Sunday, September 30, 2018

Life Stages and Pain Syndromes


Physical pain not related to injury can happen at any age.  Pain is felt uniquely by everyone, and triggered and sensed by nerves and the brain, an area which is still not completely understood by medical scientists.  While overuse syndromes and arthritis are common contributors, growing, hormonal shifts, and aging can also lead to pain syndromes. The cause of these pain syndromes are not understood, but their similar features have allowed us to identify them as situational and not physically damaging.  Following is a description of the types of pain syndromes that 5-50 percent of us experience at some point in our lives.

Children may experience growing pains generally between the ages of 2-12.  Their pain is usually in the legs and on both sides.   Growing pains are more present the night after a day involving a lot of climbing, jumping or running.  The affected limbs are not swollen or red, and have full motion.   The pains are described as achy and feel better with touch or massage.    If you suspect your child has growing pains, try a dose of tylenol or advil, use ice or heat (whichever feels better for 5-10 minutes and ask your child if the pain feels better in the morning.  Any pain that lasts more than a few days or causes limping may not be due to growing pains and should be discussed with a doctor.  
 
In Adolescents, general body pain can occur.  This includes headaches, abdominal pain, back and neck pain, and achy limbs.  There are a few terms for this pain:  Functional Pain Syndrome, Musculoskeletal Pain Syndrome, Chronic Widespread Pain, and Fibromyalgia.  These diagnostic terms have subtle differences with much symptom overlap and similar treatment.   General pain syndromes usually occur in adolescents who are fatigued, stressed and or anxious.  Depression can be a cause, an ongoing issue, or a result.  This pain can feel debilitating to a teenager and must be medically evaluated and treated to ensure recovery.  Chronic Widespread Pain associated with depression raises an adolescent’s risk of suicide. 

Unexplained joint pains due to ligament and tendon wear and tear can occur over the age of 40.  Shoulder pain is experienced by many over the age of 40 as the rotator cuff wears out and can lead to tendinitis, tears and bursitis. A syndrome without a known cause, frozen shoulder is experienced by up to 5% of the population, mostly women between the ages of 40-60.  Frozen shoulder, medically termed “adhesive capsulitis” is treatable with stretching, physical therapy, and judicious injections if necessary.  Knee, elbow, wrist, and ankle pains can also occur without an identifiable cause.  If these pains last more than a week, a doctor’s evaluation is beneficial to reassure you it is OK to use the sore area and also prescribe healing treatment.  

Back and neck pain becomes common over the age of 50 as our poor posture, weak core muscles and constant sitting catches up to us.  As long as there is no accompanying limb pain, numbness or weakness, strengthening and stretching through activities like yoga and pilates plus heat or ice may be all you need for treatment.


Pain before, during and after menopause is very common among women.  The terms Menopausal Joint Pain and Menopausal Arthralgia are synonymous.  The cause is thought to be a shift in hormones, although this has not been medically proven.  The multiple uncomfortable body symptoms that accompany menopause such as poor sleep and depression amplifies the pains signals.    Because menopause occurs between the life stages of unexplained joint pain and arthritis, the symptoms may overlap.  Menopausal Joint Pain causes can be multifactorial, and all aspects of the pain should be addressed including physical function, sleep and mood.      

Men can go through andropause, a natural lowering of testosterone levels, after the age of 60.
Testosterone has been described as a pain buffer; this is theorized to be why few men experience fibromyalgia (body pain syndrome) or TMJ (temporomandibular Jaw pain).  Andropause happens more slowly than menopause, so symptoms are not as acutely noticeable.  Because andropause and osteoarthritis cause slow onset symptoms around similar life time, pain specific to andropause is not as clearly identified.

After age 60, joint cartilage wears out as osteoarthritis sets in.  In people over age 70, 70% have X Ray evidence of osteoarthritis.  A history of excess joint strain and injuries in youth can lead to earlier onset and more severe osteoarthritis.   Genetics play a large role in the amount and time that arthritis occurs.  Arthritic pains are made worse both with under and over use.  Finding the right balance of daily activities will protect you from severe symptoms and worsening of the pain.  Strengthening the muscles around the arthritic joint helps protect it from misalignment and further injury.  

For everyone at every stage of life, staying fit and mobile will protect you from severe pain.  Keeping in tune with your body’s motions and pain at various times of the day will allow you to recognize if you are developing a pain syndrome.  Whenever pain interferes with activity, lasts more than a few days, or wakes you from sleep, try resting, icing and consider seeing a physical therapist.    You can also try over the counter pain relievers such as acetaminophen (tylenol), ibuprofen (advil or motrin) or naprosyn (aleve.)  If the pain does not resolve, it’s time to see your doctor.  You will probably see many other people your age there too!! 




1 comment:

  1. I always recommend people to resort to physical therapy, because It's so beneficial to our physical and mental health, but mostly because it helps patients on their recovery and to reduce pain. It's sad that people don't know how impactful undergoing physical therapy is. A website that has helped me become more aware of physical therapy and its importance is Preferred Rehab , you should check it out!

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