Guide to Managing Elderly Chronic Pain

An unpleasant and complex sensory, emotional experience comes under the category of pain. Pain is never expected, and when it lasts beyond the time of healing or continues for a period of three months or longer, it comes under the category of chronic pain.

Unlike wrinkled skin or graying hair, chronic pain is not a part of the normal aging process. For older adults primarily who live independently, chronic pain may have devastating and widespread effects, imposing steep economic and social costs, threatening the quality of life, and personal strain.

Even after extreme pain, many older adults do not discuss their problem and its impact on their healthcare providers because they fear invasive tests, loss of independence, hospitalization, or need to take additional medicines. It may cause underdiagnosis resulting in inadequate treatment, further diminishing quality of life.

Chronic pain is continuously a point of concern as the elderly population grows. According to a survey, in 2016, the number of Americans older than 65 years was about 36 million, 12.4% of the population. By 2030, this group of people may number 70 million (about 20% of the total population).

Causes of Chronic Pain

Advanced age increases the risk of specific health problems that can cause chronic pain. Conditions that can cause chronic pain in older adults may include musculoskeletal disorders such as osteoporosis and arthritis, peripheral vascular disorders, and neuropathic pain (postherpetic neuralgia).

How pain disrupts the quality of life?

Chronic pain is linked to depression, sleep disturbances, poor physical functioning, and reduced social activity. Pain-linked problems can make older adults more dependent on others for ADLs (activities of daily living) and may result in social isolation and a rise in healthcare costs. Pain is commonly seen as a threat that influences older adults’ coping processes.

Effects of pain on sleep

Chronic pain can disrupt your sleep in several ways. Altogether, falling asleep is problematic for various older people who have endured chronic pain stress in the day. Sleep quality may suffer because of frequent awakenings, as continuously changing sides on the bed may cause pain.

Sleep deprivation and alteration in sleep quality can lessen the pain threshold. Thus, a vicious sleep-deprived cycle occurs with lowered pain threshold, decreased sleep quality, and reduced ability to cope with chronic pain.

Depression and Distress

Many older people with chronic pain experience extreme distress or even depression which can obstruct their ability to handle or cope with pain. Additionally, the pain may worsen your cognitive dysfunction and malnutrition.

Along with financial hardship and other factors, chronic pain contributed to depression and distress among community-dwelling older adults. The chronic pain caused by arthritis interferes with daily activities and makes it harder for such people to carry out daily activities (ADLs), and it can cause distress.

Chronic pain can be directly linked to depression, and people might adapt to chronic pain and may not appear to be distressed daily; pain may create long-term effects manifesting depression.


Assessment of chronic pain in older adults can be challenging due to the population tends to underreport pain. Also, unlike patients with acute pain, those with chronic pain usually do not manifest autonomic pain responses, such as a sudden increase in heart rate and respiration.

Using a pain scale is beneficial while assessing an older adult for pain. A doctor may encourage their patient to keep a pain diary to help identify events that precipitate or increase pain. A pain diary can also offer clues about the occurrence of breakthrough pain. If the findings from the assessment suggest the patient has chronic pain, try finding out whether and to what level the pain is affecting the quality of life of an individual.

Plan of Care

Medical healthcare providers must develop a proper plan to address the patient’s chronic pain. The program should check the patient’s comfort-function goal and identify the pain management needed to reach the required functional ability.

Establishing a realistic and practical comfort-function goal offers direct patient input into their pain management and its implementation. It also holds both the medical healthcare team and the patient accountable for providing adequate pain relief.

Some older adults may need more help in establishing realistic goals. Firstly, inquire about the pain-related functional limitations that the person finds distressing.

Pharmacologic Pain Management

There are various pharmacologic pain management options. However, physiologic changes in the continuously aging body and coexisting health problems can challenge pharmacologic measures in the elderly.

Such physiological changes alter drugs’ pharmacodynamics and pharmacokinetics. For some reason, some medications are not very appropriate for pain management in older adults. Here is a list of potentially inappropriate medications for pain management in older adults, including:

  • Classes of drugs or medicines generally should be avoided in people 65 years or older because they may be ineffective or pose an unnecessarily high risk. I prefer taking a safer alternative available for older adults.
  • Medications that one should not prescribe to older adults who have certain medical conditions.

