Health and Pain Mind

Pain is common among older people. However, as people age, they complain less of pain. The reason may be a decrease in the body’s sensitivity to pain or a more stoical attitude toward pain. Some older people mistakenly think that pain is an unavoidable part of aging and thus minimize it or do not report it.

The most common cause is a musculoskeletal disorder. However, many older people have chronic pain, which may have many causes.

Effects of pain may be more serious for older people:

• Chronic pain can make them less able to function and more dependent on other people.
• They may lose sleep and become exhausted.
• They may lose their appetite, resulting in undernutrition.
• Pain may prevent people from interacting with others and from going out. As a result, they can become isolated and depressed.
• Pain can make people less active. Lack of activity can lead to loss of muscle strength and flexibility, making activity even more difficult and increasing the risk of falls.

Older people are more likely than younger people to have side effects from pain relievers (analgesics), and some side effects are more likely to be severe. These drugs may stay in the body longer, and older people may be more sensitive to them. Many older people take several drugs, increasing the chances that a drug will interact with the analgesic, reducing the effectiveness of one of the drugs or increasing the risk of side effects.

Older people are more likely to have disorders that increase the risk of side effects from analgesics. Having a heart or blood vessel (cardiovascular) disorder or risk factors for these disorders increases the risk of heart attack, stroke, blood clots in the legs, and heart failure when NSAIDs are taken. Having a kidney disorder, heart failure, or a liver disorder makes people more vulnerable to kidney damage from NSAIDs and less able to handle the fluid retention caused by the drugs.

To reduce the risk of side effects, particularly when prescribing opioids, doctors give older people a low dose at first. The dose is increased slowly as needed, and its effects are monitored. Doctors also choose analgesics less likely to have side effects in older people. For example, acetaminophen Some Trade Names
TYLENOLis usually preferred to NSAIDs for treating chronic mild to moderate pain without inflammation. Certain NSAIDs ( indomethacin Some Trade Names INDOCIN and ketorolac Some Trade Names TORADOL) and certain opioids (such as pentazocine Some Trade Names TALWIN) are usually not given to older people because of the risk of side effects.

Nondrug treatments and support from caregivers and family members can sometimes help older people manage pain and reduce the need for analgesics.