Abstract
Aging is associated with natural degenerative processes and with increased frequency of chronic diseases, which may be painful. However, pain is not an inevitable result of aging and its multidimensional characteristics are correlated with higher brain functions. Major landmarks concerning the pathophysiology of pain are the liberation of substance P and other neuropeptides both at the peripheral nociceptors and central endings, and endorphins in various elements of central nervous system. Meticulous differentiation between nociceptive, neuropathic and idiopathic pain is a mandatory prerequisite in planning the treatment rationale of the elderly with pain.