For many patients, the plan for pain management may need to include pharmacologic methods and nonpharmacologic methods.

Promoting Compliance with Drug Therapy

Compliance with any therapy can pose a challenge for both the patient and medical healthcare provider. Many elderly patients mistakenly think that they should take analgesics only when the pain becomes hard to handle; some patients fear becoming addicted to them. The doctor should emphasize the importance of using pain medication to stay in a better condition, rather than waiting for the pain to become unbearable.

Some older people may avoid pain treatment because of the risk of constipation and other adverse effects. Suppose fear of constipation obstructs the patient from taking the required medication. In that case, the medical healthcare provider should educate them about beneficial dietary changes, such as eating more fiber-rich food and drinking more fluids.

Nonpharmacologic Pain Management

In most cases, various older adults are open more to nonpharmacologic approaches for pain management. As per the requirements and adaptability status, teach patients about relaxation, exercise, guided imagery, acupuncture, yoga, spiritual interventions, and music therapy. Some other popular nonpharmacologic pain management options include:

  • biofeedback
  • humor
  • repositioning
  • distraction such as reading a book, watching television, or talking on the phone

In some situations, application or massage of something heat and cold may be appropriate. But take caution in older adults who have neuropathic pain or ischemic pain due to peripheral arterial disease. In those conditions, using heat and cold may lead to altered sensation at the extreme level and damage tissues. One must encourage their patients with joint pain or arthritis to stay as active as possible and participate in non-weight-bearing activities, such as swimming, biking, or aerobic water exercises.

Be an advocate for the elderly.

Promoting health and well-being is the essential cornerstone of nursing an elderly patient. Once you understand the overall effects of chronic pain in older adults, you can identify patients with debilitating chronic pain more efficiently, collaborate with a multidisciplinary medical healthcare team, and implement needed interventions to offer relief and improve quality of life.

It would help if you constantly stay up-to-date on the latest studies, research, and chronic pain findings. You can use the information from the reports to help guide your practice. Provide measures that promote document patient outcomes, promote comfort, and advocate for elderly patients.

You may urge the nursing leaders to pitch the federal government to fund research concerning chronic pain in the elderly and assist researchers in data collection as appropriate. Remember that pain is not a regular part of aging and older adults also deserve pain relief and the stress pain creates.

Black Friday Sale 2021

What is Black Friday?

The next day (Friday) after Thanksgiving is known as Black Friday. It is the official or unofficial start of the holiday shopping season. Almost all the stores and websites come with mind-blasting offers and discounts to attract customers. People stand in queues in front of stores to grab their favorite discounts. Sites have loads of traffic of the customers purchasing online using various discount coupons and bargain options. In the past few years, it a trend to bring appealing sales online before Black Friday.

It used to be a one-day event in the past. But now, Black Friday is no longer a one-day affair. After 2013, both offline stores and online websites start the sales way before Friday, especially from Monday or Wednesday. So now the most significant sale days include Thanksgiving Day, Green Monday, and Cyber Monday.

This shopping event is the biggest revenue-generating event of the year. People do lots of shopping for the upcoming holiday season, they book flight tickets and make hotel bookings for holiday trips and do lots more on the Black Friday sale.

Why is it called a Black Friday?

Retailers report their highest profits on Black Friday. The word “Black” in Black Friday refers to the business recording loss in red ink and profit in black ink. Modern accounting software also follows this tradition. Hence, Black Friday got its name from the profit it marks for businesses.

Are Black Friday Sales Online?

Black Friday Sales are Online! This is a bonus for the customers as now they don’t need to stand in long queues to get the benefit of discounts on their favorite products. People can buy anything and everything online on Black Friday. Book air tickets, buy daily need products, make hotel bookings, buy electronics, and anything you need online on Black Friday.

