There are many physiological changes that occur with aging. Many of these changes have a significant impact on pharmacokinetic and pharmacodynamic of analgesic medications. Elderly patients are much more prone to sideeffects and drug dosages should be reduced in this population. The elderly also have significant co-morbid diseases that include dementia, Alzheimer's disease, cardio-respiratory dysfunction, renal dysfunction, and musculoskeletal disorders. These concomitant disorders may not only limit the administration of medications, but also may preclude certain invasive, pain interventions for pain relief. They also make pain assessment challenging and pain management difficult in the elderly. Psychiatric conditions and/or psychological impact of pain and chronic primary conditions, e.g., cancer, needs to be taken into account when managing elderly patients with pain. A management strategy for chronic pain typically involves many disciplines, including chronic pain specialist, social worker, physiatrist, rehabilitation physician, and potentially a psychiatrist. Furthermore, social, cultural, and ethical issues should also be kept in mind when managing pain in an elderly patient.

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