Persistent Pain

The prevalence and intensity of persistent pain increases with age. The majority of older adults in the United States report suffering from some form of persistent pain that inhibits the way they carry out the activities of daily living. Older adults frequently report experiencing chronic osteoarthritis back pain, musculoskeletal pain, peripheral neuropathic pain, and joint pain. Persistent pain for older adults can result in social isolation, disability, and greater costs to our healthcare system.

Clinicians face a growing dilemma in effectively managing persistent pain in older adults, as overprescription of opioids and risk of addiction have resulted in a public health crisis. Unfortunately, available treatments for persistent pain are only partially effective and can have adverse side effects.

Many trials for new medications for persistent pain exclude older adults and limit participants based on use of other medications. However, older adults are frequently prescribed multiple medications to manage their health. The use of multiple medications, known as polypharmacy, is associated with higher rates of adverse drug events and interactions. Exclusion of older adults from trials due to existing drug regimens means that there is limited data on how a new medication will work for older adults and potential drug-to-drug interactions. The Alliance is committed to working with partners to help find solutions to this issue.

Approaches to treating persistent pain should be individualized to the patient. There is an urgent need to fund more research into lower-risk treatments and more effective treatments for patients.

The Alliance for Aging Research advocates for:

• Increased federal resources for clinical development of new therapeutics for pain management and study of the underlying biological mechanisms of persistent pain and age.
• Policies that support safe and appropriate use of pain management therapeutics.
• Resources to help older adults address and manage pain medication abuse.
• Appropriate representation of older adults in clinical trials for treatments for persistent pain.