Management of Chronic Pain in Elderly Patients

Pain is a fundamental yet highly complex biological and psychosocial phenomenon. While acute pain functions as a defence mechanism, alerting the body to tissue damage or injury, chronic pain loses this protective role and becomes a persistent, independent problem. Chronic pain in the elderly is of significant clinical importance, as it impacts not only physical health but also severely affects mental well-being, quality of life, and social participation. Diagnosing pain in older adults is particularly challenging due to its subjective nature, which is influenced by cognitive decline, comorbidities, and diminished communication abilities. As such, both objective scales and subjective self-assessment tools are essential in pain evaluation. Managing chronic pain in the elderly requires a multidisciplinary approach combining pharmacological and non-pharmacological therapies. Analgesic use, including non-steroid-antiinflammatory drugs (NSAIDs) and opioids, should match pain type and intensity. Age-related pharmacokinetic and pharmacodynamic changes, like reduced renal function and slower metabolism, impact drug efficacy and side effects, raising complication risks. Non-pharmacological therapies, such as physiotherapy, psychological interventions and complementary techniques (e.g., acupuncture), can also be effective, particularly for long-term pain relief. These methods aim to reduce pain perception and contribute to maintaining physical activity, psychological well-being, and social engagement. Developing and continuously revising personalized pain management plans are essential for preserving patients' quality of life. Nurses are crucial in alleviating chronic pain in the elderly, extending beyond patient monitoring to emotional support and multidisciplinary care coordination. Adequate training and access to essential tools are vital for effective pain management.