Treatment of chronic pain in the elderly is not simple. There are many elderly people suffering from pain, and research into what you can do as a doctor is very poor. From a scientific point of view, the elderly are a discriminated group of people. That is why we ask here more attention for chronic pain in the elderly and the role of the new, natural, analgesic and anti-inflammatory substance with little side effects, PEA. PEA or Palmidrol is the abbreviation for palmitoylethanolamide. The substance is available as a supplement under the name PeaCure and Normast.


Natural pain-relief for the elderly 

In 2015, the natural analgesic PeaCure became available in USA. Many hundreds of elderly people have been treated with this substance since, and its good effectiveness with little side effects makes it a sensible analgesic supplement.


The more elderly people, the more chronic pain

There are more and more elderly people. And therefore more and more elderly people in pain. In 2050, the percentage of people above the age of 65 will rise from currently 17.5 per cent to 36.3 per cent. There will be three times as much elderly people above 80 than now.

Old age goes hand in hand with complaints, and one of them is chronic pain. It is often seen in the elderly. More than 50 per cent of older persons in a home situation suffer from chronic pain, and that figure rises to even more than 80 per cent in inhabitants of nursing homes. Almost three quarters of all elderly indicate that chronic pain for them is the symptom number 1. The problem of pain in the elderly is that it is chronic, sometimes violent, and can be experienced in several locations in the body More Info.

It can make the quality of the latter years of our beautiful life quite miserable.


Treatment of chronic pain in the elderly is poor

The treatment of pain in the elderly is pretty poor.

It often does not get a lot of attention, the dosages administered are usually low, and there is little regard for the side effects so feared by the elderly. Because of that fear, older people take fewer painkillers. The hard figures make you startle. For example that more than a quarter of cancer patients over 65 years who suffer from daily pain, do net get painkillers.

On the other hand, the side effects of commonly prescribed painkillers for the elderly often lead to additional problems and dangers.


Little research in effectiveness of painkillers in the elderly

Despite the fact that chronic pain occurs so often in elderly people, the vast majority of studies into effectiveness of pain treatment has been carried out with non-elderly adults. Moreover, they often examined only short term treatment, sometimes there was only research to the effects of one single pill. Although we know that a treatment is only useful after knowing the effects over a period of weeks or months. A single pill now and then will not get you far.

There is a manifest lack of scientific evidence in support of the applied pain treatment strategies for the elderly. Hopkins Medicine, that plays an imminent role in the field of chronic pain treatment in the elderly, described the most optimal treatment of older patients as follows: pharmacological treatment of chronic pain is most effective in combination with non-pharmacological methods of treatment (e.g. an exercise program, TENS, application of heat or cold), psychological methods (for example, relaxation, cognitive behavioural therapy), educational programs, social interventions and complementary therapy.

Because the elderly often suffer from multiple medical and nutritional problems, the options for treatment with analgesia are sometimes limited, on the one hand because of an increased risk of side effects, on the other because of problems as a result of drug interaction.

The efficient treatment of pain in the elderly requires specialized knowledge and training in pain therapy. In the preparation of a treatment schedule, one should take into account the existing drug treatment and the potential impact of co-morbidity. Familiarity with important drug interactions that affect the analgesic effect and cause secondary effects is a requirement.


Little evidence, choosing the right painkiller, and the role of PEA

So there is very little evidence for the effectiveness and safety of all kinds of regular pain killers forth elderly. It is therefore on the basis of the present evidence extremely difficult to make a good choice. Indeed, a right choice supported by sufficient scientific evidence is yet impossible.

It is therefore all the more important to consider the safety and efficacy of a substance with the name palmitoylethanolamide, brand name Normast or PeaCure, when deciding about whether to use a painkiller.

This substance has been examined in a large number of clinical studies, and consistently demonstrates to have a positive impact on a range of pains, and this without causing significant side effects. [1] 

For the time being, no dosage limiting side effects have been reported, and the substance may well be taken alongside other painkillers and medicines. Also elderly people do not experience any problems, while many clearly feel the pain-relieving effect of this substance.

This choice for PeaCure is also closely linked to the most recent recommendations on how to treat the elderly who suffer from pain.

In an article in a medical journal from 2011, it was indicated how difficult it is to find good painkillers for the elderly, and to expose them as less as possible to adverse interactions between different medicines and unpleasant side effects.

Because there have no good studies been carried out into the safety and effectiveness of virtually all painkillers, the choice has to be based on an understanding of the pharmacology of pain reliever. And we quote:

Pain is highly prevalent in frail older people who often have multipleco-morbidities and multiple medicines. Rational prescribing of analgesics in frail older people is complex due to heterogeneity in drug disposition, comorbid medical conditions, poly pharmacy and variability in analgesic response in this population.

In the absence or rigorously controlled trials in frail older people and those with cognitive impairment a pharmacologic ally-guided approach can be used to optimize pain management which requires a systematic understanding or the pharmacokinetics and pharmacodynamics or analgesics in frail older people with or without changes incognition.[1]

This supports the choice we have made in our practice to treat older people who suffer from severe chronic pain with the natural pain reliever PeaCure or Normast. The chance of adverse side effects or interaction with other drugs is minimal.


[1] McLachlan AJ, Bath S, Naganathan V, Hilmer SN, Le Couteur DG, Gibson SJ, Blyth FM. | Clinical pharmacology of analgesic medicines in older people: impact of frailty and cognitive impairment. | Br J Clin Pharmacol. | 2011 Mar;71(3):351-64. doi: 10.1111/j.1365-2125.2010.03847.x.