Water therapy can help improve pain, fatigue, and quality in patients with fibromyalgia

A recent review presented the current perspectives on water therapy. Water therapy combines the benefits of water’s physical properties and exercise to help improve symptoms of fibromyalgia. It is recommended as a nonpharmacologic approach for fibromyalgia patients to improve pain, fatigue, and quality of life. The review also discussed the biological mechanisms underlying its use for pain management and its effect on the musculoskeletal, neuromuscular, cardiovascular, respiratory, and neuroendocrine systems and inflammation.  [Learn More] - posted 8/1/2019

Knee pain an important factor of fall-related walking patterns

A recent study explored the association between knee pain and fall-related gait, or walking, patterns by examining 439 older adults with different falls and knee pain status. Individuals with a history of falls had wider strides and longer double support time (both feet on the ground). Fallers with knee pain had narrower strides and greater hip range of motion. These findings suggest that knee pain is an important consideration for designing fall prevention interventions.  [Learn More] - posted 7/29/2019

a senior lady practicing yoga
Yoga can improve function, balance, and quality for chronic pain and type 2 diabetes

A recent study examined the effects of an 8-week yoga intervention for people with chronic pain and Type 2 Diabetes Mellitus compared to usual care. The average age of participants was 55 years and individuals in the yoga intervention group had significant improvements in pain interference, upper and lower extremity strength, balance, and quality of life. The results suggest that yoga might help improve function, balance, and quality of life in individuals with chronic pain and type 2 diabetes.  [Learn More] - posted 7/26/2019

Balance impairments in individuals with chronic low back pain

A recent review examined the static standing balance of people with chronic low back pain (CLBP) compared to healthy controls. Impaired balance can lead to greater fall risk and potential for injury. While most of the reviewed studies were on younger samples, most found that individuals with CLBP had worse overall performance compared to healthy individuals, which suggests that treatment of CLBP should involve balance training to improve safety.  [Learn More] - posted 7/17/2019

Chair yoga could help pain, fatigue, and function for lower extremity OA

A study recently examined the effects of an 8-week Sit ‘N’ Fit Chair Yoga program on pain and physical function in older adults with lower extremity osteoarthritis (OA) who can’t participate in standing yoga. Individuals in the chair yoga group had greater reductions in pain, pain interference, and fatigue, and saw improvements in gait speed for 3months after the program ended. Chair yoga might be a promising alternative for older people with lower extremity OA who can’t participate in standing yoga.  [Learn More] - posted 7/12/2019

Higher chronic musculoskeletal pain sites associated with lower physical activity
A woman sitting alone

A recent study examined the association between number of chronic musculoskeletal pain sites and pain severity with objectively measured physical activity in community-dwelling older adults. In a sample of 267, lower step count was found to be associated with a higher number of chronic musculoskeletal pain sites and moderate to vigorous physical activity. This suggests that the number of chronic musculoskeletal pain sites is associated with lower physical activity.  [Learn More] - posted 7/10/2019

Worse pain severity, disability, and function among African Americans with Osteoarthritis

A recent review examined differences in clinical pain severity between african americans and non-hispanic whites with osteoarthritis (OA). The study reviewed 224 articles with samples of differing age groups and found higher pain severity, higher self-reported disability, and worse objective performance testing in African Americans. Future studies should explore the reasons behind these differences in outcomes among racial/ethnic groups to help improve pain management.  [Learn More] - posted 7/8/2019

Combination of Trunk muscle training and neuromuscular electrical stimulation may improve function in chronic low back pain
Neuromuscular electrical stimulation

A recent preliminary clinical trial evaluated a trunk muscle training program combined with neuromuscular electrical stimulation (TMT+NMES) for rehabilitation of older adults with chronic low back pain (CLBP). The study found that participants in the TMT+NMES groups had greater improvements in function (performance-based and self-reported) than the passive control group. A larger study is needed to further investigate the effects of this combination therapy.  [Learn More] - posted 5/21/2019

Prevention of opioid-induced constipation should start with assessing opioid use

The American Gastroenterological Association Institute has released new guidelines on medical management of opioid-induced constipation. The first recommendation includes assessing whether opioid use is necessary, that the minimum necessary dose is prescribed, and that a comprehensive pain management program is being followed. The following recommendations include traditional laxative therapy as first-line treatment and considering peripherally acting μ -opioid receptor antagonists, or PAMORA, drugs (i.e. naldemedine and naloxegol) if laxatives are not effective. [Learn More] - posted 5/3/2019

Avoiding activity can lead to worse pain interference and function in fibromyalgia

