how gaining affects pain

1. Physiological changes from aging
regarding pain perception and its
impact on pain management for older
adults
MANI HASHEMI, MD
INTERVENTIONAL PAIN MEDICINE FELLOW
UNIVERSITY OF ILLINOIS IN CHICAGO

2. Introduction
Pain management in older adults is increasingly relevant due to
an aging population.
The International Association for the Study of Pain emphasizes
the need for research in this area.
Challenges include polypharmacy and side effects, making pain
control difficult.

3. Incidence and Prevalence
Pain is common in older adults, but
exact prevalence is hard to determine
due to varied research methods.
Institutionalized adults experience
higher levels of pain compared to
community-dwelling adults.
Factors such as BMI, education level,
and gender also play a role.

5. Impact of Pain
Pain affects functional ability, sleep, appetite, and increases
depression and social isolation.
Treating depression can reduce pain perception and improve
quality of life.

6. Changes in Pain
Perception
Aging alters pain perception
through mechanisms like
presbyalgos, affecting the
nervous system.
Altered pain perception
increases the risk of injury and
complicates diagnosis.

7. How Aging Affects Pain Experience
Presbyalgos: reducing the ability
to detect harmful signals. Due to
the loss of delta nerve fibers and
the increase in non-neuronal glial
cells.
Loss of proprioception and
altered nerve conductivity
increase the risk of injury and
pain.
Altered responses to thermal pain
observed in specific brain regions.
Compromises the protective
biological function of pain,
increasing injury risk.
Chest pain is less prominent in
older adults with myocardial
infarction, complicating diagnosis.

8. How Ageing Affects Pain Experience
1
Pain threshold
increases with age,
more prominently in
women. Which Leads
to reduced sensitivity
to mild pain,
especially thermal
stimuli.
2
Maximal pain
tolerance either
remains unchanged
or reduces with age.
3
Endogenous pain
inhibitory systems
less effective in older
adults.
4
Neuroplasticity slows
down, affecting the
ability to recover
from injury. This
results in prolonged
periods of discomfort
and functional
impairment.
5
Despite diminished
pain pathways, older
adults are less
tolerant of high-
intensity pain.
6
Also experience
longer periods of
hyperalgesia
(heightened
sensitivity to pain).

9. Clinical Impacts
Age-related physiological
changes affect the impact of
analgesic medications.
Altered pharmacodynamics
require cautious prescribing,
lower initial doses, and
careful monitoring.

11. Conclusion
Aging affects susceptibility, tolerance, and recovery from pain.
Pain management must consider age-related changes and
individual variability in response to treatments.

12. Questions?