Compared to the general population, the elderly are more likely to experience pain. In many cases, the elderly are under-treated for pain. Reasons for under-treatment include patient attitude. Older patients sometimes see pain as a normal part of the aging process, or they might want to be "good" patients and not complain about their pain. Some patients also fear becoming addicted to narcotics. Patients also might believe myths related to:
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Pain sensitivity
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Pain tolerance
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The ability to benefit from opioid drugs
Some challenges in treating the pain of elderly people
There are physiologic differences in the way older people handle pain medicines. For example, kidneys become smaller with age. There is decreased blood flow and less effective filtration (removal of the drug). In addition, the liver undergoes a decrease in mass and blood flow with aging. This makes it harder for the liver to metabolize (break down) some medicines.
The way drugs are administered to elderly people also can become a challenge. Decreased saliva might interfere with swallowing, and injections might be more difficult in light of decreased muscle mass. Oral drugs might be poorly absorbed because of changes in stomach acid levels.
Things to keep in mind
If you are an older person experiencing pain, you should take the following factors into account:
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You might experience more than one source of pain.
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You might have several medical problems and be taking a number of medicines at once. This might increase the health risks associated with analgesic (pain relieving) drugs
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You run a higher-than-average risk of side effects from all drugs, including analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs). It is important to report the over-the-counter pain medicines you take to your health care team.
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Having chronic medical problems and an increased risk of side effects does not mean than your pain cannot, or should not, be aggressively treated. You might be a candidate for any of the pain-relieving therapies available.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 2/1/2005
