Understanding and Managing Chronic Pain in Older Adults

More than half of adults over age 65 experience persistent pain, according to a National Institutes of Health (NIH) study. But despite how common it is, chronic pain in seniors is often underreported and undertreated—leading to serious consequences like depression, isolation, sleep problems, and a decline in mobility and independence.

As a caregiver, knowing how to recognize and respond to chronic pain in older adults can make a big difference in your loved one’s well-being.

What is Chronic Pain?

Chronic pain is any pain that lasts longer than expected—typically beyond three months—and may not be tied to a clear cause or injury. In older adults, it’s often linked to conditions such as:

• Nerve damage (from diabetes, shingles, surgery, or cancer)

• Chronic illness (like heart failure, kidney disease, or COPD)

• Musculoskeletal issues (arthritis, fractures, spinal compressions)

Why Is Pain Often Underreported?

Many seniors hesitate to speak up about their pain. Reasons can include:

• Thinking pain is a “normal” part of aging

• Fear of diagnosis or more medication

• Trouble communicating due to cognitive decline

• Atypical symptoms that mask pain or make it hard to describe

As a caregiver, your observations and advocacy matter. You’re often the first to notice subtle signs of discomfort or decline—and the one who can help speak up on their behalf.

How Caregivers Can Help

1. Observe and Assess the Pain

Start by gently asking about their pain and how it affects daily life. If they’re unable to clearly explain it, look for behavioral clues:

• Changes in posture, gait, or movement

• Increased agitation or withdrawal

• Sleep disruption or reluctance to be active

Use simple pain scales—like a 1 to 10 rating—or visual tools to help gauge pain levels.

2. Talk to Healthcare Providers

Pain management should be a team effort. Work closely with your loved one’s doctor or specialist to explore treatment options and ensure their pain is taken seriously. This is especially important when medications are involved, as older adults are more sensitive to side effects and drug interactions.

Treatment Options: Medication & Beyond

Pharmacologic (Medication) Approaches
Medication can help, but should be carefully monitored. Older adults may need lower doses and are more at risk for side effects—especially with opioids. Always consult a physician and report any changes in behavior, mood, or function.

Non-Pharmacologic Approaches
Medication isn’t the only option. Many older adults benefit from alternative therapies like:

• Exercise and movement (with medical clearance)

• Physical therapy or massage

• Cognitive-behavioral therapy (CBT)

• Acupuncture, osteopathic treatments, or spiritual counseling

• Support groups and education workshops

The goal is to improve quality of life, not just mask symptoms.

Chronic Pain Doesn’t Have to Be a Part of Aging

Pain is not just a normal part of getting older. With the right tools, support, and treatment, seniors can stay active, social, and independent.