Chronic pain can have a significant impact on an individual’s physical, emotional, and mental well-being. Not only can it limit mobility, making it difficult to perform daily tasks and participate in activities that were once enjoyed, but it can also cause fatigue, insomnia, and depression.

According to the Australian Institute of Health and Welfare, one in five Australians aged 45 and over live with persistent, ongoing pain. It’s estimated that the reduced quality of life and loss of productivity, caused by chronic pain, costs Australia an estimated $139 billion in 2018.

Chronic pain can be disabling and stressful, making it hard for a person to take part in the things they enjoy.

In addition, chronic pain can lead to decreased independence with the emotional toll of chronic pain also placing a strain on relationships, making it difficult for individuals to enjoy their daily lives. Chronic pain can also lead to a decrease in overall quality of life.

Unfortunately as we age, our bodies may become more susceptible to chronic pain. This can be due to a variety of factors, including natural wear and tear, arthritis, and other degenerative conditions. For those over 60, managing and preventing chronic pain is an important part of maintaining quality of life and retaining independence.

Fortunately, there are ways to manage and prevent chronic pain, whether it be through exercise, medication, or alternative therapies. In an effort to better understand chronic pain, Start at 60 spoke to those with expertise in the treatment and management of the condition in order to better understand the symptoms, treatments available and how to live a full and active life while managing chronic pain.

What is chronic pain?

As explained by Health Direct, “chronic or persistent pain is pain that lasts for more than 3 months, or in many cases, beyond normal healing time.”

Chronic pain can be caused by a variety of conditions such as arthritis, fibromyalgia, neuropathic pain, chronic headaches, and lower back pain. It can also be caused by previous injuries or surgeries, or as a result of a chronic illness such as cancer.

Not only are sufferers of chronic pain forced to live with ongoing discomfort their quality of life can also be greatly impacted which can lead to decreased mobility, depression, and a decrease in overall well-being.

Physiotherapist at Pollinate Health, Jimmy Goulis says “the area most affected by chronic pain is the lower back, also knows as the lumbar spine and the neck, which is also knows as the cervical spine.”

“These areas are pretty prevalent, but also conditions like arthritis, that’s a chronic condition. Arthritic knees, arthritic hips, these would be the most common,” he explains

CEO and Principal Chiropractor with HealthKlinix Australia, Dr. Ned Khodragha notes that “practitioners continue to see a steady amount of over-60s patients through the door with a number of different aliments. As a generation that is conscious of their health and wellbeing, we most often treat something commonly known as OsteoArthritis.”

“This is wear and tear of the tissue at the ends of bones (inside a joint usually) over time and is common among older Australians. Another type of arthritis is also a major cause of chronic pain called Rheumatoid Arthritis (inflammatory disorder where the body’s immune system attacks its own tissue),” he explains.

Khodragha points to “other major causes of pain” that are observed “in the over-60s demographic”, which include:

• Circulatory Issues
• Old injuries
• Fibromyalgia;
• Cancer

Dr Steve Woodbury from MindZen Group, who specialises in helping people manage chronic pain through exercise, notes that “there are many types of pain that are as unique as each person.”

“In the research and medical world, pain comes down to 5 basic categories: 1. acute; 2. chronic; 3. subacute; 4. recurrent; 5. cancer-related pain,” Woodbury explains.

“While pain comes in many forms, and some pain models put cancer-related pain in its own area, I suggest that practically, in the real-world, pain largely falls into the acute and chronic categories.”

“Acute Pain is the normal type of immediate pain response we expect to trauma or tissue damage to a specific part of the body.

“Chronic pain on the other hand, is ongoing, more like a constant, nagging reminder.

“Like acute pain it can be intense and specific with a clear cause. Indeed, any acute pain that lasts for over 3 months is considered chronic. But more often, chronic pain has a gradual onset, more variation in intensity and is more diffuse.

“Sometimes the pain appears to arise from an elusive complex interplay of factors, including psychosomatic causes, other times no apparent reason can be identified at all.  All this makes chronic pain much trickier to treat.”

Regardless of what is causing chronic pain, Woodbury states that it “becomes all encompassing, permeating every aspect of life”, citing the debilitating impacts pain can have on one’s life.

“Chronic pain is limiting because pain narrows your options and outlook. Regardless of what you may want to do consciously, whatever that hope or dream is, it can’t happen if pain is stopping you,” he says.

“Pain limits, not just income and freedom possibilities, it places limits your own identity and outlook on life.”

How to relieve chronic pain

Nobody wants to live with the burden of chronic pain given its significant impact on a person’s quality of life.

In addition, chronic pain be difficult to manage and often requires long-term use of medication, which can lead to side effects and in some cases dependence.