A study examined pain-related activity patterns (pacing, avoidance, and overdoing) in 119 patients with fibromyalgia. Pacing refers to completing an activity slowly or with rest periods, avoidance refers to avoiding potentially painful activity, and overdoing is completing an activity for longer or at higher intensity. Avoidance was a predictor of worse psychological and physical function and greater pain interference. Pacing was associated with less pain interference and better psychological function. [Learn More] - posted 5/1/2019

Meditation
Relaxation therapy with guided imagery can help reduce pain after surgery

A recent review examined eight studies about relaxation therapy with guided imagery for postoperative, or postsurgical, pain management. Most studies included in the review found that relaxation therapy with guided imagery can help reduce postoperative pain. The studies highlighted its use along with other therapies such as relaxation exercises, respiration exercises, meditation, and music therapy. 
[Learn More] - posted 4/29/2019

Cognitive behavioral therapy can help pain and insomnia

A recent review discussed the causes and impact of sleep disturbance and pain in older adults and examined the efficacy of cognitive behavioral therapy for insomnia (CBT-I) on pain and sleep in older adults. Sleep disturbance contributes to worse pain, pain-related distress, and disability, while good sleep improves remission rates of widespread chronic pain. CBT-I was found to help pain and insomnia and could reduce use of potentially harmful medications.  [Learn More] - posted 4/26/2019

Spinal Manipulative Therapy (SMT) can provide slight improvement in function for back pain

A recent review assessed the benefits and harms of SMT for the treatment of chronic low back pain. SMT is a combination of moving and jolting joints, massage, and physical therapy to relieve pressure, reduce inflammation, and improve nerve function and performed by a variety of different healthcare professionals. The review that SMT produced similar effects on short term pain relief and slightly better effect on function compared other recommended therapies for back pain.  [Learn More] - posted 4/24/2019

Exercise, massage, heat therapy, and relaxation help pain for older adults in long-term care
Group Exercise

A review evaluated non-drug interventions for pain that are currently utilized by older adults living in long-term care facilities. Relief of pain and increased comfort for older adults living in long-term care facilities are relevant healthcare concerns. The review found that exercise, massage, heat therapy, and relaxation were significant non-drug interventions for persistent pain in older residents living in long-term care facilities.  [Learn More] -posted 4/17/2019

Reduced vitamin D levels might play a role in painful diabetic peripheral neuropathy

A recent study evaluated vitamin D levels in people with diabetic peripheral neuropathy. The study found a significant difference in vitamin D levels in people with pain painful diabetic peripheral neuropathy compared to healthy individuals, while accounting for main confounding factors. Reduced vitamin D levels might be a factor of painful diabetic peripheral neuropathy, which could support a need for supplementation.  [Learn More] - posted 4/12/2019

Walking as effective as exercise for pain, disability, and fear-avoidance in back pain

A meta-analysis examined five studies that investigated the effects of walking alone compared to exercise and exercise with added walking on adults with chronic low back pain. It found that walking is similarly effective as exercise for pain, disability & fear-avoidance for chronic low back pain patients and is an accessible and low cost alternative to exercise.  [Learn More] - posted 4/10/2019

2019 American Geriatrics Society Beers Criteria Update
Instructing how to take a Rx

Recently, a panel of expert came together to update the American Geriatric Society (AGS) Beers Criteria. The AGS Beers Criteria is tool for healthcare providers for Potentially Inappropriate Medication, or PIMs, developed to improve medication safety and quality of care for older adults.  [Learn More] - posted 4/5/2019

FDA approves new intra-articular injections for knee osteoarthritis

The FDA has recently approved 2 intra-articular injections, single-injection hyaluronic acid gel and extended-release triamcinolone acetonide, for the treatment of osteoarthritic knee pain. These IA corticosteroid and hyaluronic acid injections are potential alternatives for patients with inadequate responses or contraindications to systemic anti-inflammatory or analgesic drugs.  [Learn More] - posted 4/1/2019

Inconsistent coverage of nonpharmacologic treatments for chronic low back pain

A recent study investigated insurance coverage for nonpharmacologic treatments for chronic low back pain. The study investigating 45 Medicaid, commercial, and Medicare Advantage plans and found little evidence for coverage of acupuncture and psychological interventions and criteria varied widely for utilization management such as visit limits and prior authorization. Lack of consistent coverage and utilization management policies is a barrier to multimodal treatment for chronic low back pain.  [Learn More] - posted 3/27/2019

