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Seeking new approaches to pain management

Basil Eldadah
Supervisory Medical Officer,
Division of Geriatrics and Clinical Gerontology (DGCG)

The NIH Annual Pain Consortium Symposium took place on May 30 and June 1 on the NIH campus this year. The annual meeting, which highlights current knowledge and advances in pain research supported by the NIH and other agencies, was particularly timely, as pain management and the use of pain medications is a topic that has gripped the nation over the past year. It’s more critical than ever that we find new ways to evaluate and manage pain.

The NIH Pain Consortium, which sponsored the meeting, comprises leadership and staff of more than 20 NIH Institutes, Centers, and Offices to coordinate pain research across the NIH. The NIA is one of those Institutes, supporting research focusing primarily on pain in aging and in older adults. In fact, we have our own internal working group of program staff who meet regularly to coordinate NIA’s pain research efforts. Together with my colleagues Molly Wagster, Coryse St. Hillaire-Clarke, and Adam Steinmetz in our Division of Neuroscience; Lisbeth Nielsen and Amelia Karraker in our Division of Behavioral and Social Research; and Deputy Director Marie A. Bernard, we work together to support research that will advance our understanding of pain, its management, and outcomes in older adults.

Treating different types of pain

Some people may think that pain and aging are synonymous. But research paints a more nuanced picture of pain in older age. Persistent pain affects a substantial portion of the older population, but it can vary in severity, location, and quality. Importantly, pain also differs considerably in its impact on function and quality of life. Persistent pain is a daily reality for many older adults despite treatment. So, maximizing function and minimizing pain’s interference with life is an essential part of a management plan.

The good news is that we have a diverse array of therapeutic modalities. Medications can provide effective pain relief, though physiologic changes with aging, underlying health conditions, and concurrent medications can interfere with their effectiveness, as well as sometimes producing undesirable side effects. Devices, rehabilitation strategies, and complementary and integrative health techniques are also widely used. Many of these approaches rely on the multiple ways in which pain signals can be modulated by a person’s experience, expectations, mood, or environment. Family members and other caregivers also can play significant role in managing an older adult’s pain. This is particularly important in the case of Alzheimer’s disease and other forms of dementia or cognitive impairment. People are affected by pain even if they can’t communicate about it in routine ways.

Research opportunities

At NIA, we want to support science that will lead to advances in our understanding of pain from neurobiological, clinical, and behavioral perspectives. I invite you to take a look at our funding announcements which show the kinds of studies we think might be undertaken to address these areas: :

You can also find a listing of pain-related funding announcements sponsored by other NIH Institute and Centers on the NIH Pain Consortium’s website. If you have questions about the current initiatives, or other ideas for pain research, we welcome your comments.

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