Guide to Managing Elderly Chronic Pain

An unpleasant and complex sensory, emotional experience comes under the category of pain. Pain is never expected, and when it lasts beyond the time of healing or continues for a period of three months or longer, it comes under the category of chronic pain.

Unlike wrinkled skin or graying hair, chronic pain is not a part of the normal aging process. For older adults primarily who live independently, chronic pain may have devastating and widespread effects, imposing steep economic and social costs, threatening the quality of life, and personal strain.

Even after extreme pain, many older adults do not discuss their problem and its impact on their healthcare providers because they fear invasive tests, loss of independence, hospitalization, or need to take additional medicines. It may cause underdiagnosis resulting in inadequate treatment, further diminishing quality of life.

Chronic pain is continuously a point of concern as the elderly population grows. According to a survey, in 2016, the number of Americans older than 65 years was about 36 million, 12.4% of the population. By 2030, this group of people may number 70 million (about 20% of the total population).

Causes of Chronic Pain

Advanced age increases the risk of specific health problems that can cause chronic pain. Conditions that can cause chronic pain in older adults may include musculoskeletal disorders such as osteoporosis and arthritis, peripheral vascular disorders, and neuropathic pain (postherpetic neuralgia).

How pain disrupts the quality of life?

Chronic pain is linked to depression, sleep disturbances, poor physical functioning, and reduced social activity. Pain-linked problems can make older adults more dependent on others for ADLs (activities of daily living) and may result in social isolation and a rise in healthcare costs. Pain is commonly seen as a threat that influences older adults’ coping processes.

Effects of pain on sleep

Chronic pain can disrupt your sleep in several ways. Altogether, falling asleep is problematic for various older people who have endured chronic pain stress in the day. Sleep quality may suffer because of frequent awakenings, as continuously changing sides on the bed may cause pain.

Sleep deprivation and alteration in sleep quality can lessen the pain threshold. Thus, a vicious sleep-deprived cycle occurs with lowered pain threshold, decreased sleep quality, and reduced ability to cope with chronic pain.

Depression and Distress

Many older people with chronic pain experience extreme distress or even depression which can obstruct their ability to handle or cope with pain. Additionally, the pain may worsen your cognitive dysfunction and malnutrition.

Along with financial hardship and other factors, chronic pain contributed to depression and distress among community-dwelling older adults. The chronic pain caused by arthritis interferes with daily activities and makes it harder for such people to carry out daily activities (ADLs), and it can cause distress.

Chronic pain can be directly linked to depression, and people might adapt to chronic pain and may not appear to be distressed daily; pain may create long-term effects manifesting depression.


Assessment of chronic pain in older adults can be challenging due to the population tends to underreport pain. Also, unlike patients with acute pain, those with chronic pain usually do not manifest autonomic pain responses, such as a sudden increase in heart rate and respiration.

Using a pain scale is beneficial while assessing an older adult for pain. A doctor may encourage their patient to keep a pain diary to help identify events that precipitate or increase pain. A pain diary can also offer clues about the occurrence of breakthrough pain. If the findings from the assessment suggest the patient has chronic pain, try finding out whether and to what level the pain is affecting the quality of life of an individual.

Plan of Care

Medical healthcare providers must develop a proper plan to address the patient’s chronic pain. The program should check the patient’s comfort-function goal and identify the pain management needed to reach the required functional ability.

Establishing a realistic and practical comfort-function goal offers direct patient input into their pain management and its implementation. It also holds both the medical healthcare team and the patient accountable for providing adequate pain relief.

Some older adults may need more help in establishing realistic goals. Firstly, inquire about the pain-related functional limitations that the person finds distressing.

Pharmacologic Pain Management

There are various pharmacologic pain management options. However, physiologic changes in the continuously aging body and coexisting health problems can challenge pharmacologic measures in the elderly.