High level of pain associated with increased risk of memory impairment

A recent study examined the longitudinal association between pain and cognitive impairment. There was no significant difference for risk of cognitive impairment between the participants with and without pain. In addition, pain and incident attention and executive function impairment were not significantly associated. Among older adults with pain, high level of pain was found to be associated with increased risk of incident memory impairment.  [Learn More] - posted 3/25/2019

Neurophysiological pain education can help improve low back pain

Neurophysiological pain education (NPE) is a cognitive-behavioral intervention involving education about pain neurophysiology to help change maladaptive illness beliefs, maladaptive pain cognition and beliefs about pain. A recent review evaluated the effect of NPE for patients with chronic low back pain (CLBP). There is evidence to support a small to moderate effect of NPE on pain and disability at 3 months follow-up in patients with CLBP.  [Learn More] - posted 3/1/2019

Physical activity and Cultural Engagement Can Reduce Risk of Chronic Pain

A recent study explored physical and psychosocial activities that could reduce the risk of developing chronic pain in older age. Longitudinal data following healthy individuals aged 50 for a decade was analyzed to determine factors that reduce the risk of developing chronic pain. Individuals that engaged in vigorous weekly activity and cultural activities were about 25% less likely to develop chronic pain while controlling for identified confounders.  [Learn More] - posted 2/26/2019

Tai Chi practice
Tai Chi May Improve Pain, Gait, and Fall Risk in Older Adults with Multisite Pain

A pilot study investigated Tai Chi for older adults with multisite pain. Tai Chi is a mind-body exercise involving postures and slow movements combined with breathing and meditation exercises. Participants were randomized to a Tai Chi or light exercise program offered twice a week for 12 weeks. The Tai Chi group demonstrated significantly lower pain severity and interference, reduced fear of falling, and improved gait.  [Learn More] - posted 2/21/2019

Meta-analysis Finds Long-Term Benefits of Glucosamine Use in Knee Osteoarthritis

A recent meta-analysis found that Glucosamine sulfate is associated with improvements in pain, physical functioning, and joint structure in knee osteoarthritis. Glucosamines were evaluated in 6 of the 42 trials identified. Benefits of Celecoxib (NSAID) for pain were lost after a sub-group analysis for high quality trials. Authors suggest further trials for improving knee osteoarthritis.  [Learn More] - posted 2/18/2019

Review of Pharmacological Treatment for Opioid Induced Constipation (OIC)

A recent review evaluates the use of PAMORAs for the treatment of OIC in non-cancer patients. Concerns exist that laxatives are ineffective in some patients because they fail to address the underlying mechanisms causing OIC. Numerous PAMORAs can be prescribed to treat constipation. The clinical considerations, including side effects, in using PAMORAs are discussed. [Learn More] - posted 2/11/2019

Low back pain
New ICD-11 Classification of Chronic Pain

In the ICD-11, chronic pain will be treated as the “parent code” for chronic primary pain, chronic cancer-related pain, chronic postsurgical or post-traumatic pain, chronic neuropathic pain, chronic secondary headache or orofacial pain, chronic secondary visceral pain, and chronic secondary musculoskeletal pain. Developers believe this will allow for greater flexibility and representation of chronic pain than the previous ICD versions.
[Learn More] - posted 2/5/2019

New web-based platform shows success in improving self-management of chronic pain

The PainTracker Self-Manager (PTSM) is a new web-based platform using acceptance and commitment therapy to enhance self-management of chronic pain. A recent pilot study found that the PTSM significantly improves chronic pain self-efficacy, acceptance, pain intensity and interference, and satisfaction with pain treatment. The PTSM is made up of 5 online modules plus additional coaching sessions via phone.  [Learn More] - posted 1/28/2019

Combination pharmacotherapy effectively treats chronic low back pain but increases patient risk 

A recent meta-analysis of twelve randomized controlled trials found that combination pharmacotherapy outperforms monotherapy and placebo for pain relief of chronic low back pain. However, patients receiving combination pharmacotherapy had an 80% greater risk for an adverse effect compared to placebo and a 40% greater risk for an adverse effect compared to patients receiving monotherapy.  [Learn More] - posted 1/14/2019

New poll describes older adults’ experiences with opioid prescribing
Taking Rx

The National Poll on Healthy Aging found that 1 in 4 older adults report filling an opioid prescription within the last 2 years. Yet only 59% report talking to their provider about when to reduce the amount of medication. Further, only 13% reporting disposing of the medication properly while 86% kept the medication in case they had pain again.  [Learn More] - posted 1/4/2019

