Management of Chronic Pain in Older Adults

With increasing age, the immune system of our body starts to weaken and the pain tolerance evidently decreases. These unwelcome changes which come into the body are unwelcome and they become all the more troublesome if the older adults are suffering from some chronic pain. This becomes an obstacle into their day to day functioning. It is, therefore, crucial to managing this pain in older adults so that they can live a normal life.

According to the experts at Halo Health Care, chronic pain is the pain which continues even after the treatment and inhabits the patient’s body for 3-6 months. This pain is difficult to manage due to the fear of overmedication, risk of side-effects or adverse-effects, and nonadherence. But if one fails to address and treat this pain, it can lead to depression, impaired sleep, impaired movement, malnutrition, and an unhealthy quality of life of older adults.

Causes of such pain in older adults can be diseases such as Arthritis or Arthritis related pains, vertebral compression treatments, and neuropathy. The treatment during cancer and diseases of heart, kidney, and lungs too can cause such pain.

For managing chronic pain in older adults, one can follow the following steps:

1. Detect the pain signature of the patient

It is necessary to conduct a detailed pain assessment of the patient. Without having the knowledge of the pain and treatment of the patient, it becomes difficult to advance with further treatment. Use a uniform numeric rating scale or verbal descriptor scale for determining the scale of pain. In addition to the intensity of the pain, one must study other characteristics of the pain such as the location and the quality of pain. If a treatment has gone wrong in the past, the knowledge of what precautions are to be taken is also important.

2. Review the patient’s health

It is crucial to study the health issues the patient has and the medication he or she is taking. A thorough review is necessary to avoid harmful drug-to-drug interaction.

It is common amongst older adults that they are suffering from multiple chronic diseases, therefore, the management of chronic pain becomes difficult. Nonsteroidal anti-inflammatory drugs are said to be effective but for patients already affected by diseases such as hypertension, diabetes, cardiovascular diseases, or peptic ulcer diseases they have to be prescribed carefully.

NSAIDs can be hazardous if given to older adults and can increase the risks of fractures, increased stress, and worsening gait function.

3. Establishing Treatment Objectives

Using the data collected regarding the pain history, intensity and signature of the pain, it is now easier to decide the course of treatment to be taken. With the study of the other medications along with other chronic diseases suffered by the patient, it will be easier to avoid adverse effects as well.

While your patient might be expecting an instant relief in mobility, you should hold open talks so that there is no room for misunderstanding. Discuss if the patients are looking to participate in the decision making or not. The physician should value their opinions as well. It is better that the physician and the patient come to an understanding as to what should be the goal of the treatment.

4. Identify all the inconveniences beforehand

The patients, due to ageing, might face various obstacles during the course of treatment. It is necessary to identify such barriers well in advance so that the adverse effects can be avoided. Plus, if any inconvenience arises, the physician has a solution handy to deal with it.

One of the strongest risk factors is cognitive impairment, which includes malfunctioning and weakening of various organs of the body.

5. Start slow and then keep on advancing with the treatment

This is the safest approach to dealing with the treatment of older adults. If the patient is responding well to the therapy and is able to tolerate the minimum dosages, the physician can increase the dosage with time. The ‘start slow and stay slow’ approach leads to under treatment which will leave the patient frustrated.

6. Regularly keep a check on the outcomes

Set up a habit of open communication with the patient or the caregiver so that you are always up-to-date with the effects and outcomes of the treatment. Make them comfortable enough to communicate their concerns over phone calls or e-mail regularly so that the problems can be addressed in time before they worsen.

Various treatments prescribed for chronic pain in older adults include nonpharmacological treatments such as cognitive-behavioural therapy, meditation, physical therapy, acupuncture, massage, chiropractic manipulation and others; and pharmacological treatments such as non-opioids, Acetaminophen, topical and injected analgesics, antidepressants, non-steroidal anti-inflammatory drugs, muscle relaxants etc.

Above are a few steps you can follow to manage chronic pain in older adults without the risk of putting their life at dander because of side effects of overtreatment.