There's no single "best" painkiller for the aged; acetaminophen (paracetamol) is often the first choice for mild-to-moderate pain due to its relative safety, but NSAIDs (ibuprofen, naproxen) can be better for inflammation but need caution due to stomach/kidney risks, while stronger options like opioids (morphine, tramadol - use with extreme caution) or nerve pain meds (gabapentin) are for severe pain, always starting low and slow with doctor supervision. A full geriatric assessment and considering comorbidities (kidney/liver issues) are crucial for safe pain management in older adults, emphasizing a personalized approach.
Good for mild, persistent pain, acetaminophen is your safest choice of the OTC pain relievers. The less-safe options are aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.
Acetaminophen is generally considered safer than other pain relievers. It doesn't cause side effects such as stomach pain and bleeding. However, taking more than the recommended dose or taking acetaminophen with alcohol increases the risk of kidney damage and liver failure over time.
Over-the-counter pain medications like acetaminophen, ibuprofen or naproxen sodium, as well as topical ointments and patches can help with pain relief, but don't discount the power of movement, says Christopher. In addition to routine aerobic exercise, try gentle stretching, yoga or a muscle massage.
The most powerful pain relievers are opioids, sometimes called narcotics. They include strong prescription pain relievers such as oxycodone, hydrocodone, or morphine. Opioids are sometimes used to treat moderate to severe pain.
Age was found to be a significant covariate for oxycodone pharmacokinetics. In elderly patients, dosing should therefore be reduced and carefully titrated to avoid considerable accumulation of oxycodone and potentially hazardous side-effects.
Several meta-analyses and RCTs indicate that glucosamine and chondroitin, especially in combination, can improve pain and joint function in patients with knee and/or hip OA.
When chronic pain feels unbearable, focus on immediate coping (pacing, distraction, deep breathing, heat/cold) while urgently contacting your doctor or seeking urgent care for severe flares to adjust medication or get immediate relief, using techniques like mindfulness and light movement as possible, and remembering that a multi-faceted management plan with therapies (PT, psychological) is crucial for long-term control, even if there's no quick cure.
Common causes of aging aches and pains
Arthritis: Over 50% of adults over 65 experience joint pain, with arthritis being one of the most common causes. Osteoarthritis, the wearing down of joint cartilage, is more common in older adults and often affects the knees, hips, hands and/or spine.
The prescription pill is said to be nonaddictive. The Food and Drug Administration (FDA) recently approved a new, non-opioid prescription pill—suzetrigine. Sold under the brand name Journavx™, the drug is helpful in treating moderate-to-severe acute (short-term) pain in adults.
Morphine. Morphine and similar drugs (like oxycodone, fentanyl, buprenorphine) are the strongest painkillers. Some come in patch form, but all work in similar ways and are used for severe pain only.
One of the primary alternatives is non-opioid medication options. These include over-the-counter drugs such as acetaminophen and ibuprofen, which can be effective for mild to moderate pain.
Pills. NSAIDs are the most effective oral medicines for OA. They include ibuprofen (Motrin, Advil) naproxen (Aleve) and diclofenac (Voltaren, others). All work by blocking enzymes that cause pain and swelling.
Paracetamol is the most common painkiller used to relieve mild to moderate pain. The usual dose is one or two tablets taken up to four times a day. It is important that you do not take more than two tablets at any one time and no more than eight tablets in any twenty-four hours.
One of the most common conditions leading to chronic pain and disability in the elderly is osteoarthritis. This is likely related to the obesity burden, combined with the senescence of connective tissues during aging, which might result in painful alterations at activity or rest (Satake et al., 2021).
Acetaminophen. Acetaminophen (Tylenol) is often the first suggestion when managing chronic pain, especially for joint or muscle aches. Acetaminophen is considered one of the safest over-the-counter pain relievers when used at recommended doses, but it has limitations and hidden risks.
Attend to your body sensations using mindfulness or meditation to connect with yourself. Allow disappointment, sadness, grief, or anger to arise if they do. Give them the space to exist without judgment. Acknowledge that life can be worth living, even when there is pain.
Simple, everyday activities like walking, swimming, gardening and dancing can ease some of the pain directly by blocking pain signals to the brain. Activity also helps lessen pain by stretching stiff and tense muscles, ligaments and joints.
Here are seven simple ways to keep your joints lubricated as you get older.
Research note: Preliminary studies suggest a type of vitamin B3 called niacinamide may improve osteoarthritis (OA) symptoms and reduce the need for nonsteroidal anti-inflammatory drugs (NSAIDs) by suppressing inflammation.
Natural Supplements to Consider
However, oxycodone and other opioid-acetaminophen combinations have become a common cause of acute liver injury, which is usually the result of excessive use of the medication for the opioid effect, which leads secondarily and unintentionally to an overdose of acetaminophen.
In our review of the literature, we found evidence that while there are risks associated with its use, buprenorphine appears no more hazardous and is likely safer and more efficacious than other opioids for chronic noncancer pain management in the elderly.