What should be the initial focus in the management of chronic pain in older adults?

Focusing on non-pharmacological interventions like physical therapy as the initial management for chronic pain in older adults is supported by a growing body of evidence emphasizing the benefits of these approaches. Older adults often have complex health profiles that may include multiple comorbidities, making them particularly vulnerable to the side effects of pharmacological treatments, especially opioids. Non-pharmacological interventions, such as physical therapy, exercise programs, cognitive-behavioral therapy, and other holistic approaches, can help manage pain effectively while minimizing risks.

These interventions not only address the physical aspects of pain but also support functional improvements and overall quality of life. They encourage active participation from the patient in their own care and promote healthier lifestyle choices, which can be particularly valuable in aging populations. By starting with non-pharmacological options, healthcare providers can develop a more comprehensive pain management plan that takes into account the individual's unique circumstances and preferences, ensuring both efficacy and safety in the treatment pathway.