BackgroundIn growing elderly populations, there is a heavy burden of comorbidity and a high rate of geriatric syndromes (GS) including chronic pain.PurposeTo assess the prevalence of chronic pain among individuals aged ≥65 years in the Southern District of Israel and to evaluate associations between chronic pain and other GS.MethodsA telephone interview was conducted on a sample of older adults who live in the community. The interview included the Brief Pain Inventory and a questionnaire on common geriatric problems.ResultsOf 419 elderly individuals who agreed to be interviewed 232 (55.2%) suffered from chronic pain. Of those who reported chronic pain, 136 participants (68.6%) noted that they had very severe or unbearable pain. There were statistically significant associations between the pain itself and decline in patient’s functional status, increased falls, reduced mood, and cognitive decline.ConclusionThe results of this study show that chronic pain is very common in older adults and that it is associated with other GS. There is a need to increase awareness of chronic pain in older adults and to emphasize the important role that it plays in their care.

BackgroundPain is one of the most common reasons for seeking medical care. The purpose of this study was to characterize patients visiting the complementary medicine clinic for a pain complaint.MethodsThis is a cross-sectional study. The study took place at Clalit Health Services (CHS) complementary clinic in Beer-Sheva, Israel. Patients visiting the complementary clinic, aged 18 years old and older, Hebrew speakers, with a main complaint of pain were included. Patients were recruited consecutively on random days of the month during a period of six months. Main outcome measures were: pain levels, location of pain, and interference with daily activities. Once informed consent was signed patients were interviewed using a structured questionnaire by a qualified nurse. The questionnaire included socio-demographic data, and the Brief Pain Inventory (BPI).ResultsThree-hundred and ninety-five patients were seen at the complementary medicine clinic during the study period, 201 (50.8%) of them met the inclusion criteria. Of them, 163 (81.1%) agreed to participate in the study and were interviewed. Pain complaints included: 69 patients (46.6%) with back pain, 65 (43.9%) knee pain, and 28 (32.4%) other limbs pain. Eighty-two patients (50.3%) treated their pain with complementary medicine as a supplement for their conventional treatment, and 55 (33.7%) felt disappointed from the conventional medicine experience. Eighty-three patients (50.9%) claimed that complementary medicine can result in better physical strength, or better mental state 51 (31.3%). Thirty-seven patients (22.7%) were hoping that complementary medicine will prevent invasive procedures.ConclusionGiven the high proportion of patients with unsatisfactory pain relief using complementary and alternative medicine (CAM), general practitioners should gain knowledge about CAM and CAM providers should gain training in pain topics to improve communication and counsel patients. More clinical research to evaluate safety and efficiency of CAM for pain is needed to provide evidence based counseling.

Background: Although diabetes mellitus (DM) is often associated with painful neuropathic syndromes, a signifi cant number of DM patients suff er from non-neuropathic (nociceptive) pain. Unfortunately, there is insuffi cient data on the epidemiology of nociceptive pain in DM patients and its eff ect on their quality of life. Objective : To characterize pain in type 2 DM patients, and assess its eff ect on their quality of life. Methods: The study population included 342 type 2 DM patients, 18 years of age and above (mean age 70.7 Ϯ 9.7), who reported having pain. The study questionnaires included the Brief Pain Inventory (BPI), the S-LANSS scale to assess pain with neuropathic features, life impact, and socio-demographic data. Results: One hundred and fi fty-fi ve DM patients (46.5%) reported having pain of predominantly neuropathic origin. Almost 75% of patients with neuropathic pain were females, compared to 57.8% of patients with nociceptive pain ( P ϭ 0.002). More patients with neuropathic pain reported constant daily pain (57.6% vs. 42.4%, P Ͻ 0.0001), and worse pain during the night (53.3% vs. 46.7%, P ϭ 0.045). The pain aff ected daily activities, walking capacity, and mood. Patients with neuropathic pain reported a greater negative eff ect of pain on their quality of life than those with nociceptive pain (41.0% vs. 15.3%, P Ͻ 0.0001). Conclusion:The impact of neuropathic pain in DM patients is much more signifi cant than nociceptive pain and aff ects their quality of life and daily function to a greater degree.

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