Acetaminophen: American Geriatrics Society (AGS) recommends acetaminophen as the first-line agent for mild to moderate chronic pain in the elderly  due to its favorable safety profile.
Acetaminophen is probably the safest for mild to moderate pain. Never use more than your doctor recommends, because it can cause liver damage and other side effects. And check to make sure the person is not taking other drugs that have acetaminophen as an ingredient.
Physical therapy. Acupuncture, magnet therapy and hypnosis are other complimentary treatments, which can prove effective and often have no side effects. Cognitive behavioral therapy, which teaches self-pain management.
Analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs), weak and strong opioids are commonly used among elderly persons.
Avoid NSAIDs like ibuprofen and naproxen Older adults should be very careful with NSAIDs. Their side effects are especially likely to cause harm as people get older.
If you have leg pain from cramps or overuse, take these steps first:
Benefits and risks. Acetaminophen is generally considered safer than other nonopioid pain relievers because it doesn’t cause side effects such as stomach pain and bleeding.
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The incidence of chronic pain will increase in older patients. The most common causes of chronic pain in this patient population include arthritis, cancer, diabetes mellitus, and cardiovascular and neurologic diseases.
The best treatment for chronic pain is a multimodal therapy plan that could include intervention from a physical therapist, pain psychologist, complementary alternative medicine (i.e. acupuncture) and self-management techniques (such as changes to the diet and exercises regimes) to help you not only manage your pain
The elderly often under report pain because it is often considered a normal part of aging. The elderly sometimes choose to suffer in silence. This may be a culturally orientated response to pain or may be related to the high cost of medications and/or inability to access medical care.
Second step. Moderate pain: weak opioids (hydrocodone, codeine, tramadol) with or without non-opioid analgesics, and with or without adjuvants. Third step.
What’s the safest OTC painkiller for an older parent? For most older adults, the safest oral OTC painkiller for daily or frequent use is acetaminophen (brand name Tylenol), provided you are careful to not exceed a total dose of 3,000mg per day.
In one review, ibuprofen was found to be similar or better than acetaminophen for treating pain and fever in adults and children. Both drugs were also found to be equally safe. This review included 85 different studies in adults and children.
Take every 4 to 6 hours, as needed, up to 4 times in a 24-hour period. The maximum dose may vary from 3,000 mg to 4,000 mg, but do not take more than 4,000 mg in a 24-hour period. Follow all instructions on the label.