© 2026 OldSmarts® | Stall Senior Medical LLC. All rights reserved.
Unauthorized duplication or distribution is prohibited.
⚕️ Understanding Physical Pain in Older Adults
Pain is common but not normal in aging. It is often:
- Chronic (lasting >3 months)
- Under-reported due to fear, stoicism, or belief that it’s “just part of aging”
- Under-treated due to biases, communication challenges, or complex health profiles
📋 Common Sources of Pain
- Arthritis (osteoarthritis, rheumatoid arthritis)
- Neuropathy (especially from diabetes or spinal issues)
- Osteoporosis and fractures
- Cancer or cancer treatments
- Surgical or injury-related pain
- Pressure sores or skin breakdown
- Dental pain (often overlooked)
- Constipation or urinary retention
❗️Discomfort Beyond Pain
Even when not in “pain,” older adults may feel physically uncomfortable due to:
- Difficulty sitting or lying for long periods
- Sensitivity to cold or heat
- Poorly fitting shoes or clothing
- Hunger, thirst, or toileting needs
- Unrelieved symptoms like nausea, itching, or breathlessness
🧱 Barriers to Pain Recognition
- Cognitive impairment (e.g., dementia) can make pain hard to express
- Language or cultural differences
- Fear of addiction to pain medication
- “Good patient” behavior — not wanting to complain
- Clinicians focusing on disease rather than distress
❤️ Approaches That Help
- Use pain scales appropriate for cognitive status
- Ask specific, gentle questions like:
“Is anything hurting or bothering you right now?”
“Where do you feel most uncomfortable?” - Consider nonverbal cues: grimacing, guarding, restlessness
- Offer non-pharmacologic options when possible:
- Warmth/cold packs
- Massage
- Repositioning
- Adaptive equipment
- Music or distraction therapies
🔄 Pain and Suffering Are Not the Same — But Are Closely Linked
Pain may lead to suffering when:
- It’s unrelieved or not acknowledged
- It interferes with dignity or independence
- It causes hopelessness or despair
Alleviating pain often reduces suffering, but some suffering may persist even after physical pain improves.
🧠 Reflection Questions
- When was the last time I asked an older adult how their body feels?
- What subtle signs of pain might I have missed?
- How can I improve comfort without relying solely on medication?