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Pain is the number one complaint of older Americans, and one in five older Americans
takes a painkiller regularly. In 1998, the American Geriatrics Society (AGS)
issued guidelines* for the management of pain in older people. The AGS panel
addressed the incorporation of several non-drug approaches in patients' treatment
plans, including exercise. AGS panel members recommend that, whenever possible,
patients use alternatives to aspirin, ibuprofen, and other NSAIDs because of
the drugs' side effects, including stomach irritation and gastrointestinal bleeding.
For older adults, acetaminophen is the first-line treatment for mild-to-moderate
pain, according to the guidelines. More serious chronic pain conditions may
require opioid drugs (narcotics), including codeine or morphine, for relief
of pain.
Pain in younger patients also requires special attention, particularly because
young children are not always able to describe the degree of pain they are experiencing.
Although treating pain in pediatric patients poses a special challenge to physicians
and parents alike, pediatric patients should never be undertreated.
Recently, special tools for measuring pain in children have been developed
that, when combined with cues used by parents, help physicians select the most
effective treatments.
Nonsteroidal agents, and especially acetaminophen, are most often prescribed
for control of pain in children. In the case of severe pain or pain following
surgery, acetaminophen may be combined with codeine.
* Journal of the American Geriatrics Society (1998; 46:635-651).
Prepared by: Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD
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