Analgesia in the elderly. Practical treatment recommendations.

Pain management in the elderly increasingly presents a challenge for general practitioners and pain specialists. A careful history and examination need to be performed so that any underlying cause of the pain can be established and treated appropriately. The nature of the pain must also be determined so that inflammatory or neuropathic components can be treated effectively. Special care should be taken when new drug treatments are initiated in the elderly because increased sensitivity, a prolonged drug half-life and drug interactions are more likely. Local therapies and nondrug treatments are often very effective in helping to alleviate pain and to increase function and independence. The use of all these techniques, combined with appropriate psychological strategies and setting realistic aims, will result in effective pain management in most patients.