STUDY:  Pain Causes Older Adults to Develop Inflammation Over Time

STUDY: Pain Causes Older Adults to Develop Inflammation Over Time

By Staff

A small study from the University of Florida Health suggests for the first time that as we age, we may all become more sensitive to pain.  The study shows that inflammation may occur more quickly, at a higher magnitude, and for a longer duration than time when adults experience pain versus when young adults experience pain.

This could mean that older adults could be at risk for developing chronic pain and may benefit from taking anti-inflammatories soon after an injury or procedure, according to the researchers.

Older adults often have a certain level of chronic inflammation in their bodies. But the University of Florida researchers found that when they induced pain in older adults, proteins associated with inflammation increased more than they did in younger participants and stayed in the bodies of older adults longer. The researchers also found that anti-inflammatory cytokines, proteins that soothe inflammation, peaked later for older adults than younger adults. They published their results were published in a previous issue of Experimental Gerontology.

“Older people go through painful procedures more often, and we wanted to research whether this accumulation of painful procedures or more acute pain episodes that older people encounter is bad,” said Yenisel Cruz-Almeida, Ph.D., MSPH, an assistant professor in the UF College of Medicine’s department of aging and geriatric research who also is affiliated with the UF Institute on Aging.

“If you have enough of those in a shorter period of time, does this predispose you to have chronic pain?” she added.

When older adults have this kind of elevated inflammatory response, they’re more likely to have pain generated in the periphery of the body – their tissue and limbs outside of the spinal cord and brain, said the study’s senior author Joseph Riley, Ph.D., director of the pain clinical research unit in the UF Pain Research and Intervention Center of Excellence.

“If older adults are more likely to have these pain messages sent through the spinal cord to the brain, and the nervous system is being adapted to go through these changes, they may become more pain prone,” said Riley, also a professor in the UF College of Dentistry’s department of community dentistry and the UF College of Public Health and Health Professions’ department of clinical and health psychology.

While the study does not establish whether accumulation of acute pain predisposes older adults to chronic pain, the researchers say their findings suggest this is a possibility, and it’s the first step in pain research to further understand the relationship between pain and aging. The researchers said the study’s sample size, though small, was more than adequate to demonstrate large differences between the older and younger adults they tested. The differences in inflammation within each group varied very little compared with the overall difference between the two groups, which suggests the populations they sampled were very different and there was little chance of sampling error, Riley said.

Cruz-Almeida and Riley studied eight healthy older adults, whose average age was 68, and nine healthy younger adults, whose average age was 21. None of the participants had illnesses such as diabetes or hypertension. During an initial visit, researchers induced pain in the participants in two ways, either using heat applied to the feet or a cold ice bath.

The first session determined how sensitive the participants were to pain. Determining a tolerable temperature allowed the researchers to recreate the same amount of pain for each participant in the subsequent sessions.

Participants rated their pain on a scale from 1 to 10. The researchers were aiming to induce pain to a Level 4 – a level that created the painful stimuli the researchers needed, but didn’t dissuade the participants from returning for the other visits required in the study.

To study inflammation in the blood, the scientists inserted a catheter into each participant before inducing pain. That allowed them to collect the participant’s blood before the pain stimulus and then at three, 15, 30, 45, 60 and 90 minutes after the stimulus. These blood samples allowed the researchers to study inflammatory markers in the blood, finding that older adults had higher levels of inflammation when pain was induced than the younger adults.

Riley said activation of the immune system and increased inflammation are not necessarily harmful, but it’s important to understand how the length of time the immune system is activated affects the body.

“We think that the longer you have the immune system activated, having these elevated inflammatory cytokines, the more this activation can alter the homeostasis of the body. Usually an imbalance like that can be associated with autoimmune disorders, which also increase with age,” Cruz-Almeida said. “But the truth is we don’t know what the direct implications would be. We think low-grade inflammation is related to endocrine abnormalities such as diabetes and the development of heart problems. … We need to keep looking and doing future research.”

Riley said immediate implications of the research for patients could be to attack pain quickly with anti-inflammatory medication.

“Early treatment of an injury even with over-the-counter anti-inflammatories may be a good idea,” Riley said. “It’s those first few days of bombarding the central nervous system with pain signals that has a bigger effect (on the body).”

