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Pain Management In The Elderly


What do I need to know about pain in the elderly?

Pain is a common complaint that is often poorly treated in elderly adults. Pain is not a normal part of aging, and may be a sign that something is wrong. Sometimes there is no clear or exact cause of pain. Pain management is an important part of your care.

What are the types of pain?

  • Acute pain: This may be caused by an illness or injury. It comes on suddenly and lasts a short period of time. Acute pain usually goes away as your body heals but may become chronic if left untreated.
  • Chronic pain: This describes pain that continues or grows worse over a long period of time. It may last for months or years. It may be pain that remains after you have recovered from an injury. Diseases such as cancer, arthritis, migraines, and back problems are also common causes of chronic pain.

How will healthcare providers know if I am in pain?

You may have many questions and fears about pain. Do not be ashamed to tell your healthcare providers about what you are feeling. Tell them where you hurt and how bad it is. You may try to deny that you are having pain to show courage or to escape treatment. Conditions such as dementia (memory problem), brain damage, or a stroke, may make it hard to express pain. The following are common signs that may tell healthcare providers that you are in pain:

  • Crying, moaning, frowning, or sighing
  • Frequent feelings of sadness, depression, hopelessness, aggression, or anger
  • Noisy breathing, or calling out
  • Not moving, or staying in one position to decrease pain
  • Poor appetite, or changes to usual sleep patterns
  • Pulling away or getting upset when touched
  • Restlessness

How is pain diagnosed?

A pain diary may help to find the cause of your pain. The diary may help you track pain cycles. The diagnosis of chronic pain is based on low long and how often you have symptoms. You may also need any of the following to check how much pain you have or find its cause:

  • Physical examination: Your healthcare provider will examine you and look for painful areas. He may touch or press different places on your body.
  • Pain scales: These may help measure how much pain you feel. There are many pain scales that include numbers or faces. Your healthcare provider may ask you to rate the pain on a scale of 0 to 10.
  • Imaging tests: These include x-rays, a CT scan, or an MRI. You may need more than one of these tests to look for the cause of your chronic pain. You may be given dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • Stimulation tests: These include electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies. These may help to find which nerves or muscles are affected by pain.

Which medicines are used to treat pain?

  • Acetaminophen: You can buy acetaminophen without a doctor's order. Ask your healthcare provider how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • NSAIDs: These medicines decrease swelling and pain. You can buy NSAIDs without a doctor's order. Ask your healthcare provider which medicine is right for you. Ask how much to take and when to take it. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.
  • Narcotics: These medicines are used for moderate to severe pain.
  • Anesthetics: These may be injected in or around a nerve. It works by blocking pain signals from the nerves.
  • Antidepressants: These may be used to treat nerve pain or other types of chronic pain.
  • Antianxiety medicine: This medicine may help you feel calm and relaxed. It may also decrease pain and help you sleep.
  • Muscle relaxers help decrease pain and muscle spasms.
  • Steroids: This medicine decreases inflammation that causes pain.
  • Anticonvulsant medicine: This medicine may be used to decrease chronic pain.

How is pain treated without medicine?

Healthcare providers will try to treat the cause of your pain. This may include treating infections or cancer. You may need the following to help control your pain:

  • Heat: Heat helps decrease pain and muscle spasms. Apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed.
  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on the area for 15 to 20 minutes every hour or as directed.
  • Rehabilitation: A physical therapist can teach you exercises to help improve movement and strength, and to decrease pain. An occupational therapist can teach you skills to help with your daily activities.
  • Assistive devices: A cane, walker, or crutches can help you move around and decrease your risk of falling. Ask your healthcare provider how to use these devices correctly.
  • Electrical stimulation: A device sends mild and safe electrical signals. The signals decrease your pain when used over a painful body part.
  • Surgery and other procedures: Your healthcare provider may use ultrasound, radio waves, thermal (heat), or laser therapy to relieve your pain. Surgery includes cutting nerves or repairing joints that are the cause of your pain.

What are the risks if pain is not treated?

If pain is not treated, it can decrease your appetite, sleep, and energy. It can also affect your mood and your relationships with others. You may feel that it is impossible to get rid of your pain. This can cause a cycle of suffering, sleeplessness, and sadness.

Where can I find more information?

  • American Chronic Pain Association
    PO Box 850
    Rocklin , CA 95677
    Phone: 1- 800 - 533-3231
    Web Address:

When should I contact my healthcare provider?

  • You have a fever.
  • You have chills, a cough, or feel weak and achy.
  • You have nausea or are vomiting.
  • Your skin is itchy, swollen, or has a rash.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You feel more pain even after you take your medicines.
  • You feel so depressed that you cannot cope.
  • You feel very anxious or irritable after you take your medicines.
  • You have problems thinking clearly, are confused, or very sleepy.
  • You have trouble controlling when you have a bowel movement or urinate.
  • You have sudden, severe chest pain or trouble breathing.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.