Supplement-American Geriatrics Society: 10 Ways to Manage Pain

Because chronic pain often is seen as a normal part of aging, it can be disregarded by sufferers and unrecognized by doctors and other health care clinicians. The American Geriatrics Society of New York City formed a special panel on chronic pain in older people and created a list of recommendations for people who experience chronic pain:

- Make pain relief a priority. Whenever pain is present, providing treatment to relieve the pain is just as important as determining its cause. You should talk to your health care provider whenever you have painful symptoms.

- Use standard pain scales. Accurately describing pain is often difficult. For that reason, a standard measure such as a word list, visual, or number pain scale should be used to quantify the severity of pain and its response to treatment.

- Use NSAIDs with caution. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, can have significant side effects to varying degrees in older patients.

- For mild to moderate musculoskeletal pain, use acetaminophen first. Acetaminophen (e.g., Tylenol) often is the drug of choice for relieving mild to moderate musculoskeletal pain (under the direction of your health care provider).

- For more severe pain, use narcotics. Opioid pain relievers are effective for moderate to severe pain. Ask your health care professional if these pain relievers are appropriate for you.

- What to do when the pain-sensing system goes awry. There are a variety of non-narcotic analgesics that have proven to be effective in the treatment of some nervous system-related (neuropathic) pain. However, in such situations, doctors must monitor their patients very closely.

- Do not rely on medications alone. Non-pharmacological approaches include patient and caregiver education, cognitive-behavioral therapy, exercise programs, and other modalities. These approaches can be used alone or in combination with medication and should be part of the care plan for most patients with chronic pain.

- What to do when patients still have pain. Health care providers should not hesitate to refer patients to multidisciplinary pain management centers when pain relief goals are not being met.

- Make narcotic opioid pain relievers more available. Regulatory agencies should revise policies to make opioid pain relievers more readily available to older patients in pain who need them.

- Learn as much as possible about pain. Consumers should learn more about pain management. Also, education should be improved for health care professionals at all levels of training and experience.