Controlling Pain: Cautions for Over the Counter and Prescription Relief

Pain is something most of us have experienced much more than we would like, whether from an accident, injury, surgery, overuse strain, headaches, or chronic pain condition.

Our senior loved ones report pain frequently and many have daily pain from arthritic joints.

What can we do to control our pain and not let it control us?

Most of our senior loved ones (and ourselves) will visit our doctors to get a prescription drug that will hopefully control their pain. Many will take over-the-counter pain relief medications hoping to ease the pain.

What we may not realize is that several medications we use for other reasons already contain pain relief combinations. When we take an additional pill, it could inadvertently be too much for our bodies and have harmful consequences.

NSAID Warning Level Increased

This week the Food and Drug Administration (FDA) heightened its warning about the negative effects of the pain reliever NSAIDs.

The non-steroidal anti-inflammatory drugs, such as Aleve, naproxen, Motrin, Advil and ibuprofen-containing products, have a new, stronger warning label cautioning us to be aware these could increase our risk for stroke and heart attack leading to death.

The FDA warns — but we already know, right — to read all ingredient labels, especially for over-the-counter remedies and multi-symptom products, because they could provide extra NSAIDs that could interact with other medications and prescription pain relievers.

What Seniors Can Do — and We Can Help

The FDA recommends that seniors continue to take any prescribed pain relief but beware of additional sources of NSAIDs that could put them over the safe dosage amount. They say that we should not take more than one NSAID product at a time, prescription or over-the-counter.

The FDA believes that risk for heart attack and stroke can happen as soon as one week on NSAIDs. The FDA wants to stress that ‘everyone’ is at risk even those without cardiac disease.

  • If your senior loved one already has cardiac disease or has had a heart attack or bypass surgery, they are at the greatest risk and should be extremely cautious about taking excess NSAIDs. These seniors are at risk of another heart attack or dying of heart attack-related causes.
  • Be sure to read the list of active ingredients in the Drug Facts label on all medications and over-the-counter pills that your senior love one takes. Find a multi-symptom medication that does not contain NSAIDs if they are already taking pain relievers.
  • Doctors warn that seniors should take the lowest possible dose of NSAIDs for the shortest amount of time for relief. If pain persists, talk to your senior’s doctor about other possible interventions.
  • As with any medication, use it only as directed and don’t share prescription medications.
  • If your senior loved one already takes a low dose aspirin to prevent heart attack or stroke, be aware that NSAIDs can interfere with that protective effect. Avoid this interaction and speak to your doctor about alternatives.
  • All family caregivers should learn the warning signs of stroke and take immediate action by calling 9-1-1 if you suspect your senior loved one might be having a stroke. Acting fast can prevent brain injury during a stroke.
  • If your senior experiences pain requiring them to take NSAIDs for relief, they should make improvements in the lifestyle that will reduce their risk of heart attack and stroke such as smoking cessation, managing blood pressure, eating a heart healthy diet and staying physically active.

Alternative or Non-Pharmacological Pain Relief

There are non-pharmacological options for pain relief especially when it is chronic in nature.

If your senior loved one can try some of these other interventions with your help and support, they might be able to eliminate or reduce their current drug regimen.

Here are a few options to help control pain:

  1. Avoid movements or activities that increase pain.
  2. Participate in physical or occupational therapy that can strengthen your senior’s muscles or give them strategies to accommodate activities to reduce pain.
  3. Massage treatments
  4. Stress reduction, relaxation techniques and guided imagery
  5. Ice and heat packs
  6. Aromatherapy
  7. Biofeedback or electrical stimulation (TENS)
  8. Bed rest during exacerbation episodes
  9. Anti-inflammatory diet
  10. Physical activity and exercise
  11. Socialization, family visits, laughing
  12. Music and art therapy
  13. Complementary approaches including acupuncture, chiropractic, hypnosis, reflexology
  14. Hot bath and cup of herb tea

Anything that your senior finds relaxing and distracting can help relieve pain.

Consequences of Pain

Pain can lead to many negative consequences for our senior loved ones. It often seems that they are unable to fully express the level of pain they are feeling, the location of their pain and that they even are having pain.

Many seniors suffer in silence from lack of pain control or inadequate/ineffective treatment of their pain.

Some seniors themselves or their primary care physicians are fearful of giving pain medications for fear of the long term effects of opioids. This can leave the senior in pain every day.

It has been estimated that 25-50% of elders who live at home have pain that is uncontrolled.

When seniors are in pain activities of daily living and mobility are at risk. Pain can lead to isolation and depression and is a consequence of chronic pain in our seniors. Having pain can interfere with restful sleep.

The quality of life for our senior loved ones can be impacted by pain. For some seniors, living at home alone can be impossible when their pain interferes with their ability to care for themselves.

Pain Reliever Side Effects

Some seniors are prescribed pain relief in prescription form but this can put them at risk for interacting with other prescription drugs, causing constipation, and increases the risk of adverse drug reactions.

Seniors have an increased number of falls when taking these medications.

Some pain medications, including NSAIDs, can lead to gastrointestinal bleeding as well as the risks described above.

Improving seniors’ quality of life by controlling their pain is important. At the same time, family caregivers can advocate for their seniors by trying some non-pharmacological interventions to prevent potential problems with multiple medications such as NSAIDs.

As family caregivers, we can help them manage the pain, cope with it through accommodations and help them live their life fully.