Black Friday Sale

People can also buy medicines online at attractive discounts. Get up to 20% discount on all medicines by using coupon code BLKFRDY on

Shopping Tips for the Upcoming Black Friday

  • Make a list of what you want in advance. This will help you from the last moment rush.
  • Visit your favorite websites to know the discounts they are offering this Black Friday.
  • Add your items in your cart before the sale starts.
  • Call the stores to get complete details of the discounts on the products and services of your choice.
  • Give preference to the products that offer more discounts to save more dollars.
  • If you are a group of people, everyone should go to a different store.
  • Check price matching policies of different stores and websites.
  • Buy the products that you need most. For example, purchase medicines, food items, and other necessary products.
  • Go for online shopping as it will save both your time and effort.

Dilaudid Addiction and Abuse

What is Dilaudid?

Dilaudid is a part of a group of drugs that are chemically similar to opium and prescribed to be taken as pain killers. The brand name of the drug is Hydromorphone and by its name, you can easily guess that the drug is derived from morphine.

Although people buy Dilaudid online because it is prescribed to be taken as a painkiller and is considered to be stronger than morphine, it is less likely that a person will get addicted to the drug if taken by someone in a larger quantity.

What are the side effects of Dilaudid?

Most people who buy a prescription drug tend to take it more than prescribed, mostly by injecting the drug into their bloodstream, mainly to get high. In such a case, the drug may cause a strong euphoria. Some people who tend to abuse the drug take it by mixing it with other opiates like heroin.

However, the signs of drug use or abuse depend on the person who is indulging in the intake or the quantity of the drug he has taken so far. Therefore, the signs of drug use or abuse in the case of Dilaudid are:-

  • Dizziness
  • Nausea
  • Vomiting
  • Stomach ache
  • Constipation
  • Finding it difficult to breathe
  • Fainting

If you want to know more about these signs and help yourself from becoming a victim of these signs of taking the drug, the best way to do so is to buy Dilaudid online in the USA and from an online pharmacy that is able to provide you with a prescription.

Withdrawal Symptoms of Dilaudid:

As you must have understood by now that if you buy Dilaudid online and start taking the drug more than prescribed or beyond the prescribed limit, you are bound to face the hazardous consequences of doing so, including wanting to take the drug more and more.

The drug may or may not work for everybody but if you suddenly stop the intake of the drug after a long time on knowing that the drug is not proving to be effective for you, you are bound to face the withdrawal symptoms of the drug.

So, the best method to save yourself from becoming a victim of the drug’s withdrawal symptoms is by slowly decreasing the intake of the drug and then stopping its intake.

But for now, let us discuss some of the withdrawal symptoms of the drug:-

  • Sweating profusely
  • Cramps in stomach
  • Anxiety
  • Vomiting
  • Watery eyes and nose
  • Restlessness, especially in the legs
  • Headache

11 Things You Need to Know About Tramadol

What Is Tramadol Used For?

Tramadol is a drug that is used as a painkiller. It is a narcotic-like severe pain killer for adults. The working of Tramadol is to blind the receptors present in the brain which are responsible for transferring the sensation of pain from the whole body to the brain.

Tramadol comes in three forms Instant release tablets, Extended-release tablets, and capsules. Instant release tablets release in our body immediately while extended-release tablets start its action slowly over time. Tramadol is a potent drug, so it should be taken under the supervision of the doctor or pharmacist. Tramadol can be administered with a combination of other medicines.

Working of Tramadol:

Tramadol is a drug that belongs to the “opioid agonists” family of drugs. All members of this family show similar working properties. Tramadol blinds the receptors in the brain that’s why receptors carry less pain message throughout the body to the brain, and our brain feels pain in decreased form.

Tramadol Oral

Side Effects of Tramadol:

The most common side-effect of this drug is you may feel dizziness, headache, nausea, vomiting, drowsiness, constipation, sweating, lack of energy, dry mouth, etc. These are the most common symptoms of Tramadol. Some people may feel some different effects also, if you are feeling as above or something else after taking Tramadol and if the problem continued, then, you must consult your medical practitioner.

Some severe side-effects of Tramadol are fast heart rate, high blood pressure, higher body temperature. You may feel unable to control the movement of your body(lack of coordination). You may feel nausea, vomiting, agitation, hallucination.

Side Effects of Tramadol

The other serious side effects of this drug are serious breathing problems like slowed breathing rate, very shallow breathing, fainting, dizziness, or confusion.