Such physiological changes alter drugs’ pharmacodynamics and pharmacokinetics. For some reason, some medications are not very appropriate for pain management in older adults. Here is a list of potentially inappropriate medications for pain management in older adults, including:

  • Classes of drugs or medicines generally should be avoided in people 65 years or older because they may be ineffective or pose an unnecessarily high risk. I prefer taking a safer alternative available for older adults.
  • Medications that one should not prescribe to older adults who have certain medical conditions.

For many patients, the plan for pain management may need to include pharmacologic methods and nonpharmacologic methods.

Promoting Compliance with Drug Therapy

Compliance with any therapy can pose a challenge for both the patient and medical healthcare provider. Many elderly patients mistakenly think that they should take analgesics only when the pain becomes hard to handle; some patients fear becoming addicted to them. The doctor should emphasize the importance of using pain medication to stay in a better condition, rather than waiting for the pain to become unbearable.

Some older people may avoid pain treatment because of the risk of constipation and other adverse effects. Suppose fear of constipation obstructs the patient from taking the required medication. In that case, the medical healthcare provider should educate them about beneficial dietary changes, such as eating more fiber-rich food and drinking more fluids.

Nonpharmacologic Pain Management

In most cases, various older adults are open more to nonpharmacologic approaches for pain management. As per the requirements and adaptability status, teach patients about relaxation, exercise, guided imagery, acupuncture, yoga, spiritual interventions, and music therapy. Some other popular nonpharmacologic pain management options include:

  • biofeedback
  • humor
  • repositioning
  • distraction such as reading a book, watching television, or talking on the phone

In some situations, application or massage of something heat and cold may be appropriate. But take caution in older adults who have neuropathic pain or ischemic pain due to peripheral arterial disease. In those conditions, using heat and cold may lead to altered sensation at the extreme level and damage tissues. One must encourage their patients with joint pain or arthritis to stay as active as possible and participate in non-weight-bearing activities, such as swimming, biking, or aerobic water exercises.

Be an advocate for the elderly.

Promoting health and well-being is the essential cornerstone of nursing an elderly patient. Once you understand the overall effects of chronic pain in older adults, you can identify patients with debilitating chronic pain more efficiently, collaborate with a multidisciplinary medical healthcare team, and implement needed interventions to offer relief and improve quality of life.

It would help if you constantly stay up-to-date on the latest studies, research, and chronic pain findings. You can use the information from the reports to help guide your practice. Provide measures that promote document patient outcomes, promote comfort, and advocate for elderly patients.

You may urge the nursing leaders to pitch the federal government to fund research concerning chronic pain in the elderly and assist researchers in data collection as appropriate. Remember that pain is not a regular part of aging and older adults also deserve pain relief and the stress pain creates.

Dilaudid Addiction and Abuse

What is Dilaudid?

Dilaudid is a part of a group of drugs that are chemically similar to opium and prescribed to be taken as pain killers. The brand name of the drug is Hydromorphone and by its name, you can easily guess that the drug is derived from morphine.

Although people buy Dilaudid online because it is prescribed to be taken as a painkiller and is considered to be stronger than morphine, it is less likely that a person will get addicted to the drug if taken by someone in a larger quantity.

What are the side effects of Dilaudid?

Most people who buy a prescription drug tend to take it more than prescribed, mostly by injecting the drug into their bloodstream, mainly to get high. In such a case, the drug may cause a strong euphoria. Some people who tend to abuse the drug take it by mixing it with other opiates like heroin.

However, the signs of drug use or abuse depend on the person who is indulging in the intake or the quantity of the drug he has taken so far. Therefore, the signs of drug use or abuse in the case of Dilaudid are:-

  • Dizziness
  • Nausea
  • Vomiting
  • Stomach ache
  • Constipation
  • Finding it difficult to breathe
  • Fainting

If you want to know more about these signs and help yourself from becoming a victim of these signs of taking the drug, the best way to do so is to buy Dilaudid online in the USA and from an online pharmacy that is able to provide you with a prescription.

