Pain under-recognized in seniors

Pain in the elderly is a serious issue that is often misunderstood and untreated or undertreated. Many seniors have several health issues and pain management can be tricky because of interactions between medications, fear of “drugging up” the patients, misunderstanding of the severity of the pain, and the effects that some drugs can have on the elderly that they don’t have on younger people.

According to the Merck Manual of Geriatrics, “In one study, pain prevalence in the elderly ranged from 36 to 88%, and prevalence may be higher among nursing home residents. In the US, about 1/5 of elderly people take analgesics at least several times per week, and 2/3 of these people take prescription analgesics for > 6 mo. In the elderly, the most common sites of pain are joints, and the most common causes of pain are musculoskeletal disorders.”

That’s a lot of people suffering with pain and it’s not new news either. In 1998, Daniel A. Monti, M.D. and Elisabeth J. S. Kunkel, M.D. wrote in an article, Practical Geriatrics : Management of Chronic Pain Among Elderly Patients, “The prevalence of persistent pain increases with age; increases in joint pain and neuralgias are particularly likely. A majority of elderly persons have significant pain problems. Persistent pain interferes with activities of daily living and quality of life, yet detection and management of chronic pain remain inadequate. In one study, 66 percent of geriatric nursing home residents had chronic pain, but it was not detected by the treating physician in 34 percent of cases.”

Part of solving the problem is recognizing there is one, so if you are caring for a senior, or you are a senior, you are not out of line to insist on pain management – on proper and effective pain management, that is.