Chronic Pain, Opiates, and Physical Therapy: Considerations for the Older Adult

  • ON-DEMAND Replay
  • Presented: 2 August, 2022
  • CEUs: 1.00


Chronic Pain, Opiates, and Physical Therapy: Considerations for the Older Adult Physical Therapists (PTs) working with adults 65 years or older encounter many patients who have had a pain experience in the past or are currently experiencing pain. According to the Centers for Disease Control (CDC) analysis of the 2016 National Health Interview Survey (NHIS) data, 27.6% of older adults have chronic pain. Pain is subjective, complex, and affected by various external and internal physical, emotional, and environmental factors. The purpose of this session is to provide an evidence-based approach to pain assessment and management that guides clinicians in caring for older adults appropriately without contributing to opioid misuse or the health disparities, ageism, and other means of health inequity commonly faced by older adults with pain. The speakers will share case examples and provide pragmatic suggestions for clinical applications within the team framework including the patient at the center of their care.


  1. Recognize and interpret subjective and objective findings related to chronic pain to create an individualized patient management plan.
  2. Select and interpret evidence-based outcome measures for assessment of pain in older adults.
  3. Integrate knowledge of the physical therapy management of pain in older adults through case studies with concurrent medical management.


  • Dahlhamer J, Lucas J, Zelaya, C, et al. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(36):1001-1006.doi:10.15585/mmwr.mm6736a2
  • Rossettini G, Carlino E, Testa M. Clinical relevance of contextual factors as triggers of place boand nocebo effects in musculoskeletal pain. BMC Musculoskelet Disord. 2018;19(1).doi:10.1186/s12891-018-1943-8
  • Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain —United States, 2016. MMWR Recomm Reports. 2016;65(1):1-49.doi:10.15585/mmwr.rr6501e1er
  • Fick DM, Semla TP, Steinman M, et al. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc.2019;67(4):674-694. doi:10.1111/jgs.15767
  • Wijma AJ, van Wilgen CP, Meeus M, Nijs J. Clinical biopsychosocial physiotherapy assessment of patients with chronic pain: The first step in pain neuroscience education. 2016.
  • Moseley GL, Butler DS. Fifteen Years of Explaining Pain: The Past, Present, and Future. J Pain.2015;16(9):807-813. doi:10.1016/j.jpain.2015.05.005

About The Speaker(s)

Kenneth L Miller, PT, DPT is an assistant professor at the Medical University of South Carolina in the Division of Physical Therapy. Dr Miller is a board-certified geriatric clinical specialist, and advanced credentialed exercise expert for aging adults. His clinical focus is on best practices for use with the older adult population. He has spoken nationally and internationally on topics of gerontology including primary prevention, frailty, outcome measures, pharmacology, best practices, and pain management for the older adult. Dr Miller recently was honored with the faculty achievement award at UNTHSC and is currently involved in survey research regarding student and early career physical therapist mental health, resilience and burnout.
Yein Lee DO, MMS, FAAPMR, is an Associate Professor at the University of North Texas Health Science Center at Fort Worth (HSC), Texas College of Osteopathic Medicine (TCOM). She is board certified in Physical Medicine & Rehabilitation and Neuromusculoskeletal Medicine/ Osteopathic Manipulative Medicine. Dr. Lee graduated from UMDNJ-SOM, which is now Rowan University of School of Osteopathic Medicine, in 2011. She completed her Physical Medicine & Rehabilitation (PM&R) residency at Thomas Jefferson University Hospital in Philadelphia. Then she completed additional training in neuromusculoskeletal medicine/osteopathic manipulative medicine fellowship. Dr. Lee joined HSC as faculty in 2016 where she began her PM&R, musculoskeletal medicine, and performing arts medicine practice. Dr. Lee has been named Top Doctor for the 350 West and Fort Worth Magazine. As a medical educator, she works with student doctors and residents daily.
Sarah Wenger, PT, DPT, OCS, FNAP has been a professor at Drexel University’s College of Nursing and Health Professions since 2007. She is the Coordinator of Academic Integration at Stephen and Sandra Sheller 11th Street Family Health Services, an interprofessional community-based federally qualified health center where she provides pro bono physical therapy services 2 days a week. Dr. Wenger enjoys working with chronic biopsychosocial dynamics and teaching students how to care for patients with complex needs. Her treatment focuses on patient education and building self-efficacy to support and empower patients to manage their chronic conditions as independently as possible. As part of an interprofessional team, Dr. Wenger developed a chronic pain clinical reasoning model and psycho-education program. Dr. Wenger has published and presented on a range of topics related to her clinical and academic areas of expertise in chronic pain, underserved populations, clinical reasoning, and interprofessional care and education

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