Chronic post-surgical pain in older adults: mechanisms, assessment, and management strategies

Chronic postsurgical pain (CPSP) in older adults is a multifactorial condition shaped by biological, psychological, and social determinants. This review synthesizes current evidence regarding the underlying mechanisms, clinical assessment, and management strategies for CPSP in the older adults. Key findings emphasize age related changes in pain processing, significant challenges in pain evaluation particularly among those with cognitive impairment, and the limited effectiveness of conventional analgesic therapies. Multimodal and personalized strategies, such as regional anesthesia, tailored pharmacologic interventions, and integrative approaches including acupuncture, demonstrate potential in reducing the incidence and burden of CPSP. Implementing structured assessment protocols and comprehensive geriatric care models is crucial for enhancing postoperative quality of life. Future initiatives should focus on integrating predictive tools, long term monitoring systems, and interdisciplinary collaboration to improve pain related outcomes in this vulnerable population.