Withdrawal Symptoms of Dilaudid:

As you must have understood by now that if you buy Dilaudid online and start taking the drug more than prescribed or beyond the prescribed limit, you are bound to face the hazardous consequences of doing so, including wanting to take the drug more and more.

The drug may or may not work for everybody but if you suddenly stop the intake of the drug after a long time on knowing that the drug is not proving to be effective for you, you are bound to face the withdrawal symptoms of the drug.

So, the best method to save yourself from becoming a victim of the drug’s withdrawal symptoms is by slowly decreasing the intake of the drug and then stopping its intake.

But for now, let us discuss some of the withdrawal symptoms of the drug:-

  • Sweating profusely
  • Cramps in stomach
  • Anxiety
  • Vomiting
  • Watery eyes and nose
  • Restlessness, especially in the legs
  • Headache

11 Things You Need to Know About Tramadol

What Is Tramadol Used For?

Tramadol is a drug that is used as a painkiller. It is a narcotic-like severe pain killer for adults. The working of Tramadol is to blind the receptors present in the brain which are responsible for transferring the sensation of pain from the whole body to the brain.

Tramadol comes in three forms Instant release tablets, Extended-release tablets, and capsules. Instant release tablets release in our body immediately while extended-release tablets start its action slowly over time. Tramadol is a potent drug, so it should be taken under the supervision of the doctor or pharmacist. Tramadol can be administered with a combination of other medicines.

Working of Tramadol:

Tramadol is a drug that belongs to the “opioid agonists” family of drugs. All members of this family show similar working properties. Tramadol blinds the receptors in the brain that’s why receptors carry less pain message throughout the body to the brain, and our brain feels pain in decreased form.

Tramadol Oral

Side Effects of Tramadol:

The most common side-effect of this drug is you may feel dizziness, headache, nausea, vomiting, drowsiness, constipation, sweating, lack of energy, dry mouth, etc. These are the most common symptoms of Tramadol. Some people may feel some different effects also, if you are feeling as above or something else after taking Tramadol and if the problem continued, then, you must consult your medical practitioner.

Some severe side-effects of Tramadol are fast heart rate, high blood pressure, higher body temperature. You may feel unable to control the movement of your body(lack of coordination). You may feel nausea, vomiting, agitation, hallucination.

Side Effects of Tramadol

The other serious side effects of this drug are serious breathing problems like slowed breathing rate, very shallow breathing, fainting, dizziness, or confusion.

Drugs Which Can’t be Used With Tramadol:

Carbamazepine is one of the examples of medicines that can not be used with Tramadol, because if you use this medicine with Tramadol, then the working property of Tramadol is effected. Tramadol may become less effective in relieving your pain on taking with this drug, or some severe side-effects may also occur. The combination of these two drugs decreases the total amount of Tramadol.

Tramadol Precautions:

We have provided for you a list of precautions that you must take to avoid the harmful effects of the drug. Follow the guidelines that are given below –

  • The tablets of Tramadol should not be used by any child who is younger than 12 years. As we know, Tramadol is a habit-forming drug, and giving it at a younger age will develop a dependency.
  • Take the tablets of Tramadol as prescribed by your health expert. You can also follow the steps given on the prescription label of the drug.
  • A woman who breastfeeds her child should not take this medicine. The drug content may get transfer to the body of the baby and hence, may cause severe harm.
  • The extended-release tablets of Tramadol should not be given to people under the age of 18.
  • Do not overdose or misuse the tablets of Tramadol. It will get you addicted to the use of medicine, and severe health issues may arise.
  • Someone who is Allergic to opioids must not take this medicine. Taking Tramadol may even worsen the allergies like hives or rashes over the skin.
  • If someone drinks alcohol or is a habitual consumer of alcohol, then you should not take Tramadol. A combination of alcohol, along with Tramadol, will increase the effect of the drug and may also cause severe drowsiness.