Living with chronic pain can be a constant struggle and it’s something that most people would prefer to avoid, therefore once the cause of one’s chronic pain has been identified, it’s important to look at measures that can adopted to alleviate the symptoms and treat the source of the pain.

Woodbury highlights that “there are many treatments available for various pains, which fall into basically treatments of the mind or body.”

“Western Medicine is more reliant on killing pain with pharmaceuticals; the Eastern approach is more about prevention and enhancing your natural pain relief abilities—more like medicine was originally in Hippocrates day (circa 460 BC),” he explains.

“For the body we have physiotherapy, massage, surgery, acupuncture, occupational therapy and the like.

“For the mind we have Psychology in all its various subcategories of CBT, psychological mindfulness, ACT, support groups and group therapies, social work, which are all focussed on talking therapies of some sort; as is counselling.”

Although many would assume treating chronic pain is simply about identifying the source of the pain and remedying the cause with medication or exercise, Woodbury points to a growing acceptance of treating pain with measures that concentrate on the connection with the mind and the body.

“Mind-Body connecting treatments come from a history of Eastern approaches that include things like proper meditation, and the movement therapies like Yoga, Qigong, Tai Chi that are designed to get mind and body working together,” Woodbury says.

“Recently mainstream psychology is embracing more of aspects of the Eastern approaches; and also, things like patting animals, painting and drawing, or listening to music, that when done through a psychologist or psychiatrist is known as Animal or Equine Therapy; Art Therapy; or Music Therapy. There are the hydrotherapies, the various retreats for wellness weekends and so on.

“You can also just do more of the things you enjoy, as well as developing your own routines of stretching, gym, Pilates, swimming in the pool or beach, and even the more recent fads of Ice Pool dipping. Effectively, anything that helps you improve strength, power, posture and overall mobility is generally encouraged.”

Khodragha also supports a “multimodal” approach to treating chronic pain, citing a mix of therapies as “the most effective way to manage and reduce chronic pain and its impact”.

“Research has shown that multimodal and interdisciplinary treatments that use a variety of physical, lifestyle, psychological, pharmacologic, and alternative and complementary therapies are the most effective way to manage and reduce chronic pain and its impact,” Khodragha says.

“Ultimately, while it may seem like avoiding activities such as exercise would allow for rest and healing, research has also shown that gentle to moderate activity and continued engagement in a healthy range of daily activities is the best form of prevention and management of chronic pain.”

Founder of Community Moves, Van Marinos seems to agree with Khodragha’s thoughts on movement regarding it’s benefit to chronic pain sufferers.

“What we do know is that movement generally helps suppress pain symptoms, so if you can find an activity or exercise mode you enjoy and something you can stick to, it should definitely help. Not to mention all the associated physical, social, and psychological benefits that come with regular exercise,” Marinos says.

“There is research to support pretty much all types of exercise for pain management. Take walking for example – in a study published in the journal Ageing, researchers at UCLA School of Medicine demonstrated that walking is just as effective for back pain relief as conventional pain treatment methods like heat, cold, massage, and relaxation techniques.

“In another study published in Annals of Internal Medicine, osteoarthritis patients assigned to a walking program experienced a 27% decrease in pain. During a poststudy follow-up, researchers also found that the walking group used pain medication less frequently.”

Although Marinos extols the values of exercise in helping to treat chronic pain, he stresses that “the best thing to do is consult their doctor to get clearance for an exercise program.”

“Once they get that, they should find an exercise professional that has experience dealing with people in pain and someone that understands their needs. From there, consistency is key,” he explains.

Physiotherapist at Pollinate Health, Jimmy Goulis also spoke of the importance of exercise when treating chronic pain, citing cardiovascular fitness as “very important”.

“Exercise is one of the most important things we can do to help people get out of chronic pain. So if they have a lot of problems with their heart and lungs and they’re not able to exercise, that limits their recovery and can contribute to chronic pain,” he says.

“Other things like mobility issues, balance issues all these things, can impact on someone’s ability to exercise.”

How to prevent chronic pain

When it comes to chronic conditions, prevention is always better than cure. Preventing chronic pain is often more effective and less costly than trying to cure it once it has already developed.

By taking steps to prevent chronic pain, it can help reduce the need for medication, decrease the risk of disability, and improve overall quality of life.

Khodragha points to “maintaining a healthful lifestyle, including a good diet and exercise” as a “strong intervention to prevent chronic pain”.

“The over 60 demographic would know this but it is always a good reminder that your body doesn’t act the way it does when it was 20 anymore,” Khodragha says.