Drugs Which Can’t be Used With Tramadol:

Carbamazepine is one of the examples of medicines that can not be used with Tramadol, because if you use this medicine with Tramadol, then the working property of Tramadol is effected. Tramadol may become less effective in relieving your pain on taking with this drug, or some severe side-effects may also occur. The combination of these two drugs decreases the total amount of Tramadol.

Tramadol Precautions:

We have provided for you a list of precautions that you must take to avoid the harmful effects of the drug. Follow the guidelines that are given below –

  • The tablets of Tramadol should not be used by any child who is younger than 12 years. As we know, Tramadol is a habit-forming drug, and giving it at a younger age will develop a dependency.
  • Take the tablets of Tramadol as prescribed by your health expert. You can also follow the steps given on the prescription label of the drug.
  • A woman who breastfeeds her child should not take this medicine. The drug content may get transfer to the body of the baby and hence, may cause severe harm.
  • The extended-release tablets of Tramadol should not be given to people under the age of 18.
  • Do not overdose or misuse the tablets of Tramadol. It will get you addicted to the use of medicine, and severe health issues may arise.
  • Someone who is Allergic to opioids must not take this medicine. Taking Tramadol may even worsen the allergies like hives or rashes over the skin.
  • If someone drinks alcohol or is a habitual consumer of alcohol, then you should not take Tramadol. A combination of alcohol, along with Tramadol, will increase the effect of the drug and may also cause severe drowsiness.

Is Tramadol Addictive?

Tramadol is an opioid-like medication. It treats severe pain by acting on the brain and changing the way the body feels and responds to pain. Tramadol works similarly like a narcotic, and hence, it is also an addictive medication. It acts on the brain resulting in causing an addiction to the drug.

Tramadol Addiction

The misuse, overdose, or more prolonged doses of the tramadol can cause severe addiction. Even at regular doses, it can be habit-forming. To prevent the addiction caused by tramadol, take it exactly as prescribed by the doctor. Stop the medication gradually when it is no longer needed.

Do not use tramadol if you are prone to substance abuse or addiction.

Can It Cause Withdrawal?

Tramadol can cause dependence. Do not stop taking the medication at once, as it causes severe withdrawal symptoms. Gradually lessen the dosage of tramadol, as directed by the doctor.

The most widely known withdrawal symptoms of tramadol are:

  • Sweating
  • Chills
  • Anxiety
  • Diarrhea
  • Nausea
  • Loss of appetite
  • Panic attacks
  • Muscle pain
  • Sleep disorders
  • Fast breathing
  • Increased blood pressure.

Withdrawal symptoms differ in different patients. Many factors are responsible for causing withdrawal. The withdrawal caused by tramadol is influenced by:

  • Patient’s age
  • Patient’s health
  • Genetics
  • Other drugs used by the patient
  • Patient’s history of substance abuse.

Is Tramadol Good For Back Pain?

As you must have learned it by now, Tramadol is a drug that is mainly prescribed for the treatment of pain inside a human body. The pain that occurs is carried to the brain through the pain receptors present in the Central Nervous System (CNS). Patients should not buy Tramadol online if they do not have a prescription for the drug.

Tramadol Good For Back Pain

The dosage of Tramadol is prescribed when other non-opioid pain medications are not active enough on a person’s health. The immediate-release form of Tramadol is given to a patient when the pain is severe and needs to be treated then and there. These forms of Tramadol are not for recreational purposes. Doctors mainly prescribe the immediate-release form of Tramadol for back pain, postoperative pain after spine surgery, and sciatica (pain running through the sciatic nerve). Thus, Tramadol is a suitable drug to treat back pain.

Is Tramadol An Anti-Inflammatory?

No, Tramadol is not categorized as a nonsteroidal anti-inflammatory drug (NSAID). Instead, Tramadol is more of a synthetic drug that is produced by man. It belongs to the class of opioid analgesics that help in the treatment of pain. People who buy Tramadol online without a prescription may not have information about this.

An anti-inflammatory drug like aspirin is also used as a pain reliever, but it does have some harmful side effects. The anti-inflammatory drugs have a high risk of causing stomach ulcers or extreme pain, bleeding internally, high blood pressure, kidney or liver problems, and so on. Therefore, people who are taking Tramadol need not worry about the harmful effects of anti-inflammatory drugs.

