Pain in the Older Person

Answers to Common Questions

What is chronic pain?

Chronic pain is pain that lasts for at least three months.  It can be part of an ongoing disease, like osteoarthritis, or result from previous injury or illness, like pain after shingles.  Sometimes, the pain can be spontaneous, and it may be difficult to find an obvious cause.

Many older people experience chronic pain.  The most common type is joint pain, or arthritis, which is related to degeneration of the joint over time.

Neuropathic pain is also more common as a person gets older.  This is an intense, often burning, pain with shooting or electric-shock sensations.  Neuropathic pain is due to damage of nerves and is often associated with an illness like diabetes or shingles.

Are My Aches and Pains Just part of getting older?

NO.  Although some types of chronic pain are more common as a person gets older, this does not mean that pain is a normal part of aging.  Older people do not have to silently accept pain.

If you experience ongoing pain, especially if it is a type of pain you have never had before, it is important to see your doctor.

What is the impact of chronic pain on older people?

Living with chronic pain is not easy.  The potentially far reaching and devastating impact makes it very important to seek effective pain management.  Do not hesitate to tell your doctors how the pain is impacting on the different parts of your life.  For example, have you noticed:

-Difficulty walking or climbing stairs

-Trouble carrying out routine tasks.

-That you withdraw from regular contact with family and friends.

-Increased feelings of isolation, sadness, depression, anxiety and anger.

Can pain in older people be managed?

YES! However, research has shown that older people may be more reluctant than younger people to seek care.  This might be because they think their pain is a “normal” part of aging, like hair becoming grey, and that there is nothing that can be done about it.  Another obstacle is the belief that one should not complain about pain – that it is better to “tough it out”.  Beliefs such as these can lead to needless pain and increased impact and suffering.

There are two goals of pain management: The first is to relieve the pain as much as possible.  The second is to reduce the impact of the pain.

Clinical studies have shown that older people can be helped with medications, exercise, group therapy, physiotherapy, and many of the other treatments available for younger people.

One of the best ways to manage chronic pain is with a “multidisciplinary” or “multimodal” approach.  This means that treatments from different health care disciplines may be tried either singly or in combination.  Pain clinics usually provide this type of care.

Management might include analgesic medications (pain killers), such as acetaminophen, ibuprofen or morphine and other opioids (or narcotics).  Sometimes, medications that are helpful for other problems might be used to treat pain, such as medications for depression or seizures.

Other  medications might be used to control the impact of the pain, such as, something to help with sleep or mood problems.  People with neuropathic pain are often helped by medications that reduce the abnormal activity in damaged nerves.  Older people may need lower doses of these drugs because as we age, our bodies metabolize drugs differently, but these medications are safe when used under medical supervision.

It is important that your doctor know about any other medicines you are taking (whether prescription or not, including herbal medicines).  All side effects should be reported to your physician immediately.

Should pain medicines be saved for My “worst” pain so that I don’t become addicted?

NO.  It is not necessary to save pain medications for your “worst” pain.  It is best to take your medications according to the schedule developed with your doctor.  Some people benefit from having extra medicine to take during a time of pain flares.  This can be discussed with your doctors.

Other medications, like those used for neuropathic pain, are most effective when taken regularly, regardless of day-to-day changes in your pain.

Addiction to opioid (or narcotic) drugs, such as morphine, is rare among people using these drugs for pain under a physician’s supervision. It is important to discuss any fears regarding addiction or medication use you may have with yo ur health care workers.


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