Abstract

Is there evidence for the current British Pain Society (BPS) guidelines for the non-pharmacological
management

of

pain

in

the

elder

population?

Manuel J. Amenbar A.
Pain is an important problem for the growing elder population, with a tendency to under-express their
pain and stop moving, thus losing functionality and having increased pain generally due to muscle
spasms, stiff joints and loss of bone and muscle mass. This affects their autonomy to achieve ADL,
as well as less socialization and leisure activities with their families and friends. Because of agerelated changes, pharmacological treatment has to be delivered with caution, due to the high risk of
side effects from medications, including liver and kidney damage. Non-pharmacological therapies
might be a plausible alternative as an adjuvant to conventional treatment, helping decrease doses,
thus minimizing side effects. According with the guidelines of the British Pain Society (BPS) for the
management of pain in the elderly, there are several non-pharmacological treatments available,
which include 4 big groups: Exercise and Physical Activity, Psychological Interventions,
Complementary and Alternative Medicine (CAM) and Assistive Devices.(20) Objective: Through this
extended essay it was aimed to explore the literature available and to determine if there is evidence
for the non-pharmacological techniques listed by the BPS for the management of pain in the elderly.
Methodology: Literature review using as search tools PEDro, Medline and Google Scholar. Pain and
elderly were the main keywords used for the literature search. This essay includes articles from the
year 2000 onwards, published in English, with a sample mean age of 60 or more. Preferentially,
RCTs, meta-analysis and systematic reviews, scoring 3 or more in the Jadad Scale were included.
Surveys, non-randomised trials and case reports were included in some sections, due to the small
amount of articles found. Conclusions: There is not enough evidence to support the use of these
therapies for the management of pain in the elderly. However, the majority of the articles reviewed
had methodological limitations and additionally, some had more evidence than others. There is a
need for future research to consider creating treatment protocols and assessment tools that are fitted
to this specific population. Also, further studies are needed using unified criteria to create systematic
reviews and meta-analysis, so empirical proof can be exhibit.