Is Tramadol Good For Joint Pain?

Though there have been several uses of Tramadol related to pain, a person must not buy Tramadol online without knowing the issues it can treat. Tramadol, when combined with hydrochloride, is a centrally acting analgesic for pain that will double the mechanism of pain medication treatment.

Tramadol Good For Joint Pain

The FDA has approved this combination for the management of moderate to severe pain. Doctors also prescribe this medication for the treatment of arthritis or joint pain followed by physical therapy.

Where Can You Buy Tramadol?

There are many websites and online pharmacies that sell Tramadol at a reasonable price. One must keep in mind not to buy Tramadol online without a prescription. It is illegal to purchase Tramadol without its prescription from a drug store or even through an online medium. Along with this, you need to be sure about the platform from where you will be purchasing your drug is authorized by the FDA (Food and Drug Administration).

Before you buy Tramadol online, do compare the prices and look for an official website. Some sellers in the online market are dealing in drugs that are low quality and higher pricing. You need to be aware of such frauds going on in and around the online market.

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An Overview of Pain Management – Treatment & Care

Pain management is a branch of medicine that applies science to the reduction of pain. It covers a wide spectrum of conditions, including neuropathic pain, sciatica, postoperative pain, and more.

Introduction To Pain Management

Pain management is a regular language term that may be used for the treatment of several types of pain. It may be simple to complex, depending on the severity and cause of the pain. Like a less complicated pain, we can give an example of nerve root irritation from a herniated disc with radiating down the leg. Doctors manage these conditions by epidural steroid injection and physical therapy.

In some cases, pain becomes severe and does not go for a long time. In these cases, patients need a wide variety of skills and techniques for treatment. Some of the required skills and techniques are,

  • Medicine management
  • Chiropractic therapy or physical therapy
  • Interventional procedure
  • Psychological support and counseling
  • Referral to other medical specialists
  • Other alternative therapies
  • Meditation, etc.

All the skills mentioned above and services are compulsory for the management of daily life pains that may involve every aspect of a person’s everyday life.

How Does A Doctor Guide Pain Treatment?

Doctors guide a pain treatment by the intensity of the pain, pain history, duration, structure involved in causing the pain and relieving and aggravating conditions. All concepts behind most of the interventional therapies for pain management depend on the internal nerves system.

Identifying the exact cause of the problem and applying its best treatment plays a significant role in pain management. There are some opioid medications for the treatment of different types of pains. For example, you may buy Tramadol online to manage moderate to moderately severe pain; you may also buy Ultram online as a brand name of Tramadol.

What Are The Basic Types of Pain?

Pain can be possible for different types of reasons. The pain sources may be divided into two groups neuropathic pain and nociceptive pain. The treatment of pain mostly depends on the kind of pain.

Pain Treatment

Neuropathic Pain

This type of pain may be caused by a disease or damage that affects the nervous system. Many times, there are some possibilities of sudden illnesses that have no apparent cause. Frequent examples of this pain are diabetic peripheral neuropathy and shingles. This pain may occur after a stroke or after a nerve is cut. Neuropathic pain may include;

  • Fibromyalgia
  • Irritable bowel syndrome
  • Interstitial cystitis
  • Sympathetically maintained pain
  • Complex regional illness.

Treatment of Neuropathic Pain

It is difficult to manage various neuropathic pains. Doctors recommend a careful diagnosis and often a combination of methods of treatments to make an excellent chance of pain improvement.

Nociceptive Pain

Bone damage is a significant example of nociceptive pain. Loss of tissue and injuries initiates signals that are transferred through peripheral nerves to the human brain via the backbone. Pain messages have modulated the pathway and tell our brain that something is hurting to the body. The backbone stimulator is one of the most potent tools for treating neuropathic pain. You may buy OxyContin online for the treatment of this pain.

Nociceptive pain can be divided into two parts;

  • Radicular pain
  • Somatic pain

What Are Other Causes of Pain?

