Understanding Chronic Pain – It’s a Growing Problem Among Older Americans

Chronic pain is a growing problem among older Americans. Understanding the causes of this pain, the special medical needs of the elderly, and the role of pain self-management can help seniors reduce or eliminate this condition.

As the U.S. evolves into a nation with an older population, greater attention is being paid to healthcare problems more common among the elderly. Research has shown that 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of older adults who live on their own and 75{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 85{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the elderly in care facilities suffer from chronic pain. Yet, pain among older adults is largely under treated, with serious health consequences, such as depression, anxiety, decreased mobility, social isolation, poor sleep, and related health risks.

There are natural changes that occur with aging that affect pain — sleep patterns change, muscles and joints gradually become more rigid, and energy decreases. Frequently, older people don’t report their pain, because they don’t know that it can be treated or they believe it will lead to expensive tests or more medications. And there can be conditions, such as vision or hearing loss or dementia, that can limit communication about pain.

To help overcome these barriers, treatment of chronic pain may involve a team of different pain-management specialists, including a physician, nurse practitioner, physician assistant, pharmacist, and others who specialize in pain management.

“It takes a team to take care of a patient,” said Dr. Ann Berger, chief of the Pain and Palliative Care Service of the National Institutes of Health (NIH) Clinical Center. The service brings together people from a variety of disciplines to help patients manage their symptoms and relieve their physical, emotional, and spiritual suffering.

“We’re the quality-of-life team; that’s how I introduce ourselves to our patients,” Berger said. “This is the first truly integrative approach to pain management.”

Since pain, especially chronic, long term pain, is prevalent across so many different diseases and conditions, the NIH also created a Pain Consortium to help study all aspects of pain prevention and treatment. This interdisciplinary consortium is composed of 18 different institutes and centers, and helps coordinate planning for key research opportunities in every aspect of pain.

Treating pain in older adults requires special care because nutritional problems or multiple medical problems such as diabetes, heart disease, and arthritis — are common. Helping seniors self-manage their pain is an important part of reducing or eliminating that pain.

Communication with your caregiver or care team is the best way to help you manage or end your chronic pain. Here are some questions to ask:
• What is causing my pain? What can I do about it?
• What is the name of the pain medicine I will be taking?
• How long will it take for the medicine to work?
• What side effects should I expect?
• If I forget to take the pain medicine, what should I do?
• When should I take the pain medicine on a regular schedule? Before, with, or after meals? At bedtime?
• Are there any dangers to taking this pain medicine I should know about?
• Will this pain medicine cause problems with any other prescription drugs or over-the-counter medicines I am taking?

This article was prepared by the National Institutes of Health.