Chronic pain treatment in the elderly is multidimensional and includes noninvasive as well as invasive therapies. Invasive therapies include pharmacological therapies with nonopioid, opioid, and adjuvant medications.Author:
Nalini Vadivelu, Roberta L HinesCited by:
Non-steroidal anti-inflammatory drugs (NSAIDs): Oral non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen, ibuprofen, diclofenac, and celecoxib can be used for chronic pain in the elderly when acetaminophen fails to control the pain effectively.
For mild pain, the most appropriate first choice for relatively safe analgesia is acetaminophen . For mild to moderate pain or pain uncontrolled with acetaminophen , the use of NSAIDs is appropriate.
Acetaminophen is usually recommended as a first line treatment for mild to moderate pain, such as from a skin injury, headache or musculoskeletal condition. Acetaminophen is often prescribed to help manage osteoarthritis and back pain. It may also be combined with opioids to reduce the amount of opioid needed.
Chronic pain is pain that is ongoing and usually lasts longer than six months. This type of pain can continue even after the injury or illness that caused it has healed or gone away. Pain signals remain active in the nervous system for weeks, months or years.
Tramadol hydrochloride, an analgesic that has some opioid properties and is used for mild to moderate pain, should be used with caution in the elderly because it may cause dizziness and reduce the seizure threshold.
Ibuprofen , naproxen, and aspirin are the most popular active ingredients in OTC NSAID treatments. Acetaminophen works by reducing inflammatory chemicals (called prostaglandins) in the central nervous system (spinal cord and brain) and can block pain impulses from nerves in the joints.
Best First-Line Defense: Tylenol Regular Strength Tablets. Best Extra-Strength First-Line Defense: Tylenol Extra-Strength Caplets. Best Second-Line Defense: Advil Coated Pain Reliever and Fever Reducer Tablets. Best Second-Line Defense Runner-Up: Aleve Pain Reliever & Fever Reducer Caplets.
AVOID products that contain the antihistamines diphenhydramine (Benadryl) and chlorpheniramine (AllerChlor, Chlor-Trimeton). These medications are often included in OTC remedies for coughs, colds, and allergies. AVOID OTC sleep products, like Tylenol PM, which contain antihistamines such as diphenhydramine.
Based on the research to date, it appears that naproxen ( Aleve , Naprosyn , Anaprox) may be less risky than other NSAIDs. Aspirin cousins. Consider trying cousins of aspirin called nonacetylated salicylates. These include salsalate (Disalcid) and trisalicylate (Trilisate).
If over-the-counter drugs do not provide relief, your doctor may prescribe stronger medications, such as muscle relaxants, anti-anxiety drugs (such as diazepam [Valium]), antidepressants (like duloxetine [ Cymbalta ] for musculoskeletal pain), prescription NSAIDs such as celecoxib (Celebrex), or a short course of
1. Patients have the right to proper, respectful, informed and non-discriminatory pain management and care. 2. Patients have the right to choose and access health care providers who can provide proper, respectful, informed and non-discriminatory pain management and care.
To fight the opioid epidemic, physicians have been advised to cut down on opioid prescriptions. But that may mean some patients were cut off “ cold turkey ,” causing withdrawal symptoms. In other cases, patients with chronic pain may be advised to continue to take opioids.
Common sequelae of untreated chronic pain include decreased mobility, impaired immunity, decreased concentration, anorexia, and sleep disturbances ,.
THE FOUR MAJOR TYPES OF PAIN: Nociceptive Pain: Typically the result of tissue injury. Inflammatory Pain: An abnormal inflammation caused by an inappropriate response by the body’s immune system. Neuropathic Pain : Pain caused by nerve irritation. Functional Pain: Pain without obvious origin, but can cause pain.
23 per cent say life isn’t worth living ; 64 per cent would seek better treatment, if they could afford it. More than three-quarters of people who report being in chronic pain say it has lasted more than three years, and for 29 per cent it has lasted more than a decade.