Allen Lebovits, Ph.D.

Many elderly patients who have chronic pain also have high levels of stress often because repeated medical interventions have failed to provide relief. In these situations, stress-management interventions can be very helpful. Many patients readily acknowledge that stressors, including conflicts with family and friends, can exacerbate pain. Reducing a patient’s stress can be very helpful in reducing levels of pain.

The initial step in stress management is to identify which stressors are affecting the patient’s quality of life. After identifying these issues and convincing the patient how stress can often affect their perception of pain, implementing several important stress-management interventions can be particularly helpful to elderly patients. These include:

– Cognitive-behavioral training such as relaxation training.
– The development of time management techniques.
– Sharing their emotions or problems.
– The use of humor.
– Participating in physical exercise.

Cognitive-behavioral techniques include relaxation training and biofeedback. ProHEALTH offers many modalities that may help patients overcome their perception of pain.

Time management consists of creating daily task lists arranged by priority. Done properly, time management is effective for patients who are overwhelmed by their illness or pain as they try to reintegrate back into their social lives.

Expression of emotions and discussing problems with significant others, friends, or professionals can be an effective method of relieving stress. As we get older we often have great difficulty coping with increasing functional limitations and making important decisions. Discussing these issues and getting advice from others often help to reduce anxiety. Internalizing emotions is generally considered to be unhealthy and has been correlated with a variety of medical conditions, including chronic pain. An elderly patient who has a strong support system often is able to cope more effectively with stress.

The use of humor can be an effective stress reducer. Laughing at one’s problems and taking a humorous perspective on difficult situations can facilitate stress reduction. Similarly, making time for fun by involving oneself in recreational activities can be a good distraction and break up the chronic nature of pain.

If medically feasible, physical exercise on a regular basis, usually recommended to be done three times a week for 20–30 minutes, can be a particularly effective stress reducer. Those with pain should never initiate a physical exercise program without the guidance of a physiatrist or physical therapist. Swimming is considered to be one of the best cardiovascular exercises, particularly good for those suffering with pain as there is limited stress placed on the joints.