Study finds that older adults receive high doses of opioids while hospitalized

A recent retrospective cohort study found that 1 in 5 older adults reported moderate to severe pain while hospitalized. 80.2% of those reporting pain as moderate to severe received opioids while hospitalized, of which 23.6% received “high” doses as designated by CDC guidelines. At discharge, 9.4% of participants with no history of chronic pain had a new prescription for an opioid.  [Learn More] - posted 12/26/2018

Barriers to pain management identified by Black older adults 

A recent mixed methods study with community dwelling Black older adults highlighted the need for improved pain management within this population. 86% of participants reported pain in daily life, but additionally reported concerns regarding pain management related to understanding side effects, fears about addiction, provider mistrust, and difficulties communicating with providers. Authors discuss the implications of these findings for nursing education, practice, and research.  [Learn More] - posted 12/18/2018

Breaking pain research from the 2018 Gerontological Society of America Conference 4

After analyzing the National Health and Aging Trends Study dataset researchers at the annual GSA conference argued for expanded access to hospice/palliative care programs after finding that an unmet need for pain management led to double the emergency department visits for persons with dementia in the last month of life.  [Learn More] - posted 12/10/2018

Breaking pain research from the 2018 Gerontological Society of America Conference 3

The Mobilization Observation Behavior Intensity Dementia (MOBID) pain scale has now been psychometrically tested in United States nursing homes. Previously developed and tested in Norway, the MOBID now indicates adequate reliability and validity for use in US nursing homes. However, researchers recommend further testing of the scale related to possible unnecessary items.  [Learn More] -  posted 12/3/2018

Breaking pain research from the 2018 Gerontological Society of America Conference 2

Little research has looked at the role of health care providers in older adult use of cannabis. New research found that only 10% of older adults using cannabis for pain management have received a recommendation for cannabis use from a provider. Patients using cannabis report their main education source on its use is from friends and family.  [Learn More] -  posted 11/27/2018

Man in the chair alone
Breaking pain research from the 2018 Gerontological Society of America Conference 1

Older adults report that visiting with friends and family is their most valued leisure activity. Researchers from John Hopkins found that older adults with the symptom cluster of pain, mild insomnia, and moderate depression and anxiety are five times more likely to be restricted from visiting friend and family compared to those with no pain symptoms. 
[Learn More] - posted 11/20/2018

Pain Severity Increases Risk of Memory Impairment 

New results from the National Institute on Aging funded Central Control of Mobility in Aging Study found that pain in older adults is not associated with the incidence of cognitive impairment. However, this 3-year longitudinal study with 441 eligible participants did find that older adults with high levels pain are at increased risk for developing a memory impairment. Pain had no effect on attention of executive function in older adults.  [Learn More] - posted 11/13/2018

Innovative Pain Assessment Methods: The Future? 

A new iPhone application for pain assessment in older adults with cognitive impairment recently underwent a qualitative feasibility assessment with UK paramedics. The paramedics reported a high need for pain assessment tools and education when caring for older adults with cognitive impairment. However, they reported concerns about integrating the use of technology in the paramedic setting. Authors conclude by discussing the need for innovative pain assessment methods for the pre-hospital setting and the importance of continued work in this area.  [Learn More]  - posted 11/5/2018

Fast Fact on Opioid Prescribing in Older Adults

A new FAST FACT published in the Journal of Palliative Medicine focuses on the safety considerations needed when prescribing opioids to older adults. This FAST FACT provides an important reminder of drug and dosing information for prescribing opioids to older adults. For example, avoiding drugs like meperidine and codeine. Authors also remind practitioners of the risks for adverse drug reactions in older adults compared to other adults related to the physiologic changes of aging, atypical presentation in older adults, increased risk for falls while taking opioids, and increased risk for delirium.  [Learn More] - posted 10/23/2018

Opioid-related Adverse Reactions Underreported

A recent pilot study by researchers at the University of Connecticut concluded that a significant number of older adults do not contact their primary care provider after experiencing an analgesic related adverse drug reaction (ADR). In this study with twenty-two older adults, eight participants having an opioid related ADR did not seek help within the healthcare system. Examples of reported opioid related ADRs included symptoms of confusion, constipation, and fatigue. The authors recommend enhanced patient education, thorough medication reconciliation, and reaching out to patient after prescription.  [Learn More] - posted 10/16/2018

Over-the-counter (OTC) Analgesics and the Implications for Patient Care

An Interdisciplinary Look at Labeling Changes to OTC Analgesics and the Implications for Patient Care published by the Gerontological Society of America in 2018. - posted 7/16/2018