Chronic Pain Management
Many tools beyond opioids.
Beyond meds
- Physical therapy — proven, Medicare covered.
- Acupuncture — some Medicare coverage 2020+.
- Tai Chi — proven for arthritis.
- Yoga — gentle senior versions.
- Massage — relief + relaxation.
- Heat/cold therapy.
- TENS unit — $50, electrical relief.
- CBT — chronic pain therapy.
Medication options
- Tylenol — first try. Safe under 3g/day.
- NSAIDs — Advil, Aleve. Watch stomach + kidneys.
- Topical NSAIDs — Voltaren gel. Fewer side effects.
- Capsaicin cream — natural.
- Lidocaine patches — localized relief.
- Cymbalta, Lyrica — nerve pain.
- Cortisone injections — joint pain.
Avoid these in seniors
- Long-term opioids (addictive, falls).
- Benzodiazepines (confusion, falls).
- Muscle relaxants (drowsy).
- Beers Criteria — drugs to avoid in seniors. Ask doctor.
- NSAIDs long-term (bleeding, kidneys).
- Over-medicating common — review with pharmacist.
Lifestyle helps most
- Movement — counterintuitive but helps.
- Anti-inflammatory diet.
- Lose 5-10 lbs = 4x less knee pressure.
- Sleep — pain worse when tired.
- Stress reduction.
- Social connection.
- Pain catastrophizing therapy.
When to see specialist
- Pain > 3 months.
- Limiting daily activities.
- Multiple meds not working.
- New or sudden pain.
- Pain doctor specializes.
- Cancer pain — palliative care helpful.
Free resources
Arthritis Foundation — free pain courses. Walk With Ease — proven. Pain Management apps — Curable, MyPainDiary. Stanford Self-Management — chronic disease courses. Living with pain doesn't mean accepting suffering. Manageable.