How Not to Be a King (or Queen) of Pain

5 things you can do now to avoid pain later

In no particular order, here are my some of my biggest fears about getting old: becoming a bag lady; getting cancer and/or Alzheimer's; developing a turkey neck; and going blind. Here's what I ought to be afraid of: a world of pain.

There are about 12 million Americans dealing with cancer — but 100 million are contending with chronic pain, in which the body's nerve signals fire the equivalent of hot needles and/or an ongoing ache, sometimes for months, years, or decades. Even if you added up all the people in the U.S. with cancer, diabetes, stroke and heart disease you'd only get to about 60 percent of the number of those who hurt pretty much every day, according to statistics from the American Academy of Pain Medicine. The biggest causes include osteoarthritis (especially in the back, knees and hips), low back pain and headache/migraine.

So why doesn't the Grim Reaper of this world strike more fear in our hearts? It could well be because we think of pain as just part of the price of admission into this life, like taxes and, well, the Grim Reaper. Not so, says Margaret Caudill-Slosberg, M.D., Ph.D., author of "Managing Pain Before It Manages You." "Pain is a warning signal to the body. It is not an inevitable consequence of aging," she says emphatically. Assuming you want to avoid a whole lot of ache in your later years — and we think you do — here are five meaningful but simple things you can do to head off pain or lessen the hurt if it's already struck.

1. Put down the fork. When asked what we do that makes pain a lot more likely to strike, Dr. Caudill-Slosberg is quick to answer: "Overeating and sedentary lifestyle." (More on the second one below.) Obesity is the single biggest contributor to chronic pain, so if you do nothing other than get down to or maintain a healthy weight, you're way ahead of the game. It may also be that foods and drinks lead to or worsen pain, though this is notoriously hard to tease out in research, says Dr. Caudill-Slosberg. For some pain conditions, like rheumatoid arthritis, an autoimmune disorder, and migraines — which are often triggered by red wine, some cheeses and the artificial sweetener aspartame — there's an well-known relationship between food and flare-ups. But for most painful conditions there's no such established connection. "Try to move to more of a fresh — not prepared — diet, and try to moderate caffeine and alcohol if you have a chronic pain syndrome," suggests Dr. Caudill-Slosberg. "Keeping your weight in check, though, is a must-do. It's not OK to gain a little every year; it's not true that that's normal."

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2. Pick up your sneakers. It's no coincidence that it's the weight-bearing parts of our body — hips, knees, back — that are most likely to feel the ache, since those are the ones that suffer when we don't use them (meaning when we skip exercise or other physical activity). "Certainly the people who have the worst problems are those who are obese or deconditioned, who didn't pay attention to a regular exercise program," notes Dr. Caudill-Slosberg. "These are people who didn't realize that after age 30 you have to start paying attention to your aging back or your health isn't going to stay the way it was at 30. That's a hard revelation." Take your time easing back into regular exercise; don't just sweep out the cobwebs in one 48-hour sprint of weekend warrior-ing. That's a recipe for another kind of pain: overuse injuries.

3. Pay attention. "Pain serves as a warning of harm to the body," says Dr. Caudill-Slosberg. So while you shouldn't think of pain as a normal part of aging, you also shouldn't ignore discomfort (possibly denying, consciously or not, that you're getting older). "It depends on the degree of what's going on in the body. Pain that develops could be back pain, the onset of the flu, or appendicitis," adds Dr. Caudill-Slosberg. "I've had older friends tell me, 'I'm having this problem with pain, it must be that I'm getting old.' I would check it out before you assume it's just aging." As the years pass, you're likely to notice more stiffness in the morning, she adds. "If stiffness gets better as the day goes on, that's classic for osteoarthritis, but if over time it doesn't get better or you find it's taking longer to, say, open jars — that your daily functioning is impaired — it may be worth going to your internist to get something other than over-the-counter pain relievers."

4. Manage your stress. One of the strangest things about pain is that we can't really measure it; it remains a highly subjective experience. What I would rate as a pull-my-hair-out 10 on a pain scale might be a not-so-bad 4 for you. Which means that there's always going to be a softer side to pain management; put another way, because pain originates in the brain, your mind matters just as much as your body. In fact, when I asked Dr. Caudill-Slosberg what the role of the mind is in modulating pain, she responded, "It's everything." Not only will learning relaxation and mindfulness techniques along with meditation skills likely lessen your experience of pain, they'll make it easier to cope with whatever life throws your way. Developing the mind-body connection "will protect you and help improve your defenses, because life does change," says Dr. Caudill-Slosberg. "Things happen — you lose your job, you develop cancer or pain — and when you have the skills to address the loss of health and well-being you're in a much better situation ... Once you've practiced slow, purposeful concentration on a regular basis, there's lots of evidence to show that this calming effect carries over, even when you're not actively practicing yoga or meditation. It allows the person to stop and focus in the middle of a crisis and it helps people get back on their feet."

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5. Don't sit up straight. Esther Gokhale has been called "the posture guru of Silicon Valley," a place that knows something about sitting for endless hours hunched in front of a computer. Her elite status among technocrats comes from her technique — the Gokhale Method — designed to help ease a variety of musculoskeletal discomforts, the most common kind of chronic pain. Simply put, Gokhale, the author of "8 Steps to a Pain-Free Back," wants to help more people relearn the natural, healthy posture we had when we were toddlers. "The natural architecture of the body is pain-free, highly functional and beautiful," she explains, "It's a J spine, rather than an S-shaped or C-shaped spine." In a J-shaped spine, your bottom is behind (not underneath) you, the belt line slants forward and the upper lumbar area is lengthened, not curved. "The bones of the vertebrae stack well in that position, so the muscles are relatively relaxed and there's strength and ease in the body," says Gokhale, who struggled with severe sciatic pain herself for years. When the bones of the spine don't stack well, the edges of the vertebrae are stressed, she says, which forms bone spurs and triggers the start of osteoarthritis. Good posture, she adds, isn't the "stand up straight" or "chin up, chest out" advice we got from our parents; both put unhealthy pressure on the spine. Gokhale offers free online workshops to anyone who wants to learn her technique; sign up at

Tags: well being