Causes of Pain in the Elderly


A large, detailed study of chronic pain in the UK involving over 3600 people highlighted that the type and location of chronic pain varies with age.

Further analysis of those patients who reported chronic pain demonstrated that while back pain was the most common cause of pain in those less than 55 years old, arthritis was the most frequent cause of chronic pain in people aged over 55, with 26% of patients 65 and over and 28% of those aged over 75 reporting this pain. The prevalence of pain associated with angina was also found to increase with age in people aged over 55.1

Arthritis and joint pain are particularly common causes of pain in the elderly.

As the proportion of people aged 65 years and older is growing continuously, the chronic pain conditions that are seen in this population will become more prevalent in the future.

Another particularly common type of pain in the elderly is neuropathic pain.2

A large longitudinal study of medical records of the general population in The Netherlands revealed that the overall incidence of neuropathic pain increases with age, reaching a maximum between the ages of 70–79 years.

Analysis of the various types of neuropathic pain showed that (with the exception of carpal tunnel syndrome) diabetic neuropathy, post-herpetic neuralgia, facial neuralgia, and, most particularly mononeuropathy, all peak in incidence after the age of 69 years.

In addition to age-related increases in osteoarthritis and joint pain, typical syndromes causing pain in people aged 65 years and over include: osteoporosis, immobility and decubitus, post-herpetic neuralgia, cancer, painful neuropathy, angina and ischaemic pain, temporal arteritis and peripheral vascular disease.3

Elderly people report suffering from moderate pain more than from severe or mild pain. In a large, internet-based survey of pain involving 53,524 people across five European countries (France , Germany, Italy, Spain, UK), 62% of people over the age of 60 suffering from chronic pain reported moderate pain, while 24% reported severe pain, and only 13% reported mild pain.4

Older people in pain are almost twice as likely to perceive their health status to be poor, and use more healthcare services than those without pain.5

 

References

1 Elliott AM, et al. Lancet. 1999;354:1248-52.
2 Dielman JP, et al. Pain. 2008;137:681-8.
3 Kaye A, et al. Oschner. J 2010;10:179-87.
4 Langley PC. Curr Med Res Opin. 2011;2:463-80
5 Reyes-Gibby C, et al. Pain. 2002;95:75-82.