This week, we speak with Beth Harriman, an Administrative Assistant in Hamilton, Ontario, Canada.

Can you tell me about when you first started experiencing the pain and what kind of pain it was?

About a 1-1/2 yrs ago I started waking up with back pain if I stayed in bed too long. It’s pain in my lower back and feels like a muscular ache. Some nights I will wake up and 2 or 3 in the morning unable to get comfortable. Other nights I sleep through the night but wake with pain and stiffness.

Did you seek help right away?

I didn’t seek help right away because I’m not one to go to the doctor every time something hurts. I did finally go to my family physician after about 8 or 9 months with no relief. We tried buying a new bed, thinking our bed was getting old and was not supporting my back well enough. The new bed has helped to ease it a bit, but not relieve it completely.

What did the doctors tell you when you did seek help?

My doctor sent me for diagnostic tests, including x-rays and ultrasound to rule out organ problems. Nothing of concern was seen. My physician and I agreed that it is likely muscle pain.

What have you tried to help you with your pain?

Stretching, exercises, new bed, pillow between knees, hot water bottle, sleeping on my back, propping knees up with pillow, moving around more during the day (I work at a desk and sit a lot).

Can you tell me a bit about what worked and what didn’t?

Stretching and back exercises seem to help a little.

How does having this pain affect you in terms of how you live your life?

Sleeping is difficult and obviously I’m not getting a restful sleep. I find I’m tired throughout the day.

If you were to look back over what you have tried/haven’t tried, would you change anything?

I would have visited my physician sooner.

Would you like to add anything?

Got a cure?

Thanks for talking to us Beth. If I hear of a cure, you’re on my list. J

Image: iStock.com

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Company’s calling – back pain

According to the Merck Manual of Geriatrics, “In one study, pain prevalence in the elderly ranged from 36 to 88%, and prevalence may be higher among nursing home residents. In the US, about 1/5 of elderly people take analgesics at least several times per week, and 2/3 of these people take prescription analgesics for > 6 mo. In the elderly, the most common sites of pain are joints, and the most common causes of pain are musculoskeletal disorders.”

That’s a lot of people suffering with pain and it’s not new news either. In 1998, Daniel A. Monti, M.D. and Elisabeth J. S. Kunkel, M.D. wrote in an article, Practical Geriatrics : Management of Chronic Pain Among Elderly Patients, “The prevalence of persistent pain increases with age; increases in joint pain and neuralgias are particularly likely. A majority of elderly persons have significant pain problems. Persistent pain interferes with activities of daily living and quality of life, yet detection and management of chronic pain remain inadequate. In one study, 66 percent of geriatric nursing home residents had chronic pain, but it was not detected by the treating physician in 34 percent of cases.”

Part of solving the problem is recognizing there is one, so if you are caring for a senior, or you are a senior, you are not out of line to insist on pain management – on proper and effective pain management, that is.

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Pain under-recognized in seniors

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What type of chronic pain do you have?

The FDA (the US Food and Drug Administration) has issued its second warning about a medication, the Fentanyl skin patch. Fentanyl is a restricted medication that should only be used for moderate to severe long-term pain, however, some doctors are prescribing it for shorter term pain, such as relief following surgery.

Fentanyl is a great medication for thousands of people who are receiving it for the right reason; however, if it is being used incorrectly, it can lead to overdose and death.

In Canada, fentanyl skin patches go by the brand name Duragesic®.

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FDA Warning: Fentanyl Patch

I’d like to put together a glossary on different medical terms used when treating or managing pain. So many times healthcare professionals (including myself) will use words without realizing that they may not be understood or, worse, misunderstood.

I’ll start on that but you can all help, if you want. If you have come across a word or term that you didn’t understand, please submit it and we’ll include it in the glossary. The more comprehensive it is, the better it will be for everyone all around.

The words or terms can be as simple as describing the difference between acute pain (short-term, usually sudden pain that usually has a specific cause) and chronic pain (pain that lasts 3 or more months, can come and go, may or may not have a specific cause), or defining what is neuropathic pain (pain that comes from the nerves). We can add names of medications and treatments as well.

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Putting together a pain glossary

When is pain something serious, something you shouldn’t ignore? I know most of us have had at least one time when something hurt and we’ve wondered about the seriousness of it; is it something to shake off or something to get checked?

There are some types of pain you should never put off. A false alarm is better than ignoring a potentially fatal health issue.

1 – Chest pain

Although heart attacks can be felt differently between men and women, chest pain is nothing to fool around with and if you even have an inkling that you may be having chest pain due to your heart – get this checked. Right away.

Signs and symptoms of a heart attack include:

• Discomfort in the chest – this could be a feeling of pressure or squeezing, or outright pain. It can be constant or transient (coming and going)
• Discomfort from the chest that spreads to one arm (particularly the left), the jaw, the back, or down to the stomach
• Feeling short of breath, unable to catch your breath

For more signs and symptoms, check out the list at the American Heart Association.

2 – Pain in the calf of the leg

Blood clots can form in the deep veins of the body, but most often in the calf of your leg – these clots, called DVTs (deep vein thrombosis) occur most often in people who have had a history of DVT, had recently had surgery, trauma or broken bone, and those who are unable to move about or who have restricted movement. More risk factors can be found on this National Heart and Lung Institute page.

The signs and symptoms include:

• Sudden pain or tenderness in the leg, may appear or increase when you are walking
• Swelling in the leg Redness or swelling over one spot on the leg

This is an emergency and needs to be attended to as soon as possible. If not, the clot can move from the leg and go to the lung – this can be fatal.

The signs and symptoms of a pulmonary embolism, when the clot gets to the lungs are:

• Sudden shortness of breath
• Pain when breathing, especially deep breaths
• Coughing up blood

3 – A headache like you’ve never felt before

While most headaches are benign (harmless other than the pain), severe sudden headaches, could be the sign of something serious, such as an aneurysm, a bulging of an artery in the brain that can burst.

Brain Aneurysm Resources is a good site for reading up on more information on this topic.

Don’t take chances with your life. Get that pain checked. We want to see you back here!

Images: iStock

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Pain you should never ignore