As people growing older or become elderly, several health risks and health complications and problem may happened because the natural degeneration of human systems and organ. When you are growing older and become member of elderly population, some complications associated with general body aches and pains may occur.
Definition of Pain in Elderly
Pain is defined according to Mersky and by the International Association for the Study of Pain as ‘‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’’ (Mersky, 1986: S217). It must be explicitly recognized that low back pain is an experience, not simply a response to a stimulus. Thus, ‘‘activity induced in the nociceptor and nociceptive pathways by a noxious stimulus is not pain medications, which is always a psychological state, even though we may well appreciate that inflammation and pain most often has a proximate physical cause’’ (Mersky, 1986: S217). Two situations in which the proximate physical causes of pain are more clearly and quantifiably specified are in acute, procedural pain (e.g., injection, third molar extraction) and in experimental studies of pain in the laboratory. To our knowledge there are no systematic studies of age differences in procedural pain. A number of laboratory studies of the effects of aging on pain sensation have been published, and these are reviewed below.
Dimensions of Pain in Elderly
Human pain has been described as having sensory, emotional, and cognitive dimensions. The sensory components of pain are described in terms of location, temporal properties, quality, and quantity. Quantity in terms of pain intensity is the property most frequently studied, usually by verbal descriptor scales such as the widely used McGill Pain Questionnaire or by visual analog scales (VAs).
Effects of aging on the motivational-emotional dimension of pain has received less attention than the sensory-discriminative dimension. Recently it has been shown that two quite different emotional components of pain exist. One is associated with the immediate unpleasantness of pain. This emotional component (stage 1 pain affect) usually does not exist in the absence of the sensory qualities of a painful event and is primarily, but not uniquely, determined by pain intensity. The second emotional component of pain (stage 2 pain affect) is associated with broader feelings or moods that are in large part determined by interactions of the history of pain with cognitiveevaluative processes (meanings, expectancies, memories, social context, and pain-related limitations in activities of daily living [PRL-ADLs]). Stage 2 pain affect represents suffering that often occurs in the absence of the nociceptive event or that occurs for any threat to personal integrity. The effect of age on stage 2 pain affect has not been systematically studied.
The cognitive-evaluative dimension of pain has received even less attention in relation to aging. The cognitive aspects of pain involve the meaning of the pain to the individual and expectancies concerning the pain, as well as the contexts in which it occurs, its impact on voluntary or obligatory ADLs (PRLADLs) and its effects on social, family, and occupational activities. The cognitive dimension of pain is now recognized to have a greater impact on the two emotional components than on the sensory dimension of pain, with a larger effect on stage 2 than stage 1 pain affect.
There is a model to review the known effects of age on pain. The different dimensions of pain are illustrated in this figure. In this figure, a nociceptive event results in specific sensations that can be appreciated in terms of intensity, location, temporal quality, as well as other qualities. Cognitive appraisals, combined with the sensory quality of the nociceptive sensation(s) and autonomic arousal, condition the immediate unpleasantness of the painful event (stage 1 affect). The second type of emotional response to pain (stage 2 affect in Figure 1), however, is mediated by more complex cognitive events that are influenced not only by the sensory quality and primary affective response but also by the current context and past history with the same or similar pains.
