Taking Pain Medications Increases Fall Risk in Individuals with Cognitive Impairment

Older individuals with cognitive impairment such as dementia have a dramatically increased fall risk (they are at least twice as likely to fall as someone the same age without cognitive problems). If these same adults are taking prescription pain medications for chronic pain, the risk is even greater.

A study outlined in Age and Ageing indicates that researchers at Texas A&M used dating from the National Health and Aging Trends Study to analyze links between pain medication and falls in older adults. The study compared results for participants who took pain medicines every day, five or six days a week, two to four days a week, once a week, or less. Other parameters included age, ethnicity, chronic conditions, and living conditions. Study results indicate an increased likelihood of falls in probable dementia patients who regularly took pain medications (defined as two or more days a week over at least a month).

Researcher Aya Yoshikawa, DrPH, Texas A&M Health Center for Population Health and Aging, noted,

“To address the risk of falls associated with pain medication, especially for probable dementia, it is essential to conduct screening and medication reconciliation in the health care system. The provision of education about pain medication and alternative pain management programs is critical to preventing falls.”

Osteoarthritis Increases Risk of Developing Parkinson’s Disease

Recent studies at the National Taiwan University in Taipei indicate that individuals with osteoarthritis are more likely to develop Parkinson’s Disease. The results are based on a longitudinal study that determined patients with osteoarthritis were 41% more likely to develop Parkinson’s than individuals who don’t suffer from inflammation due to arthritis.

Inflammation of the joints contributes to osteoarthritis pain, while neuroinflammation (swelling of the nerves and surrounding tissue) in the brain leads to Parkinson’s due to neurodegeneration. The study also revealed that individuals with osteoarthritis are more likely to develop comorbidities such as heart disease, diabetes, high blood pressure, and lung disease.

Researchers hypothesized in a recent article in Arthritis Care & Research that several factors contributed to the findings, including:

• Lower levels of vitamin D in osteoarthritis patients. Vitamin D contributes to the brain’s synthesis of dopamine.
• Patients with osteoarthritis are less physically active. Inactivity reduces the brain’s ability to stave off neurodegeneration and the production of specific neurons.
• Increased levels of cytokines that lead to neuroinflammation and irritation of microglia in the brain.

The researchers noted that early-stage Parkinson’s Disease might be missed in patients with osteoarthritis because knee and hip inflammation symptoms are similar to those of Parkinson’s, including shorter strides when walking and slower, more deliberate movements. For this reason, Shin-Liang Pan, MD, Ph.D., and colleagues suggest physicians need to be more vigilant in looking for early signs of Parkinson’s in patients with osteoarthritis.

Women With Chronic Fibroid Pain are Increasingly Showing up in Emergency Rooms

A twelve-year study reveals that more women than ever are ending up in emergency rooms because of severe pain and bleeding caused by fibroids, non-cancerous tumors in the uterus. Each year, tens of thousands of females are seen in ERs across the country due to abnormal menstrual bleeding and unbearable pain and cramping. However, only 10% of these women are admitted for an overnight stay.

These results indicate that part of the problem is the lack of alternative care. Researchers theorize that women may go for long periods tolerating their discomfort until it becomes unbearable because they don’t have insurance or access to quality women’s health care.

Dr. Erica Marsh, study author and chief of reproductive endocrinology and infertility at the Center for Reproductive Medicine, Von Voigtlander Women’s Hospital in Ann Arbor, stressed, “If you have symptomatic fibroids, it’s important for you to establish care with a women’s health provider so you can be counseled on all the options for treatment and symptom relief in a relaxed and trusted setting.”

The price of a trip to the emergency room for fibroid pain can run well over $5,000 due to the need for imaging scans and tests to determine the source of abnormal bleeding. The study, published in the May issue of Obstetrics & Gynecology, indicates that the women most frequently seen in emergency rooms were lower-income patients in their mid-thirties to their early forties.

Interventions for fibroids include medication, interventional radiology, and surgery. By visiting a gynecologist regularly, fibroids can be caught and treated before they land a patient in the emergency room.

U.S. Pain Foundation Asks Federal Government to Report Chronic Pain Information and Increase Public Awareness

In cooperation with several organizations focused on chronic pain and its impact, the U.S. Pain Foundation is requesting that Congress take proactive steps in addressing the chronic pain crisis in the United States. There are two facets to the request.

1. Congress should set aside two million dollars for the CDC to collect and analyze information on population health and chronic pain, with the results being published annually.
2. Congress should encourage the Department of Health and Human Services to provide details of the Pain Management Best Practices Task Force Report to PCPs across the country. Congress should augment this with a public awareness campaign to educate the public about chronic pain and how it differs from acute pain.

According to the Foundation, chronic pain currently affects over 50 million adults in the United States. Despite chronic pain being costly, disabling, and pervasive,  the price of treating chronic pain is disproportionately high, and access to effective treatment is limited. Proper reporting and funding may help alleviate the problem. Policymakers, physicians, health care providers, and the general public all need to be better educated about chronic pain and its cost on an individual and national level.

For more information on the U.S. Pain Foundation’s initiative and how you can help, check out their June 2, 2021 advocacy article here.