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Geriatric Medicine pp 865–882Cite as

Pain and Pain Management

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Abstract

The treatment of pain in the elderly patient presents many challenges: their pain syndromes are often due to chronic diseases that are not curable; the metabolic and pharmacodynamic changes that accompany aging complicate the prescribing of analgesics; cognitive dysfunction confounds pain assessment; functional ability may be impaired; and psychosocial issues often need to be addressed. In short, further data are required to improve pain treatment in this population. The appropriate management of pain in the elderly is based on general principles of assessment, pharmacotherapy, and use of anesthetic, neurosurgical, and cognitive-behavioral interventions. The strategy employed includes a careful history and physical examination to define the symptom complex, the pain pathophysiology and etiology, and to pursue a diagnostic and therapeutic plan. Often, the pain can be treated by directing attention to the underlying cause, for example, replacing a fractured hip. In other instances either the cause cannot be determined or it is not amenable to medical or surgical intervention and pain management consists of treating the pain complaint with analgesics alone.

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Authors
  1. David J. Hewitt
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  2. Kathleen M. Foley
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Editors and Affiliations

  1. The Henry L. Schwartz Department of Geriatrics and Adult Development, The Mount Sinai Medical Center, 10029-6574, New York, NY, USA

    Christine K. Cassel M.D. (Professor and Chairman) & Diane E. Meier M.D. (Associate Professor) (Professor and Chairman) &  (Associate Professor)

  2. Center for Study of Aging and Geriatric Research Education and Clinical Center, Duke University Medical Center, 27710, Durham, NC, USA

    Harvey J. Cohen M.D. (Director) (Director)

  3. University of Washington Medical Center, 98195, Seattle, WA, USA

    Eric B. Larson M.D., M.P.H. (Medical Director) (Medical Director)

  4. Gerontology Division, Harvard Medical School, Brigham and Women’s Hospital, 02115, Boston, MA, USA

    Neil M. Resnick M.D. (Chief) (Chief)

  5. Geriatric Research Education and Clinical Center, Sepulveda VA Medical Center, 91343, Sepulveda, CA, USA

    Laurence Z. Rubenstein M.D., M.P.H. (Director) (Director)

  6. Department of Medicine, University of Chicago, 60637, Chicago, IL, USA

    Leif B. Sorensen M.D. (Professor and Vice Chairman) (Professor and Vice Chairman)

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Hewitt, D.J., Foley, K.M. (1997). Pain and Pain Management. In: Cassel, C.K., et al. Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2705-0_57

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  • DOI: https://doi.org/10.1007/978-1-4757-2705-0_57

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