Pain Management

Basic Facts

Pain is a common experience for older people. The extent to which pain disrupts daily routines may get worse with age. Pain is often poorly evaluated and managed in older people.

There is no reason to suffer silently with persistent pain as you get older. Healthcare professionals agree that it is everyone’s right to receive adequate pain management that improves quality of life and conserves the ability to carry out the activities of daily living. Good pain management can also keep you healthier by allowing you to stay active, eat well, and enjoy a normal social life.

If you are in pain, you may not want to talk about it or tell anyone how bad it really is. There are several common reasons that may prompt you to keep silent about your pain including:

  • A belief that pain is unavoidable
  • Fear that pain will increase as the underlying disease gets worse
  • A desire to avoid expensive tests or going to the hospital
  • A desire to not be seen as a complainer
  • Not wanting to be a burden to loved ones or caregivers
Whatever the reason, it is important to report any pain and seek evaluation to determine a treatment plan that meets your needs.

In most cases, it is possible to manage pain to allow you to do the things that are important to you.  Pain that is poorly managed is associated with:

  • Depression and anxiety
  • Poor sleep
  • Loss of appetite
  • Inability to carry out daily functions
  • Loss of independence
  • Social withdrawal
  • Increased difficulty with thinking  (dementia)
  • Increased cost to the healthcare system

What Does “Pain” Refer To?

Pain is a complex, unpleasant experience that you feel through your sense organs. It is influenced by your memories and expectations, and it also causes an emotional reaction.

The sensation of pain travels on nerves to the spinal cord and then to your brain. The message informs your brain about the severity of pain (mild or severe), pattern of pain (sudden or persistent), and the location where it originates. Another important part of pain is its quality (such as: aching, burning, stabbing, crushing).  How you describe the quality of your pain helps determine the cause of the pain, such as nerve-related pain, muscle/bone pain, or organ-related pain. 

Your primary care provider may be able to find a medical reason for your pain by doing an x-ray or other imaging tests, but with persistent or chronic pain there is often no identifiable cause.  This does not mean that the pain is not real. Your own experience of pain is what matters.

The Most Common Types of Pain

Pain may be acute or persistent (sometimes called chronic). It is possible to experience both acute and persistent pain simultaneously.

Acute pain, which comes on quickly and may not last very long, results from an injury, surgery, or other type of tissue damage. It usually goes away when the injury heals.

Persistent pain (pain that has lasted for at least 3 to 6 months) can be long-lasting and may or may not be associated with a disease or injury. If you have persistent pain, you are more likely to experience depression or anxiety, and you may feel that your quality of life and daily functioning have been impacted.

Pain may also have different causes. Pain related to muscles, bones, and organs is a response to an injury or disease. It usually stays in a single area and responds well to treatment.

Pain caused by damaged nerves or the brain is likely to cause unusual sensations, may be harder to identify location, and can be difficult to treat.    

How Common is Pain in Older Adults?

Pain is one of the most common health problems experienced by older adults. Between 25% and 50% of all older people living at home, and up to 80% of older people living in nursing homes, report that they are in serious pain.

Some kinds of pain, such as back pain, seem to decline in frequency as people get older. Other types, such as large joint pain (pain in the knees, hip, or feet) may increase. About 12% of older adults have widespread pain, and pain is reported more often by women than by men.

Updated: March 2017