' PTSD and pain. Additionally, several physiological, cognitive, and behavioral conceptualizations of why depression and PTSD are often related to pain are presented...
2015: Journal of Geriatric Medicine and Gerontology
Nathalie Wrobel, Tahmine Fadai, Stefanie Brassen, Ulrike Bingel
: The prevalence of chronic pain rises with increasing age. It has been suggested that the mechanisms responsible for the development of chronic pain overlap with mechanisms involved in aging, potentially implicating age-related changes in descending modulatory pathways. This observation raises the question whether other forms of endogenous pain modulation, in particular placebo analgesia, become compromised with age. Because of the known contribution of placebo effects to analgesic treatment outcomes this question is of important clinical relevance...
September 13, 2016: Journal of Pain: Official Journal of the American Pain Society
Jojanneke J G T van Summeren, Flora M Haaijer-Ruskamp, Jan Schuling
OBJECTIVES: To explore an outcome prioritization tool (OPT) in eliciting individuals' preferred health outcomes (remaining alive, maintaining independence, reducing pain, reducing other symptoms) in the context of medication review in family practice. DESIGN: Cross-sectional pilot study with mixed-methods design. SETTING: Family practice. PARTICIPANTS: Multimorbid individuals (N = 60; aged ≥69) with polypharmacy (≥5 chronic medications) derived from the practice lists of a purposive sample of 13 family physicians (FPs)...
September 9, 2016: Journal of the American Geriatrics Society
Manoj Kumar Pattnaik, Sarada Prasanna Sahoo, Sameer Kumar Panigrahy, Kalyani Bala Nayak
Morgagni hernias (MHs) are rare and constitute about 2% of all diaphragmatic hernias. Although uncommon, it has potential for considerable morbidity if the diagnosis is missed. An elderly woman with known history of chronic asthma and constipation presented to us with vague right-sided chest pain. General physical examination was unremarkable and coincidentally diagnosed to have diabetes mellitus. Chest roentgenogram posteroanterior view revealed a right paracardiac opacity and right lateral view showed the opacity in the peridiaphragmatic area of anterior mediastinum...
July 2016: Lung India: Official Organ of Indian Chest Society
Joanne Hui Min Quah, Pei Wang, Roderica Rui Ge Ng, Nan Luo, Ngiap Chuan Tan
AIM: Older adults are susceptible to two or more chronic ailments or multimorbidity. The present study aimed to establish the relationship between multimorbidity and health-related quality of life (HRQoL) amongst Asian elderly patients in primary care in a developed nation. It also assessed how functional disability and chronic musculoskeletal pain are associated with HRQoL. METHODS: A cross-sectional study was carried out in a Singapore public primary care clinic...
August 31, 2016: Geriatrics & Gerontology International
M Seretny, L A Colvin
Vascular disease covers a wide range of conditions, including arterial, venous, and lymphatic disorders, with many of these being more common in the elderly. As the population ages, the incidence of vascular disease will increase, with a consequent increase in the requirement to manage both acute and chronic pain in this patient population. Pain management can be complex, as there are often multiple co-morbidities to be considered. An understanding of the underlying pain mechanisms is helpful in the logical direction of treatment, particularly in chronic pain states, such as phantom limb pain or complex regional pain syndrome...
September 2016: British Journal of Anaesthesia
Ryan Hulla, Michael Moomey, Tyler Garner, Christopher Ray, Robert J Gatchel
This study examined the biopsychosocial characteristics of chronic low back pain (CLBP) in an understudied but increasingly larger part of the population: the elderly (i.e., 65 years and older). A new innovative physical functioning measure (postural control, which is a proxy for the common problem of slips and falls in the elderly) was part of this biopsychosocial evaluation. Also, the National Institutes of Health (NIH)-developed Patient-Reported Outcome Measurement Information System (PROMIS) was also part of this comprehensive evaluation...
August 23, 2016: Healthcare (Basel, Switzerland)
Tracy Jackson, Sarah Thomas, Victoria Stabile, Matthew Shotwell, Xue Han, Kelly McQueen
BACKGROUND: The global burden of chronic pain is projected to be large and growing, in concert with the burden of noncommunicable diseases. This is the first systematic review and meta-analysis of the prevalence of chronic pain without clear etiology in general, elderly, and working populations of low- and middle-income countries (LMICs). METHODS: We collected and reported data using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, excluding acute pain or pain associated with a concurrent medical condition...
September 2016: Anesthesia and Analgesia
Yeon-Gyu Jeong, Yeon-Jae Jeong, Jung-Wan Koo
[Purpose] This study investigated the flexion-relaxation phenomenon of the erector spinae in elderly women with chronic knee osteoarthritis and determined whether the flexion-relaxation phenomenon can be used as a pain evaluation tool in such cases. [Subjects and Methods] Seventeen elderly females with chronic knee osteoarthritis and 13 healthy young females voluntarily participated in this study. They performed three postural positions in 15 s: trunk flexion, complete trunk flexion, and trunk extension, each for 5 s...
July 2016: Journal of Physical Therapy Science
Kathleen Broglio, Joseph Pergolizzi, Maribeth Kowalski, Shau Yu Lynch, Ellie He, Warren Wen
In elderly (≥75 years) individuals, age-associated physiologic changes and a higher prevalence of comorbidities, polypharmacy, and increased susceptibility to medication-induced side effects complicate pain management. Hysingla(®) ER (HYD) is a once-daily, single-entity, extended-release hydrocodone formulation approved for the treatment of chronic pain that is insufficiently controlled by alternative treatments. In this post-hoc analysis of a previously reported study, the effectiveness and safety of HYD for the treatment of moderate-to-severe chronic pain among the elderly (≥75 years) for a 52-week duration was investigated...
August 5, 2016: Geriatric Nursing
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