Chronic pain is more common and results in more substantial morbidities in the elderly. Meanwhile, the age-related changes in physiology make the pain management more complex and, therefore, may need more attention. The management of non-cancer chronic pain should be personal and multidisciplinary, which is based on the physical status, life function, and social or family support of each patient. This article reviews the efficacy and the risk of adverse effects, timing of the use, and additional considerations of different medications. Acetaminophen is the first-line treatment choice for the elderly with mild to moderate pain. Under closely monitoring, trials of opioids are appropriate for patients with moderate to severe pain or poor responses to the first-line therapies. Considering the significant adverse effects, it is recommended to avoid long-term use of systemic non-steroidal anti-inflammatory drugs.
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