[The approach to chronic pain management in the elderly]

Abstract

Chronic pain is a common, yet frequently overlooked and undertreated complaint among older patients. It may result in an impairment of the function and quality of life of these patients. Chronic pain is a syndrome, which influences and is influenced by many potential factors (physiological psychological and social), all of which require treatment to achieve an optimal clinical outcome. Effective management of chronic pain in this population is attainable, if properly recognized and treated. Reasons for inadequate pain control by clinicians include lack of training, inadequate pain assessment and reluctance to prescribe opiates. The approach to pain assessment and management is often different and more complex for older patients than for younger ones. In older people, a host of factors can impede assessment and drug management, including multiple medical problems and many potential sources of pain, sensory impairment, depression, disability and impaired cognitive function. In addition, pharmacokinetics and pharmacodynamics unique to the geriatric population make this group vulnerable to adverse medication effects. By using appropriate pharmacological combined with non-pharmacological treatment, it is often possible to improve function ability to a greater extent than the severity of pain reduced.