Take a start low, go slow approach to pain management

Chronic pain affects over two-fifths of the UK population, so about 28 million adults are living with pain that has lasted for three months or longer. Many more older people are affected than younger.

Over-prescription of opioids is a problem in the UK as well as the US, complicating previous strategies. Now help is at hand in the form of a framework from the Mayo Clinic which highlights that treating chronic pain is best achieved when drugs are used alongside non-drug therapies.

“Chronic pain is very common in older adults, and is often associated with other issues, such as depression, insomnia, social isolation and poor quality of life,” says Dr Brandon Verdoorn from the Mayo Clinic. “While it’s generally not curable, it can be managed with a systematic approach that begins with a thorough, function-based pain assessment followed by recognition and treatment of contributing conditions.”

Framework

• Begin with a thorough assessment of pain;
• Address associated conditions, such as depression and insomnia;
• Start with low-risk pain management strategies, including non-drug methods that get the patient actively involved in her or his own improvement;
• Use higher-risk – often drug-related – strategies cautiously, when needed;
• Frequently reassess and discontinue ineffective treatments.

Dr Christina Chen, also involved in the work, comments:

“With a careful and systematic approach, pain management can be safely optimized for older adults.”

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