Management of chronic non-rheumatic pain in the elderly

Chronic non-rheumatic pain in the aged should be viewed in the context of physiologic and clinical alterations due to aging which may create diagnostic problems. In the elderly, the abnormality of the clinical presentation and the patient's failure to remember the time and the nature of the precipitating incident may be extremely misleading. Many clinical features may also be altered by the aging process itself. Thus the unwary physician is apt to be mistaken in establishing the etiologic basis for pain syndromes. Once a diagnosis has been achieved, it should be evaluated in the light of other age-related disturbances. Treatment should be as simple as possible. The prescription of combination preparations may involve use of a drug that is beneficial for one disorder but harmful for another. Aged persons display a marked tendency toward abnormal reactions to the usual drug regimens. A wise combination of treatment by medical means (including drugs), physiotherapy, and sometimes surgical procedures, usually is effective for the relief of this type of chronic pain.