Pain
Pain is one of the most common complaints among older adults. Between 25 and 50% of older adults living at home, and 45 to 80%
of those living in nursing homes, have significant pain. Most often, the pain is chronic or persistent, associated with
chronic medical conditions such as Fibromyalgia, Degenerative Disc Disease, and Failed Back Syndrome.
Many older adults do not tell anyone about their pain or how severe it is. In some cases, they think that pain is a
consequence of aging that cannot be avoided or treated. Others ignore or deny the pain because they don't want to accept that the
pain may mean that their condition is worsening or progressing. Some people try to ignore pain because they don't want
to be seen as troublesome or a burden. However, none of these is a good reason for living with persistent pain.
Persistent pain decreases quality of life in many ways. It affects us physically, socially, and psychologically. It can result in
difficulty in performing activities of daily living, problems thinking, depression, anxiety, social isolation, loss of appetite,
and sleep problems. It can indirectly affect balance and walking, increasing the risk of dangerous falls. Pain can also slow down
or prevent rehabilitation, which is associated with loss of function and more dependence on others. Chronic pain may also cause
people to seek relief in heavy prescription medication or even alcohol or illegal drug use, leading to the serious complications
associated with substance abuse.
Pain Management
Transcutaneous Electrical Nerve Stimulation (TENS)
Transcutaneous Electrical Nerve Stimualtion is a noninvasive therapy for management of acute and/or chronic intractable,
post-surgical and post-trauma pain. It is a method of applying low voltage elctrical pulses through the skin using electrodes.
The mechanism of action of TENS is similar to that of implantable nervous system stimulators
without the surgical invasiveness and cost.
TENS decreases nociceptive input to the central nervous system, as described by the classic
"Gate Control Theory" of Melzack and Wall (1965).
TENS decreases pain, increases activity, and promotes return to work or normal activity of daily living (ADL's). TENS reduces the
need for pain medication and the need for physical and occupational therapy (PT/OT). TENS users remain alert, functional and productive.
TENS is cost effective by reducing medication cost, medication related complications, PT/OT cost, and promoting faster return-to-work
time. TENS is a low risk, first-line treatment option with no side effects:
- No tolerance, physical dependence or withdrawal symptoms reported in 40 years of clinical TENS use.
- No potential for overdosage.
- Does not interfere with pharmacological agents.
Neuromuscular Electrical Stimulation (NMES)
Treatments using NMS create involuntary muscle contractions that minimize the degenerative changes in muscles that usually occur
following immobilization or partial denervation. Neuromuscular Stimulation is indicated for use in conditions that may result in:
- Disuse atrophy (tissue wasting)
- Restricted range of motion such as sprains
- Joint and ligament repair or reconstruction
- Knee cartilage injury (chrondomalacia patella)
- Stroke and spinal damage
NMES is also indicated for:
- the re-education of partial nerve damaged muscle groups
- for relaxation of spastic muscles
- post-operative care to improve blood flow in selected muscles
- the maintenance of range of motion
- a complimentary way to perform muscular training
According to research, patients who benefit from NMES include those with the following conditions:
- strokes
- head injuries
- neurological disorders such as multiple sclerosis, and Guillain-Barre syndrome
- spinal injuries
- cerebral palsy
- joint replacements
- tendon repairs
- urinary and rectal incontinence
- arthritis
Inferential Stimulation (IF)
Inferential helps control pain and speeds the healing process by delivering small pulses of electrical current
to an injury through electrodes that pass current through the skin and stimulate underlying nerves producing a
mild, tingling sensation to provide relief from acute and chronic pain. (IF) is used for very localized areas
where deep current for pain control or increased circulation is needed. (IF) is ideal for use at the home and
work, is lightweight, wearable and battery operated with AC adaptors.
IF can be used for pain associated with many conditions including:
- Back pain (most common)
- Arthritis
- Strains and sprains
- Neuralgia
- Reflex sympathetic dystrophy (RSD)
- Shingles
- Degenerative joint disease
The advantages of interferential stimulation are:
- It is a safe and effective alternative to medications often used for pain control
- It helps place the patient in charge of controlling their pain
- It is non-addictive and has no side effects with the exception of possible skin irritation caused by the
electrodes which Quality Pain Therapies, Inc. does offer sensitive skin electrodes upon request
Traction (Cervical and Lumbar)
Traction is the application of a mild stretch to the muscles, ligaments, and tissue components of the spine to
provide pain relief. Traction promotes separation of the intervertebral joint space that contains the disc and may
reduce a "bulge" or impingement of the structures within this area. Traction devices may be used to treat various
portions of the spine. Most devices are designed to treat either the cervical spine (neck) or the lumbar spine (low back).
Traction provides effective pain relief for a variety of spine disorders
resulting from conditions such as:
- Muscle spasm
- Degenerative joint disease
- Spondylosis
- Facet joint dysfunction
- Nerve root compression
- Osteoarthritis
- Myofascial syndrome (pain from postural changes)
The advantages of traction are:
- It allows the patient to effectively manage pain
- It provides comfortable, convenient relief without side effects that may be caused by medications
such as pain relievers and muscle relaxants
- Devices are designed to be used lying down which make them more effective and easy to use
- Traction is portable and can be used at home or when traveling to enhance therapy
received in the clinic
Quality Pain Therapies, Inc. distributes Saunders® Cervical and Lumbar traction and also the Starr
Traction™ cervical traction.
