By Dr. Sunny Ramchandani, President of Flagship Medical Group

Managing chronic pain can be challenging, and for seniors, it may become more complex due to other health conditions or age-related changes. For many older adults, it’s a long-term issue that can make staying active and maintaining overall health more difficult. Chronic pain often develops from conditions like arthritis, nerve damage, or injuries that never fully healed. In some cases, it’s the result of gradual changes in the body’s joints, muscles, and nerves over time. Because the causes can be varied and sometimes overlap, finding relief often requires a more personalized, comprehensive approach. 

At Flagship Health, we understand the unique health needs of seniors and are committed to taking a holistic approach to help you navigate the complexities of chronic pain management.

This article explores the most common causes of chronic pain in seniors, practical strategies for relief, and how a personalized, team-based approach can significantly improve quality of life as we age.

Understanding Chronic Pain in Seniors

Chronic pain, typically defined as pain lasting longer than three to six months, is common among older adults. According to the CDC, 36% of adults aged 65 and older reported experiencing chronic pain within the past three months, compared to 12.3% of adults aged 18 to 29.

For seniors, chronic pain can affect nearly every aspect of daily life. It may limit mobility, making it harder to stay active or perform everyday tasks, and can contribute to muscle weakness or balance issues over time. Pain often interferes with sleep, which can lead to fatigue and make it even more difficult to manage other health conditions. These challenges can reduce independence and make routine activities, like cooking, cleaning, or shopping, more difficult to manage.

These realities highlight the need for effective pain management strategies tailored to the unique needs of older adults.

Common Causes of Chronic Pain in Seniors

1. Osteoarthritis 

Osteoarthritis (OA) is the most common form of arthritis and a leading cause of chronic pain in seniors. According to the World Health Organization, 73% of people living with osteoarthritis are over the age of 55. The condition develops when the protective cartilage that cushions the ends of bones gradually wears away, resulting in pain, stiffness, and reduced mobility. 

Management often includes low-impact exercise, physical therapy, and anti-inflammatory medications to reduce discomfort and maintain joint health.

2. Lower Back Pain 

Chronic lower back pain is another leading issue for seniors, affecting nearly 45.6% of adults aged 65 and older, higher than any younger age group. Common causes include:

• Gradual degeneration of the discs that cushion the spine
• Narrowing of the spaces in the spine that can put pressure on nerves
• Years of poor posture

This condition can greatly reduce mobility, interfere with sleep, and make daily tasks feel like uphill battles.

Management strategies often involve targeted physical therapy, core-strengthening exercises, and posture correction to help improve function and reduce pain.

3. Fibromyalgia 

Fibromyalgia is a long-term condition that causes widespread pain throughout the muscles and joints, often accompanied by:

• Fatigue
• Sleep problems
• Heightened sensitivity to touch

While it can affect people at any age, symptoms are often more noticeable in seniors. The condition’s exact cause is not fully understood, and because its symptoms can overlap with other health issues, it can take time to diagnose.

Managing fibromyalgia often requires a combination of approaches, including gentle exercise, stress reduction techniques, and medical support to help improve comfort and quality of life.

4. Neuropathic Pain 

Neuropathic pain, or nerve-related pain, is particularly common among seniors, especially those with conditions such as diabetes, shingles, or nerve injuries. It often presents as burning, tingling, numbness, or shooting sensations that can occur in specific areas or throughout the body. Because neuropathic pain originates from nerve damage or dysfunction, it can be persistent and difficult to manage with standard pain medications alone.

Treatment may include a combination of prescription medications targeted at nerve pain, physical therapy, and complementary approaches such as gentle exercise to help improve comfort and daily function. 

5. Chronic Headaches

Persistent headaches, including migraines and tension-type headaches, can significantly affect quality of life for seniors. They may be triggered or worsened by factors such as:

• Medication side effects
• Stress
• Dehydration
• Vision problems
• Underlying health conditions

Chronic headaches can lead to fatigue, reduced concentration, and difficulty engaging in daily activities.

Management often involves identifying and addressing potential triggers, making lifestyle adjustments, and using targeted treatments such as medication, relaxation techniques, or physical therapy to reduce frequency and severity.

Practical Strategies for Managing Chronic Pain

Chronic pain can affect nearly every part of daily life, from mobility and independence to sleep and mood. While it is challenging to live with ongoing discomfort, evidence-based approaches can help reduce symptoms, improve function, and enhance quality of life.

 Exercise and Physical Activity

Regular, gentle exercise is one of the most effective ways to manage certain types of chronic pain, particularly musculoskeletal conditions such as arthritis, osteoarthritis, and lower back pain. Research shows that physical activity can reduce pain and improve physical function by approximately 40% in adults with arthritis. Low-impact activities like walking, swimming, or tai chi can help improve flexibility, strengthen muscles, and support joint health, making it easier to stay active and maintain independence.

Mind-Body Techniques

Practices such as meditation, deep breathing exercises, and guided imagery can help seniors manage pain perception and reduce stress. These techniques can be particularly beneficial for those dealing with conditions like fibromyalgia or chronic headaches. When incorporated into a regular routine, mind-body practices may also improve mood, enhance sleep quality, and promote a greater sense of control over pain, making them a valuable complement to other treatment approaches.

Physical Therapy

Working with a physical therapist can provide targeted exercises and stretches designed to address specific pain issues and improve mobility. Physical therapy is especially helpful for conditions like osteoarthritis or lower back pain, where strengthening supporting muscles, improving posture, and enhancing flexibility can make daily activities easier. A therapist can also teach safe movement techniques, recommend assistive devices if needed, and help patients gradually increase activity levels to reduce discomfort and prevent further injury.