  • Facial pain
  • Coccydynia
  • Headaches
  • Peripheral nerve pain
  • Post-herpetic neuralgia
  • Compression fractures
  • Myofasciitis
  • Cancer pain
  • Lateral epicondylitis, etc.

Cyber Monday Sale 2019

What is Cyber Monday?

Cyber Monday is the next Monday following the Thanksgiving holiday in America. After Black Friday sales, online retailers created Cyber Monday to encourage people to shop online. Quickly this day is becoming the biggest online shopping day of the year. Online retailers offer appealing deals and discounts to attract customers. Cyber Monday online sales substantially started rising from the year 2017.

Cyber Monday is the online counterpart of Black Friday that offers a way for small retail websites to compete with the larger ones. It is an international marketing event celebrated across the world.

History of Cyber Monday

Ellen Davis and Scott Silverman coined the term “Cyber Monday.” The e-commerce community first used it in 2005. According to the head of, they coined the word based on the researches showing that Monday after Thanksgiving was one of the biggest online shopping days of the year. The ComScore reported that online sales on Cyber Monday jumped 25% in 2006, 21% in 2007, and 15% in 2008.

Cyber Monday is the following Monday after Thanksgiving and often falls in November. The date range of Cyber Monday is between November 26 to December 2, and it’s always four days after the Thanksgiving Thursday holiday.

Online Shopping on Cyber Monday

People nowadays love to shop online. It saves their time, effort, and money too! Cyber Monday sales include all types of products and services online. Websites offer huge discounts, coupons, and even cashbacks to the customers. Products ranging from basic needs to households, from medicines to game consoles, and from furniture to smart devices, people will get it all in the Cyber Monday sales.

It is the best time to shop online before the big holiday season. Remember to buy the products of your needs first. Purchasing daily need items such as household products, medicines, and other essentials in the Cyber Monday can save you lots of money. Different websites offer different ranges of sales and discounts. Shop for the genuine medicines on and get FLAT 10% OFF by using coupon code “CYMNDY.” Some tips for Cyber Monday shopping are:

  • Make a list of the items that you need to buy
  • Go to different websites to compare prices and deals
  • Add the items of your choice to the cart before the sales start
  • Buy your favorite products once the sites start offering discounts.

Thanksgiving: History, Day and Traditions

Thanksgiving is a national holiday in countries like Canada and the United States Of America celebrating the harvest and the blessings of the preceding year. Most of the Americans believe that their Thanksgiving is molded on a 1621 harvest feast shared by Wampanoag people and the English colonist (Pilgrims) of Plymouth. This American holiday is particularly rich in symbolism and tradition. The traditional fare of Thanksgiving meal, typically, turkey, potatoes, cranberries, pumpkins pie, and bread stuffing. As far as vehicular traffic is concerned, Thanksgiving is the busiest of the year. This is because all the members of the family pay visits to each other.

Thanksgiving is celebrated on the 4th Thursday of November each year in the United States of America. Thanksgiving is celebrated every year in the USA since the year 1789, the year it was proclaimed after a request by Congress by George Washington. Though Thomas Jefferson chose not to observe this day as a national holiday, it still observed intermittently until Abraham Lincoln became the President. It was during the presidency of Abraham Lincoln that Thanksgiving became a federal holiday in 1963 in the midst of the American Civil War.

Thanksgiving is also a day of charity, a day to open up our hearts for those who need us. The poor are usually provided with food on Thanksgiving day. Some communities organize food or charity drives in the various parts of the country to collect non-perishable packed food, canned food, and charitable organizations provide a full course meal to people on Thanksgiving Day.

Happy Thanksgiving

Thanksgiving dinner derives its roots from the dinner held in 1621 by the Pilgrims who settled by the Plymouth Plantation and Wampanoag people. Turkey is the most important part of the Thanksgiving dinner. Besides turkey, this dinner also includes potatoes, cranberries, pumpkin pie as some of its must-haves.

Thanksgiving marks the beginning of the ‘Holiday Season’ in the United States of America. Every state of the USA has its own very way of celebrating the festival of Thanksgiving. On this day, many states of the USA observe the much-awaited parades, containing big balloons, high school marching bands, Television stars, Cartoon Characters, and whatnot.

We wish you a very happy Festive Season!