A careful combination of drug and non-drug therapies is the best strategy for safely improving quality of life in residents with chronic pain, according to Mayo Clinic geriatricians.

Treatment should start with low-risk, noninvasive strategies and then slowly introduce pain medications, including opioids as needed, according to physicians Brandon Verdoorn, M.D., and Christina Y. Chen, M.D., in Mayo Clinic Proceedings. They recommend that providers use the following framework to help manage care:

• Begin with a thorough pain assessment, focusing on pain-related function.

• Address associated conditions, such as depression and insomnia, at the same time.

• Start with low-risk pain management strategies, including nondrug interventions that get the patient actively involved in her or his own improvement.

• Use higher-risk — often pharmacologic — strategies cautiously, when needed.

• Frequently reassess and discontinue ineffective treatments.

Pain medications “are important tools for addressing chronic pain, which ultimately affects one’s function and independence,” Chen said.