Non-drug approaches for pain management in older adults
Gerald W. Clum, D.C.
Today, approximately 43 million people aged 65 or more years reside in the United States, and according to the U.S. Department of Health and Human Services, nearly 70% of this population will need long-term care and services.
Paralleling the rise of the aging population is the higher incidence of pain and susceptibility to adverse effects of pain medication. Approximately 25 to 50% of community-dwelling older adults report significant pain problems, with the prevalence of pain in geriatric nursing home residents documented to range between 45 and 80%.
With those in residential facilities experiencing potential physical, psychological, social and financial burdens, the need for healthcare models that can minimize these challenges is apparent.
Non-pharmacologic pain management options, including chiropractic care, offer a safe and effective alternative for the geriatric population.
An estimated 5 million patients aged 65 or more years are cared for by chiropractic doctors, placing chiropractic care as the most commonly sought form of alternative healthcare.
Providing a drug-free, hands-on approach to acute and chronic neuro-musculoskeletal pain — a leading cause of disability in older adults — chiropractic services are documented to yield improved clinical outcomes, reduced costs and high levels of patient satisfaction.
As the population ages, musculoskeletal tissues show increased bone fragility, loss of cartilage resilience, reduced ligament elasticity, loss of muscular strength and fat redistribution, decreasing the ability of the tissues to carry out their normal functions. These changes impose on the functional performance required for independent living and contribute to frailty and fracture risk.
And although the most common reason older adults seek chiropractic care is for musculoskeletal conditions, chiropractic doctors also are trained in the management of overall health and general wellness and can help to enhance quality of life, reduce injuries and falls, and improve physical function through various care approaches, including spinal adjustments, nutritional counseling, strength training and balance exercises.
In fact, recent research demonstrates that good sagittal alignment, muscle strength and physical ability reduce the risk of falling, whereas poor posture, reduced strength and other functional shortcomings trigger the opposite.
The problem remains that opioids often are prescribed for acute and subacute spinal pain, including low back pain, despite low-quality evidence regarding their use in this circumstance.
In their pursuit to meet patient need and demand for instant pain relief, American doctors often default to prescribing (and over-prescribing) narcotic painkillers, with nearly one-third of Medicare beneficiaries receiving at least one commonly abused opioid, such as oxycodone or fentanyl.
Communities caring for seniors should educate residents of the dangers associated with opioid prescription painkillers and the benefits of alternative pain management options, including chiropractic.
Chiropractors who are well-trained in health assessment, diagnosis, radiographic studies, health promotion and illness prevention are well-positioned to provide many primary healthcare services to older adults.
In a rapidly aging society, care providers must deliver safe and effective care plans to this important segment of society through continued research and education on alternative care.
For additional information about the dangers of opioid prescription painkillers and the benefits of chiropractic care, download the white paper “Chiropractic: A Safer Strategy Than Opioids.”
Gerard W. Clum, DC, is president emeritus of Life Chiropractic College West and director of The Octagon, Life University.
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