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Pain Medicine in Older Adults: How Should It Differ?

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Treatment of Chronic Pain by Integrative Approaches

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Abstract

Older adults (commonly defined as those ≥ age 65) are not simply a chronologically older version of younger patients. Homeostenosis, that is, progressive restriction of an aging organism’s capacity to respond to stress because of diminution of its biological, psychological, and social reserves, underlies the distinction of old from young. As pain is a stressor that commonly accompanies aging, the provision of safe, clinically effective, and cost-effective pain care to older adults requires awareness of these specific aging-related changes. The main goals of this chapter are to (1) educate the pain practitioner in basic principles of aging needed to guide the evaluation and treatment of older adults, (2) provide clinical case examples to illustrate the advantages of treatment that is guided by these principles as compared with traditional pain care and why traditional pain care may actually harm these patients, and (3) offer specific therapeutic guidelines for the treatment of nociceptive, neuropathic, and widespread pain in older patients.

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Authors and Affiliations

  1. Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA

    Debra K. Weiner M.D. & Natalia E. Morone M.D., M.S.

  2. University of Pittsburgh School of Medicine, 3471 Fifth Ave., Suite 500, Pittsburgh, PA, 15213, USA

    Debra K. Weiner M.D.

  3. Department of Medicine, Psychiatry and Anesthesiology, University of Pittsburgh School of Medicine, 3471 Fifth Ave., Suite 500, Pittsburgh, PA, 15213, USA

    Debra K. Weiner M.D.

  4. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Jordan F. Karp M.D.

  5. Department of Psychiatry, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, PA, 15213, USA

    Jordan F. Karp M.D.

  6. Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA

    Cheryl D. Bernstein M.D.

  7. 5750 Centre Avenue, Suite 400, Pittsburgh, PA, 15206, USA

    Cheryl D. Bernstein M.D.

  8. Department of Medicine, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213, USA

    Natalia E. Morone M.D., M.S.

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  1. Debra K. Weiner M.D.
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  3. Cheryl D. Bernstein M.D.
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  4. Natalia E. Morone M.D., M.S.
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Correspondence to Debra K. Weiner M.D. .

Editor information

Editors and Affiliations

  1. President and CEO, Clinical Professor of Anesthesiology, The Center for Pain Relief, West Virginia University School of Medicine, Charleston, West Virginia, USA

    Timothy R. Deer

  2. Clinic Chief, Clinical Associate Professor, Department of Anesthesiology, Stanford Pain Medicine Center, Redwood City, CA, USA, and Stanford University School of Medicine, Stanford, California, USA

    Michael S. Leong

  3. Medical Director, Clinical Associate Professor, The LITE Center, South Miami, FL, USA, and University of Miami Miller School of Medicine, Miami, Florida, USA

    Albert L. Ray

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Weiner, D.K., Karp, J.F., Bernstein, C.D., Morone, N.E. (2015). Pain Medicine in Older Adults: How Should It Differ?. In: Deer, T., Leong, M., Ray, A. (eds) Treatment of Chronic Pain by Integrative Approaches. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1821-8_19

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