Geriatrics and Chronic Pain

Abstract

Mr. Williams is a healthy, active 72-year-old who plays par golf 3 days a week. He is also a regular volunteer in his church and at a local nursing home. He comes to the doctor complaining of pain in his low back, buttock, and leg when he walks approximately two blocks. Often, the leg goes numb as well. Once he gets the pain, it only goes away after he sits down. Because of the pain, he has had to discontinue golfing and most of his volunteer activities. He recently started riding a bicycle to keep up his activity level, and reports he can ride for several miles without any pain. The only time he can walk without developing severe buttock and leg pain is when he helps his wife by pushing the shopping cart in the grocery store. Mr. Williams also notes that the residents at the nursing home where he helps serve meals have begun to tease him, saying, “You’re getting old, Bob. You’re looking more and more like an old man everyday. Look how you stoop when you walk!” Mr. Williams’ physical examination shows excellent forward flexion of his back, although he reports discomfort with back extension. His neurological examination is normal and he briskly walks up and down the hallway in the office without complaint. Mr. Williams is reminded that he’s “not a kid anymore,” and his doctor suggests developing an interest in more sedentary activities.