As we age, the experience of feeling persistent pain is unfortunately widespread. For seniors, managing pain isn’t just about relieving physical discomfort; it can have a lasting impact on one’s physical health, mobility, and quality of life. There are a handful of reasons why seniors experience pain at a higher prevalence than younger adults, including chronic conditions, age-related inflammation, and a higher susceptibility to falls. Understanding the importance of addressing pain appropriately is endlessly valuable for this population of individuals. This blog post will help you understand the types of pain experienced by older adults, what challenges this pain may cause, and strategies for pain management. Let’s work towards a pain-free future!
Understanding Pain in Older Adults
Seniors can experience many different types of pain in almost any area of the body. However, there are a few types of pain that are most commonly experienced by older adults. These types of pain include[1]:
- Joint pain in the fingers, knees, hips, and spine
- Joint stiffness, particularly in the morning
- Lower back pain
- Neck pain
- Nerve pain
Seniors may experience these common types of pain, as well as other more uncommon types of pain, for a variety of reasons. For example, seniors naturally experience disease and chronic conditions at a higher rate than younger adults [2]. Although not all these diseases and disorders are inherently painful, some may bring on pain symptoms. The rate of injury and surgery is also higher among the senior population [3], which typically causes pain during recovery. Some other factors that influence pain perception and management in seniors include:
- Physiological Changes: Aging can cause pain receptors to become more sensitive, affecting seniors’ perception of a specific ailment’s pain. For example, studies show that aging decreases one’s pain tolerance [4], which can make pain feel more unbearable to seniors.
- Psychological Changes: The negative emotions and stress associated with psychological conditions like anxiety and depression, which are common in older adults, can amplify pain perception [5]. Likewise, chronic pain can also bring about negative emotions —- and the cycle continues.
- Environmental Factors: A senior’s level of social support, living environment, and access to regular care can greatly impact how they experience and manage pain. Social isolation, financial constraints, and a lack of a caregiver can all exacerbate pain and leave it untreated.
- Medication: Polypharmacy, or the use of multiple medications, can complicate pain management and exacerbate other symptoms due to drug interactions and side effects [6].
Common Challenges of Managing Pain in Older Adults
Pain management can be disrupted or feel impossible due to a handful of challenges that older adults face. Some of these common challenges include:
- Communication Barriers: Age-related communication barriers, such as hearing loss, language barriers, or cognitive decline, can make seniors unable to effectively communicate how they feel to their caregivers and loved ones. Because of this, seniors may be suffering from pain in silence and feel unsure of how to make their pain heard.
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- Comorbidities: It is not abnormal for seniors to experience multiple conditions simultaneously. If more than one condition causes painful symptoms, seniors may feel overwhelmed by the pain they are experiencing.
- Underreporting of Pain: Many seniors view pain as a natural sign of aging. They may believe that all seniors feel the same amount of pain they do, or that their pain will pass with time. Although pain is common in seniors, not reporting it until it becomes unbearable can put their lives at risk. Reporting pain early helps with intervention at a state in which the possible disorder or problem is more likely to be cured or managed effectively.
- Fear of Addiction and Side Effects: Concerns about the possibility of becoming dependent or addicted to painkillers, or experiencing harmful side effects, are common in seniors. Many seniors may feel like agreeing to take painkillers means handing over their control over their health, or may feed into the existing stigma of taking painkillers.
What is a Pain Management Physician [7]?
A pain management physician is a medical doctor (MD) or doctor of osteopathic medicine (DO) who specializes in treating different types of pain. They focus on diagnosis, evaluation, and treatment of pain so that those affected can feel as though pain doesn’t run their lives. Pain management physicians must go through specialized training to become experts in managing chronic, acute, and cancer-related pain.
Pain management physicians play a large role in caring for older adults with chronic pain, as they conduct comprehensive assessments, discuss treatment options, help manage medication, and provide personalized care for their patients, ensuring their lives are as pain-free as possible.
Physician Strategies for Managing Pain in Older Adults
Pain management physicals employ the following practices and strategies for helping seniors manage their chronic pain:
Comprehensive Assessments
- Pain management physicians always conduct thorough assessments so that they can better understand the causes, symptoms, and severity of a senior’s pain. They not only assess physical factors that may be causing pain but also look towards possible psychological and social factors that may have brought this pain on. A thorough evaluation is important so that the physician can assess which treatment style may be best for the particular patient’s lifestyle, preferences, and condition.
Multimodal Approach
- Patients are offered a wide range of treatment options when seeking care from a pain management physician. Many may assume that the only pain treatment is medication, but this is a common misconception. Along with medication, pain management physicians will likely also offer treatment options like interventional procedures, physical therapy, occupational therapy, and psychological therapies [8].
Medication Management
- Because seniors typically have more than one medical condition, they are likely to take more than one medication. Pain management physicians are professionally trained to prescribe and manage pain medications safely while minimizing risks like drug interactions and dangerous side effects. Some types of medications that are typically used for chronic pain include nonsteroidal anti-inflammatory drugs, acetaminophen, COX-2 inhibitors, opioids, and anti-depressants. For seniors, especially, having a doctor available to answer medication questions, discuss side effects, and create a treatment plan is extremely important.
Addressing Polypharmacy and Drug Interactions
- When seniors coordinate care with their physicians and make sure they properly grasp their medication information, polypharmacy risks are reduced. This way, seniors can hopefully end up taking fewer medications rather than more, therefore reducing the risk of side effects and interactions. Regular medication review and reconciliation are vital for optimal treatment options and to ensure the safety of all patients.
When to Seek Primary Care for the Management of Pain in Older Adults
If you are a senior who has been experiencing persistent pain for more than 3 months, it is time to seek help from a professional in pain management. Primary care physicians can effectively assess the causes of chronic pain and help formulate long-term management techniques. Additionally, if your pain has increased in severity and has become more and more uncomfortable, do not hesitate to reach out to your doctor for help.
Timely intervention is the golden rule when it comes to pain management — getting help sooner rather than later is always the right choice. Through regular check-ups and check-ins with your doctor, you can easily keep track of whether your pain has worsened or a new condition has arisen.
Older Adult Pain Management in Primary Care at Greater Good
Here at Greater Good Health, we integrate pain management services into primary care for older adults. If you are a senior struggling with chronic pain, find a clinic near you or contact us for assistance!