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Authored by: Staff

There are 6 comments for this article
  1. Jean Price at 2:04 pm

    This all may have a flip side, as people age perhaps accumulated inflammation can actually cause diseases! Or make chronic pain even worse! And in the future, since pain treatment has its taboos, I wonder what young people will face, or those who can’t take antiinflammtory medications for their youthful injuries? However this group was very small, and not enough has been done yet shed a true light on these issues. Perhaps with the preliminary work findings, some interest will be generated to pursue this. God knows any research about pain might make it more acceptable and more deserving of treatments!

  2. marty at 4:07 am

    I am happy for these studies. I was on Vioxx when it was out and it did wonders for me. Since then not so lucky. I found it even harder to keep working 2 jobs once they took it off the market. I took everything to help me with my pain and all I got was stomach problems and the pain got worse and worse even taking celebrex. Now my insurance only covers the Celecoxib which seriously does very little. But once I hit 60 and more things on me gave out and surgeries started my pain level was doubled and still is. As you get older it really is harder to fight and deal with the pain. I am plum worn out and probably own half of the natural remedies out their. A very light massage or very easy chiropractic adjustments helped but sadly insurance does not cover those.

  3. Wilson Hulley at 10:44 am

    Wilson Hulley slarbird42393@COMCAST.COM
    1330 Hrs
    19 May 2016

    I remember a dear friend Larry Ng who was an accupunturist – the best in the country. A Master in his profession. Larry was part of many surgery teams in the Washington, DC area. Accunpunture carries no drug “kickback”,,,

  4. Krissy at 9:09 am

    This is why older people all laugh together about their aches and pains, even without diagnoses of disease. It is nice to see that older people are being studied. The inflammation in someone like me, with RA, Lupus and ME/CFS, DDD, Raynaud’s, sciatica, scoliosis and spinal stenosis, bulging disks and many bone spurs lead to some pretty uncomfortable days, not to mention those times when I can’t even walk.

    Other factors could be involved (opinion here) and one would be that many older people have unwanted bacteria in their lower GI that goes undetected. I hope studies continue toward that and other stomach issues. I took aspirin for 11 years, and added Naproxen/Aleve (it was Rx then) for eight years and it resulted a big ulcer. I got off aspirin about a year ago (again) and cannot tolerate it anymore, but still need 800mg Ibuprofen every six hours to help with oxycodone and Fentanyl. The Ibuprofen really works well in conjunction with opioids for me.

    My stomach problems are huge. There are only a few things I can eat now, so I will have to deal with it soon. But regarding this study, it sounds to me like a milestone in research.

  5. Kerry at 8:47 am

    Why is this news? I’ve had my ear to the ground and have found many other studies with similar conclusions. When will actual practicing doctors except for a few humble dedicated physicians actually read and heed studies?? One study I read said it takes an average of 12 years for major studies to get into the clinical setting. What it didn’t say was it takes 25 yrs or longer, if ever, for small studies get validated by the “highly respected and regarded studies” before the clock begins ticking on those 12 yrs! Today doctors ignore the sick with chronic inflammation and severe pain right before their very eyes and the glaring endocrine dysfunction associated with those. People complain as they get older how much worse they feel. This study is very important yet will never be read or understood by the majority of our physicians who stop educating themselves the day they throw their cap up at graduation from med school. They never have drilled in them they have somethings still left that needs to be learned. They should learn to learn from each and every patient they have in their exam room today.

  6. Tim Mason at 7:30 am

    Interesting take on an old idea. Anti-inflammatories, having been around for quite some time, have been used by many of us older folk.
    Many of these COX-I and COX-II inhibitors work fine for a short period of time. However, daily use of these drugs are often contradicted in patients that already have heart problems and stomach problems. Nausea and stomach ulcers are short term and long term side effects of these drugs. Remember Viox? It was removed from the market for causing heart attacks.
    I used anti-inflammatories for 15 years. First started with DayPro for 4 years and finally made it up to Celebrex. (The X in the name identifies these drugs as Cox inhibitors).
    After a year of nausea and losing 40 pounds I found myself having an upper GI performed. I had stomach ulcer the size of a quarter. I took Carafate for three months and cleared it up.
    The side effects of Cox inhibitors can be insidious. Use with caution.