Chronic Pain in the Elderly: Mechanisms and Distinctive Features.

Biomolecules

Second Division of Anesthesiology, Intensive Care & Emergency Medicine, University of Brescia at Spedali Civili Hospital, Piazzale Spedali Civili 1, 25100 Brescia, Italy.

Published: August 2021

Background: Chronic pain is a major issue affecting more than 50% of the older population and up to 80% of nursing homes residents. Research on pain in the elderly focuses mainly on the development of clinical tools to assess pain in patients with dementia and cognitive impairment or on the efficacy and tolerability of medications. In this review, we searched for evidence of specific pain mechanisms or modifications in pain signals processing either at the cellular level or in the central nervous system.

Methods: Narrative review.

Results: Investigation on pain sensitivity led to conflicting results, with some studies indicating a modest decrease in age-related pain sensitivity, while other researchers found a reduced pain threshold for pressure stimuli. Areas of the brain involved in pain perception and analgesia are susceptible to pathological changes such as gliosis and neuronal death and the effectiveness of descending pain inhibitory mechanisms, particularly their endogenous opioid component, also appears to deteriorate with advancing age. Hyperalgesia is more common at older age and recovery from peripheral nerve injury appears to be delayed. In addition, peripheral nociceptors may contribute minimally to pain sensation at either acute or chronic time points in aged populations.

Conclusions: Elderly subjects appear to be more susceptible to prolonged pain development, and medications acting on peripheral sensitization are less efficient. Pathologic changes in the central nervous system are responsible for different pain processing and response to treatment. Specific guidelines focusing on specific pathophysiological changes in the elderly are needed to ensure adequate treatment of chronic pain conditions.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8391112PMC
http://dx.doi.org/10.3390/biom11081256DOI Listing

Publication Analysis

Top Keywords

pain
14
chronic pain
12
pain elderly
8
central nervous
8
pain sensitivity
8
chronic
4
elderly
4
elderly mechanisms
4
mechanisms distinctive
4
distinctive features
4

Similar Publications

Objective: The aim of this study is to evaluate the effectiveness of immersive technologies in the rehabilitation of patients with non-specific neck pain and identify any potential side effects associated with their use.

Design: Systematic review.

Subjects/patients: Individuals with non-specific neck pain.

View Article and Find Full Text PDF

Tailgut cyst is an exceedingly rare congenital anomaly originating from embryonic remnants of the tailgut. Owing to its asymptomatic nature in the early stages, it is prone to clinical misdiagnosis. We present a case of a 55-year-old female with initial symptoms manifesting as sacrococcygeal pain.

View Article and Find Full Text PDF

Rhabdomyolysis Following Trimethoprim-Sulfamethoxazole Therapy: A Case Report and Review of the Literature.

Curr Drug Saf

January 2025

National Center Chalbi Belkahia of Pharmacovigilance, Department of Collection and Analysis of Adverse Effects, Tunis, Tunisia, University of Tunis El Manar, Faculty of Medicine, Research unit: UR17ES12, Tunis, Tunisia.

Background: Trimethoprim-Sulfamethoxazole (TMP-SMX) is a commonly used antibiotic for the treatment of several infections, such as urinary tract infections, respiratory infections, and in certain cases, septic arthritis. Rhabdomyolysis (RM) is very rare and less than 20 cases have been reported, so far, in the literature, in particular in immunocompromised patients. Here, we report a case of TMP-SMX-induced RM in an immunocompetent patient, adding to the limited data on this association.

View Article and Find Full Text PDF

Double-blind randomised trial of saline solution for gargling and nasal rinsing in SARS-CoV-2 infection.

J Glob Health

December 2024

Department of Anesthesiology, Critical Care and Pain Medicine, UTHealth, Houston, Texas, USA.

Background: Previous studies have shown that hypertonic saline nasal irrigation and gargling reduced the duration of symptoms in upper respiratory infections caused by coronavirus. This study aims to investigate the effects of two saline regimens on symptoms associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Methods: Between 2020 and 2022, individuals aged 18-65 years who tested positive for SARS-CoV-2 infection via polymerase chain reaction (PCR) were randomly assigned to either low- or high-saline regimens for 14 days.

View Article and Find Full Text PDF

Aortic dissection is a life-threatening vascular emergency associated with high morbidity and mortality. Clinical manifestations might include severe chest pain to neurological deficits, depending on the arterial segments involved. Extensive dissections involving multiple aortic segments and branch vessel occlusions, such as the carotid arteries, are rare and pose unique diagnostic and therapeutic challenges.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!