For most of us, our wish is to live longer and grow as old as we possibly can. This helps achieve lifetime goals and also observe the trend of lifetime struggle.When you look at most elderly people in our communities, especially those who are 70 years and above, you notice a habit of not drinking the required amounts of water daily.Noticeable common problem amongst the majority of senior citizens is persistent pain of ‘unknown’ origin. Many health experts say this pain emanates from neuro-muscular perspective.Neuro-muscular complaints are health complications linked with nerves and their muscles. While it is true that the majority of elderly people suffer from pain due to neuro-muscular problems, a hidden stimulant behind pain of the ‘unknown’ origin in most of our elderly people is dehydration resulting from inadequate water intake.This is a very important signal to our society and health experts that use pain killers to treat this kind of pain needs a second thought.To prescribe a pain killer for someone whose pain is caused by dehydration will not help much; instead this might further disrupt his body systems.My grandmother is now 102 years old. I have been her personal doctor ever since I qualified as a doctor but when I took time to analyse her regular clinical complaints, I realised that pain was very dominant. She has no neurological deficit and no underlying chronic illness as well that could elicit her recurrent pain. Last year, I diagnosed her with chronic fatigue syndrome directly linked to dehydration.She does not like to drink water but she craves for fluids with high contents of sugar.In one of my clinics, I offered her a glass of water instead of medicine and told her that she has to learn, develop an intimate urge to drink as much water as possible. I explained to her that her natural thirst signals were no longer working due to cellular dehydration, and that without drinking enough water, her life will not be well balanced.She complained to me that whenever she takes water, she gets nauseated.She could relate this to gastro-intestinal infestations, locally referred as "inzoka”, or the warms, whenever she takes water.For this it is very obvious that when the body receives an admirable amount of water it will be ‘excited’ and the next step will be an instant removal of some of the toxins lurking in the gastro-intestinal tract that includes the stomach and intestines giving rise to nausea sensations.The advice for such elderly people is to help them learn how to sip small amounts of relatively warm, ionized water every after 30-45 minutes to help them remove these toxins until they are able to drink larger quantities of regular water that will give the body an automatic chance of toxins removal.Toxins cause irritations at cellular level and make an old person spend sleepless nights complaining of pain of ‘unknown’ origin.The scientific basis of our explanation is that when our body responds to an increased shortage of water, our brain activates neurotransmitter histamine that directs certain water regulators for redistribution in our blood circulation.This system of water redistribution helps to move water to parts where it is needed most and purposely for essential metabolic activity and survival when facing such a shortage.When histamine, as a regulator, moves across pain-sensing nerves in the body system, this triggers strong and continual pain. Such pain signals have been seen in patients with dyspepsia, fibromyalgia, neuralgia, migraine, and persistent but mild headaches.While there might be other causes of the above-mentioned body illnesses, they are major signals for a widespread or localised form of dehydration.The elderly do not feel thirst as readily as younger people. This increases the chances of them consuming less water and consequently suffering dehydration. The body loses water with age and there is a notable loss of muscle mass.Additionally, the kidneys’ ability to sieve toxins from the blood progressively declines with dehydration and this is why progressive chronic kidney disease is more common in elderly people than in young people.The urine of the elderly tends to be dark-yellow in colour and concentrated with low levels of urine output. This also signals the presence of dehydration, thus need for increased water intake.Dr. Joseph Kamugisha is a resident oncologist based in Jerusalem, Israel