A Country In Pain? Elderly Singaporeans Seek Relief from Chronic Pain.
Do you find yourself experiencing frequent pain? You are not alone. According to the Well-being of the Singapore Elderly (WiSE) study published in the Pain Research and Management journal in 2018, about one in five (19.5 per cent) elderly aged 60 and above suffer from chronic pain.
As Singapore’s population continues to age – with one in four Singaporeans expected to be 65 and above by 2030 – chronic pain could place a strain on the nation’s healthcare system, support services and caregivers.
Pain is a multidimensional, complex and unpleasant sensory and emotional experience. Chronic pain is a persistent and long-lasting discomfort or pain that extends beyond the expected time of healing. Unlike acute pain, which typically serves as a warning signal of injury or illness and diminishes as the underlying cause is addressed, chronic pain can persist for weeks, months, or even years. It is often considered a condition in its own right, characterised by its prolonged duration and the potential to significantly impact a person’s quality of life.
Feeling pain on a regular basis is not normal, even for the elderly. Generally, persistent pain may be due to an unhealthy lifestyle. For instance, high stress levels, anxiety, sleep issues, muscle tension and poor posture. Consuming too much caffeine and alcohol could also trigger pain, said Dr Yeo Sow Nam, director of The Pain Specialist at Mount Elizabeth Hospital. But sometimes, the cause of pain may be a total mystery, he added.
Persistent chronic pain should not be ignored. Those niggling pains can disrupt the lives of those affected, limiting their mobility, impeding their daily activities, their work productivity and deteriorate their quality of life.
A 2019 study involving about 600 Singapore-based employees with migraines showed that 81 per cent had between one and three headache days a month, while the remaining 19 per cent had four to 14 such days a month.
Pain Management
Conventionally, patients with chronic pain are prescribed with opioids such as morphine, codeine, and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. However, painkillers are not the best solution as they do not address the underlying cause of chronic pain. Prolonged use can also result in concerns such as gastrointestinal ulcers due to extended use of NSAIDs. One may also develop a dependency on these medications such as opioids.
In countries such as Australia, pain management is now approached and treated as a condition in itself rather than a symptom of a disease or condition. GPs are the first line of the triage, leading the treatment and working closely with allied health professionals. These may include minimally-invasive procedures, patient education, behavioural therapy, physical therapy, and more.
In Singapore, however, GPs tend to refer patients to specialists to treat the condition, depending on where the pain is situated. For example, an orthopaedic surgeon if the pain is in the knee or a neurologist for headaches.
Some hospitals have started to recognise pain as the fifth vital sign for early diagnosis upon admission of a patient, in addition to blood pressure, pulse, breathing rate and temperature. This is an encouraging step towards officially incorporating pain as a patient’s monitoring structure.
If Singapore aspires to bridge gaps in pain management, it is important to ensure that more Singaporean doctors and GPs are trained in this area.
The more training one has in pain management, the more options he/she will be able to provide their patients with to manage their condition, and the higher likelihood that patients will be treated with minimally invasive therapies with less recovery downtime.
Pain management does not have a “one size fits all” solution. The ultimate goal of healthcare professionals is to prescribe a course of treatment to minimise or eliminate the cause of pain, enabling patients to lead a pain-free life.
Sources:
Today Online 20/09/2017
CNA Online 13/6/2023