Kiplinger's Retirement Report, Vol 7, Issue 1, January 2000

page 16 - Retirement Living

At some point in our lives, most of us have experienced pain"after an accident or surgery, for instance. It hurts, sometimes acutely, and then it goes away. Chronic pain, on the other hand, is pain that lingers on and on, and it can be profoundly debilitating. Intractable pain can even cause tissue damage.

The good news is that dozens of pain-management centers around the country are finding better ways to help those in chronic pain. The newest approaches deemphasize drugs and focus more on teaching patients how to cope with their pain and get on with living without giving up or giving in.

A survey conducted for the National Council on the Aging found that one in five older Americans takes a pain medication five or more times a week. The most common reasons for seeking relief are arthritis, cancer, back pain, spinal disorders, shingles, complications from diabetes and nerve damage, says neurologist Robert Gerwin, who heads the Pain and Rehab Medicine Clinic in Bethesda, Md.

NEW STRATEGIES FOR SUFFERERS

Stress reduction, exercise and even meditation may be part of a pain-management program. Patients suffering from arthritis, for example, may be able to avoid the need for prolonged medication by retraining and reconditioning the muscles that support the affected joint.

This kind of multidisciplinary approach is what draws patients to the Mayo Clinic's 22-year-old Pain Rehabilitation Center in Rochester, Minn. By the time people come to the clinic, they've already seen an array of surgeons and specialists, and they're looking for a new approach to manage a very complex problem, says John Hodgson, the clinic's program coordinator.

The rehab center teaches people to recognize their pain triggers and to minimize the body mechanics or other behaviors that aggravate their condition.

The newest pain-management practices don't mean patients will be deprived of medications that can control their pain, even narcotics such as those derived from opium. For instance, those with unrelieved excruciating pain may be given a surgically implanted pain pump to help them. But most people will be encouraged to wean themselves from relying too much on aspirin or ibuprofen because they may damage the protective lining of the stomach and cause internal bleeding.

page 16 - Retirement Living

" The American Academy of Pain Management (13947 Mono Way, #A, Sonora, CA 95370; 209-533-9744; www.aapainmanage.org) has a list of the pain centers it accredits on its Web site.

" The American Chronic Pain Association (916-632-0922; www.theacpa .org) is a nonprofit group with nearly 450 chapters nationwide. Call for the location of the nearest support groups in your area.

" The American Geriatrics Society (212-308-1414; www.americangeriatrics .org) will send you a free copy of Aging with Ease: A Guide to Pain Management on request. It was developed from the Society's recently published AGS Clinical Practice Guidelines: The Management of Chronic Pain in Older Persons (the executive summary is on the Web site).

" The American Pain Foundation has a Web site (www.painfoundation.org) with consumer health information, related links and a list of accredited pain-treatment facilities.

" The American Pain Society posts the locations of pain-management facilities nationwide on its Web site at www.ampainsoc.org.

" Mayo Clinic on Chronic Pain ($14.95; 800-291-1128), edited by David Swanson, M.D., is a comprehensive guide to the self-management of chronic pain. The book is written in plain English and contains useful sections on understanding pain, taking control of it, special exercises, and interacting with family and friends. The book also discusses medications and how to find an appropriate pain-management center.

" The National Chronic Pain Outreach Association (P.O. Box 274, Millboro, VA 24460-9606; 540-862-9437) is a membership organization that offers a quarterly newsletter and an extensive list of publications and tapes on chronic pain. Membership is $25 a year.

From Kiplinger.com