Because they are so different from younger adults, the number of risks associated with chronic pain in older adults is much higher. Here are a few.
More Medication Side Effects
Seniors are more prone to pain medication side effects than the average adult. In addition, many older adults also have other chronic health conditions such as heart disease or diabetes, and drug interactions can be an issue. Finding an appropriate medication to treat chronic pain is often a challenge, but with older adults this is even more so. Some common medication side effects in the senior population include:
- Confusion
- Hallucinations
- Ulcers and gastrointestinal bleeding
- Constipation
- Liver damage
- Sodium and water retention
- Difficulty breathing
- Nausea
- Vertigo
- Drowsiness
Most doctors will choose a medication based on the underlying cause of pain and other medical conditions. Unlike the average adult population, seniors benefit more from a practice called titration: initial doses of medication are at low strength, and gradually increase until an appropriate and effective dose is reached. Patients are monitored throughout the process for adverse effects.
Increased Risk of Depression and Anxiety
Depression and anxiety are commonly associated with chronic pain in all populations, but older adults seem particularly prone to these effects. Seniors with chronic pain may feel a sense of hopelessness, a fear of dying or simply sadness related to living the remainder of their lives in pain.
Seniors may already feel a sense of loss, as they gradually lose the ability to function as they previously did. Decreased eyesight may already keep them from driving. They may no longer be able to walk through the grocery store. They may resent having to use assistive devices, such a walker or a cane. A perceived loss of independence can lead to feelings of depression and despair. These feelings are intensified by the presence of a chronic pain condition.
Studies show that older adults with chronic pain tend to have higher levels of depression and anxiety than those who don’t suffer from chronic pain.
A Sedentary Lifestyle
As we age, we tend to slow down. We need more rest breaks, and tolerate shorter bursts of activity at any given time. Exercise and activity are key components of chronic pain management, but safe exercise may be more of a challenge in the senior population due to changes in physical abilities.
For the older adult with chronic pain, getting safe exercise may be as easy as joining a local health club or senior fitness center. Many organizations offer low-impact exercise, such as water aerobics and beginner’s yoga classes, that can help seniors move again safely. Some may even offer walking clubs by age.
Joining such organizations and communities not only helps seniors with chronic pain start to move again, but offers wonderful opportunities for socialization with peers. This can help seniors cope with chronic pain.
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Daniel A. Monti, M.D. and Elisabeth J. S. Kunkel, M.D. Practical Geriatrics: Management of Chronic Pain Among Elderly Patients. Psychiatric Services 49:1537-1539, December 1998
Pain. The Merck Manual of Geriatrics. Section 6. Neurologic Disorders
Chapter 43. Accessed 5/21/09. http://www.merck.com/mkgr/mmg/sec6/ch43/ch43a.jsp
B. Sofaer, A. P. Moore, I. Holloway, J. M. Lamberty, T. A. S. Thorp and J. O’Dwyer. Chronic Pain as Perceived By Older People: a Qualitative Study. Age and Ageing Advance Access published online on July 25, 2005.
