| One-Minute Clinician

Pain in the Elderly: What to Consider

Pain is common in the aging population. Findings from an NIH funded study found >50% of the older people surveyed had pain within the last month, often in 1 location.


  • People gain weight as they age
  • Bones break down
  • Older people have spinal cord issues

Drugs for the elderly: care must be taken

  • Older organs don’t function the way they did: they need more tender loving care
  • Even if labs show that kidneys or liver are working well, the organ is not working like that of a 20-year-old
  • Dose adjustments may needed more frequently
  • Fat has changed in the body
  • A drug is going to move through the body differently
  • Older people are much more sensitive to opioids and analgesics


  • Start lower—you can always go up, but once you start too high, side effects could affect the patient. Start low, go slow, but GO
  • Give longer dosing intervals
  • Monitor monitor monitor
  • Don’t forget acetaminophen: it’s a very mild pain killer but works for elderly populations because they’re sensitive to it. We’ve put patients on acetaminophen around the clock and they barely use any opioid medications
  • NSAIDs or ibuprofen drugs: you may think they’re very mild but they can be harmful to the elderly: they’re on the Beers List (medications that can be harmful to older people)