Pain Management in the Elderly: Treatment

Treating the Pain

The most common treatment of pain in older people involves the use of analgesic drugs or painkillers, according to an American Geriatric Society study, upon which this discussion is based (Effective Pain Management in Older Patients, AORN, Jan. 2000). The physician must review medications, doses, effectiveness and side effects on an ongoing basis. Although older people are more likely to experience adverse reactions than their younger counterparts, analgesic drugs may be safely used by seniors if they are closely monitored. All medication should be prescribed based on the senior’s needs and situation.

Analgesics include acetaminophen, which is generally for mild to moderate musculoskeletal pain, and nonsteroidal anti–inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. Acetaminophen is often used in place of NSAIDs due to the risk of gastrointestinal bleeding associated with NSAID use. Opioid analgesics include morphine and codeine. Opioids may be helpful in relieving moderate to severe pain.

Whenever possible, exercise should be part of the care of a senior afflicted with chronic pain. Studies have shown that seniors with chronic musculoskeletal pain can achieve improved functioning through moderate aerobic and resistance training on a regular basis. Each exercise program must be tailored to the senior’s individual needs and preferences, and supervised by a trained professional who has worked extensively with the elderly. The senior should receive continuing encouragement and be checked to make sure that injuries are not aggravated.

Other approaches to treating pain include patient education programs, acupuncture, massage, biofeedback, physical therapy, and relaxation techniques. A patient education program generally includes information about the nature of pain, pain management strategies, and how to use pain assessment instruments and medications.

Pain Management Research

Medscape and the National Library of Medicine are excellent sources of medical articles about pain diagnosis and treatment. Both web sites are free, but Medscape requires registration. Try using search terms such as “pain management seniors” or “pain management elders”. Many universities, public libraries and medical centers also contain books and documents on pain management that may be accessed by the public.

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