Proper Nutrition and Hydration

A balanced diet rich in anti-inflammatory foods can play a key role in managing chronic pain. Nutrient-dense foods high in omega-3 fatty acids, such as salmon, mackerel, and walnuts, along with antioxidant-rich fruits and vegetables like berries, leafy greens, and bell peppers, may help reduce inflammation and support overall health. Whole grains, lean proteins, and healthy fats can further contribute to steady energy levels and muscle strength, which are important for staying active despite pain.

Sleep Hygiene

Chronic pain and poor sleep often influence each other, making it harder to rest well and manage discomfort. Implementing good sleep hygiene practices, such as maintaining a consistent sleep and wake schedule, creating a comfortable and dark sleep environment, and avoiding caffeine, heavy meals, or screen time before bed, can improve both sleep quality and overall well-being.

By combining these strategies, seniors can address chronic pain from multiple angles, improving not only physical comfort but also mood, energy, and independence. The key is finding the right mix of approaches that fit individual needs, preferences, and lifestyle.

Medications and Medical Interventions

While lifestyle and non-pharmacological approaches are often the first choice for managing chronic pain, medications can still be valuable when pain significantly limits daily activities or quality of life. The right medication can ease discomfort enough to make other treatments, such as physical therapy or exercise, more effective. Because older adults may also be managing multiple health conditions, medication plans should be carefully individualized to maximize benefits while minimizing risks.

Options may include:

• Over-the-counter pain relievers: Medications such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can be helpful for mild to moderate pain from conditions like osteoarthritis, muscle strains, tension headaches, or general musculoskeletal discomfort. They should be used with caution to avoid potential side effects such as stomach irritation, kidney issues, or liver damage, especially with long-term use.
• Topical treatments: Creams, gels, or patches containing ingredients like lidocaine or capsaicin can be applied directly to the affected area for targeted relief, making them useful for localized pain such as arthritis in the hands or knees, muscle soreness, or nerve-related pain from conditions like shingles. Because they work at the application site, topical treatments generally carry fewer systemic side effects compared to oral medications, which can make them a safer option for some seniors.
• Prescription medications: Depending on the type and source of pain, a provider may recommend certain prescription drugs, including those designed specifically for nerve-related pain. These require careful monitoring to ensure safety and effectiveness.
• Interventional procedures: In some cases, treatments such as nerve blocks, steroid injections, or minimally invasive surgeries may be considered to address specific pain sources and provide longer-lasting relief. These interventions may be effective for conditions like neuropathy, fibromyalgia, or advanced arthritis, but they require careful monitoring to ensure safety, prevent dependency, and manage potential side effects.

Because medication needs can change over time, it is essential to work closely with a healthcare team to find the safest and most effective options. Regular check-ins allow for adjustments to dosage, switching medications when necessary, and monitoring for potential side effects or drug interactions.

The Importance of a Personalized, Team-Based Approach

A team-based approach means coordinating care with all members of your health team so your chronic pain is managed in the context of your overall health. With this kind of care, your treatment plan is designed just for you, taking into account all the factors that may be causing your pain as well as any other health issues that could make it worse.

Your plan can be adjusted over time as your needs change. When your care team works together, they can help reduce the chance of medication conflicts, avoid treatments you do not need, and make sure you get consistent, coordinated support. Just as importantly, a team-based approach focuses on more than just your symptoms. It is about improving your comfort, function, and overall quality of life so you can keep doing the things that matter most to you.

When to Seek Professional Help

While some degree of discomfort can be a normal part of aging, chronic pain should never be dismissed as something you simply have to live with. Knowing when to reach out to a healthcare provider can help ensure you receive timely and effective support.

Consider scheduling an appointment if:

• Pain doesn’t improve with rest or over-the-counter treatments: Persistent discomfort despite self-care may point to a more serious or complex issue.
• There is a sudden onset of new or severe pain: Rapid changes in pain levels can indicate an injury or medical condition that needs immediate attention.
• Pain is accompanied by other symptoms: Fever, unexplained weight loss, or changes in bodily functions can be signs of an underlying illness that should be evaluated promptly.
• Daily tasks become difficult: If pain or limited mobility interferes with activities like walking, cooking, or dressing, it’s time to explore more targeted management options.

Early intervention often leads to more effective pain control and can help prevent complications or long-term disability. By discussing symptoms openly with your healthcare team, you can work together to identify the cause and develop a personalized treatment plan.

Empowering Seniors to Take Control of Chronic Pain

Chronic pain doesn’t have to limit the way you live. With the right strategies, support, and personalized care, many seniors can significantly improve their pain management and overall quality of life.

At Flagship Health, we’re committed to partnering with you on this journey, providing the expertise and compassionate care needed to navigate the challenges of chronic pain.

By understanding the common causes of chronic pain, implementing practical management strategies, and embracing a team-based approach to care, seniors can take control of their pain and focus on enjoying life to its fullest.

You don’t have to face chronic pain alone — our team is here to support you every step of the way.

To schedule an appointment or learn more about our senior health services, contact us today.

About Dr. Ramchandani

Dr. Sunny Ramchandani is the President of Flagship Medical Group with over 20 years of experience caring for patients, including extensive work with the senior population. A former White House Fellow and Navy physician, he previously served as Chief Population Health Officer at Naval Medical Center San Diego and helped lead national health reforms in Afghanistan. Dr. Ramchandani holds degrees from the U.S. Naval Academy, Yale School of Medicine, and Harvard School of Public Health.