Khodragha advises that over 60s “remind themselves that they need to “manage stress with deep breaths using the diaphragm muscles, participating in enjoyable activities, reducing sources of unnecessary stress whenever possible.”

“Maintain a healthy diet and weight and exercise regularly,” Khodragha adds.

“Reduce excessive alcohol use and smoking.

“If in doubt, always consult a medical professional or practitioner who can help diagnose pain and provide treatment options.”

Woodbury suggest that over 60s “stay as healthy as you can for as long as you can.”

“Keeping your systems in great working order really helps stay as pain free as best you can. The basic game is eat well, sleep well, play well, which all helps the body work best – feed it; use it; enjoy it,” he says.

“It does not matter how old we get, we are essentially designed to play. If you can bring in that idea of playing, having fun more often, then everything seems more worthwhile. You smile more, you connect more, and you get as active as possible to enjoy more things. When you feel good, pain becomes a lessor phenomenon.”

In addition to looking after the body, Woodbury notes that “it is important not to underestimate the power of the mind” given that “emotional and physical pains influence each other”.

“Feeling happier, more often, keeps excess cortisol and stress hormones in check. The whole idea is to keep stress out, and bring more pleasure in. Take time for yourself where you can. Find things you enjoy—reading a book, doing something creative like art, taking up a sport, or exercise helps the brain re-wire to more useful states,” he explains.

“Do something new, or do something you always do in a whole new way, like putting the other shoe on first this week or using the other hand when you clean your teeth. These simple changes help your brain remain active and actually helps re-wiring at the neurological level. Your brain likes a novel challenge.”

Marinos is a “big advocate of strength training through all stages of life as a lack of strength and muscle mass can lead to a cascade of negative health outcomes”.

“We are made to be highly active for optimal functioning. Unfortunately, the less we do, the further our body sinks into disfunction. If you can manage to start moving just a little bit more everyday, and then a little bit more on top of that, your body will return the favour you in spades,” he explains.

Goulis previously spoke of the importance of cardiovascular exercise in treating chronic pain and spoke further regarding the importance of maintaining strength as “a crucial factor to address”.

“We know that strength declines with age, but it declines again with chronic pain if people are avoiding activity,” he states.

“People who avoid activity, lose strength, they lose fitness, they often lose a bit of balance too, which might make them more at risk of falls.

“The general domains will be around cardiovascular fitness, strength, balance and flexibility. People can get stiff and tight and these are all things that need to be assessed and prescribed with exercise.”

Enjoying a full and active life with chronic pain

Living with chronic pain can be challenging, but it is possible to enjoy an active and fulfilling life despite it. One key aspect of managing chronic pain is understanding the condition and learning how to cope with the symptoms. This may involve working with a healthcare provider to develop a treatment plan, which may include physical therapy, medication, and lifestyle changes.

It can also be helpful to set realistic goals for oneself and break them down into small, manageable steps. For example, instead of trying to run a marathon, one may start by walking for 10 minutes a day and gradually increasing the duration and intensity of the exercise.

In addition to physical activity, it is also important to engage in activities that bring joy and fulfilment. This may include hobbies, social activities, or volunteer work. These activities can serve as a welcomed distraction from the pain and can also provide a sense of purpose and accomplishment.

Another important aspect of managing chronic pain is learning how to manage stress. Stress can make pain worse, so it’s crucial to find healthy ways to cope with stress, such as through relaxation techniques, mindfulness practices, or therapy.

Overall, living with chronic pain can be difficult, but by understanding the condition, setting goals, engaging in activities that bring joy, and managing stress, one can lead an active and fulfilling life.

Goulis points out that when it comes to chronic pain, “what you often see is people stopping movement or changing their behaviour, or avoiding the very things that might help them in the long run. There’s just a lessening of what we call envelope of function.”

“So they start to limit their activities more and more because they’re in pain and they don’t understand why it’s not going away. And there’s a belief that pain means harm. But with pain we understand that the pain that has persisted beyond that initial injury is no longer telling us whether something’s harmful or not. It’s often just a signal that’s gone on too long.

“I think my summary would be 60 plus people should be treated exactly the same as every other population. They still have a lot of lifespan left and they should be encouraged to continue working towards coming out of chronic pain as much as possible. They should get a really good diagnosis and rule out the sinister potential causes of their pain and then seeing a good physio to work on to achieving their goals is important.

“I’m always optimistic that pain can improve, especially when people start working towards meaningful goals.”

Khodragha notes that “it’s important that if you feel you are suffering from chronic pain that you have this diagnosed properly.”

“Talking about your chronic pain to a group of people who may be suffering similar symptoms may help you understand the pain more and give yourself a more realistic expectation on the relief you will get from certain treatments & lifestyle changes,” Khodragha says.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.