Is Tramadol Addictive?

Tramadol is an opioid-like medication. It treats severe pain by acting on the brain and changing the way the body feels and responds to pain. Tramadol works similarly like a narcotic, and hence, it is also an addictive medication. It acts on the brain resulting in causing an addiction to the drug.

Tramadol Addiction

The misuse, overdose, or more prolonged doses of the tramadol can cause severe addiction. Even at regular doses, it can be habit-forming. To prevent the addiction caused by tramadol, take it exactly as prescribed by the doctor. Stop the medication gradually when it is no longer needed.

Do not use tramadol if you are prone to substance abuse or addiction.

Can It Cause Withdrawal?

Tramadol can cause dependence. Do not stop taking the medication at once, as it causes severe withdrawal symptoms. Gradually lessen the dosage of tramadol, as directed by the doctor.

The most widely known withdrawal symptoms of tramadol are:

  • Sweating
  • Chills
  • Anxiety
  • Diarrhea
  • Nausea
  • Loss of appetite
  • Panic attacks
  • Muscle pain
  • Sleep disorders
  • Fast breathing
  • Increased blood pressure.

Withdrawal symptoms differ in different patients. Many factors are responsible for causing withdrawal. The withdrawal caused by tramadol is influenced by:

  • Patient’s age
  • Patient’s health
  • Genetics
  • Other drugs used by the patient
  • Patient’s history of substance abuse.

Is Tramadol Good For Back Pain?

As you must have learned it by now, Tramadol is a drug that is mainly prescribed for the treatment of pain inside a human body. The pain that occurs is carried to the brain through the pain receptors present in the Central Nervous System (CNS). Patients should not buy Tramadol online if they do not have a prescription for the drug.

Tramadol Good For Back Pain

The dosage of Tramadol is prescribed when other non-opioid pain medications are not active enough on a person’s health. The immediate-release form of Tramadol is given to a patient when the pain is severe and needs to be treated then and there. These forms of Tramadol are not for recreational purposes. Doctors mainly prescribe the immediate-release form of Tramadol for back pain, postoperative pain after spine surgery, and sciatica (pain running through the sciatic nerve). Thus, Tramadol is a suitable drug to treat back pain.

Is Tramadol An Anti-Inflammatory?

No, Tramadol is not categorized as a nonsteroidal anti-inflammatory drug (NSAID). Instead, Tramadol is more of a synthetic drug that is produced by man. It belongs to the class of opioid analgesics that help in the treatment of pain. People who buy Tramadol online without a prescription may not have information about this.

An anti-inflammatory drug like aspirin is also used as a pain reliever, but it does have some harmful side effects. The anti-inflammatory drugs have a high risk of causing stomach ulcers or extreme pain, bleeding internally, high blood pressure, kidney or liver problems, and so on. Therefore, people who are taking Tramadol need not worry about the harmful effects of anti-inflammatory drugs.

Is Tramadol Good For Joint Pain?

Though there have been several uses of Tramadol related to pain, a person must not buy Tramadol online without knowing the issues it can treat. Tramadol, when combined with hydrochloride, is a centrally acting analgesic for pain that will double the mechanism of pain medication treatment.

Tramadol Good For Joint Pain

The FDA has approved this combination for the management of moderate to severe pain. Doctors also prescribe this medication for the treatment of arthritis or joint pain followed by physical therapy.

Where Can You Buy Tramadol?

There are many websites and online pharmacies that sell Tramadol at a reasonable price. One must keep in mind not to buy Tramadol online without a prescription. It is illegal to purchase Tramadol without its prescription from a drug store or even through an online medium. Along with this, you need to be sure about the platform from where you will be purchasing your drug is authorized by the FDA (Food and Drug Administration).

Before you buy Tramadol online, do compare the prices and look for an official website. Some sellers in the online market are dealing in drugs that are low quality and higher pricing. You need to be aware of such frauds going on in and around the online market.

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