Seniors and Chronic Pain

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 percent of older adults who live on their own and 75-85 percent of the elderly in care facilities suffer from chronic pain. Yet, pain among older adults is largely undertreated, 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,” says Ann M. Berger, M.D., chief of the NIH Clinical Center’s Pain and Palliative Care Service. 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,” says Dr. Berger. “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—diabetes, heart disease, arthritis—are common. Helping seniors self-manage their pain is an important part of reducing or eliminating that pain.