Over-the-counter options include topical analgesics (creams with menthol, capsaicin, or diclofenac), heat and cold therapy products, TENS devices, ergonomic supports and braces, and compression products. These are appropriate for managing chronic musculoskeletal pain when used as directed and are generally safer than oral NSAIDs for long-term use in older adults.
With important caveats. Acetaminophen (Tylenol) is generally safer than NSAIDs (ibuprofen, naproxen) for seniors but must stay within daily limits to avoid liver damage. NSAIDs carry elevated risks of gastrointestinal bleeding, kidney damage, and cardiovascular events in older adults with long-term use. Consult your physician before using any OTC pain medication regularly.
For many common conditions — osteoarthritis, back pain, shoulder pain — evidence supports physical therapy as more effective than medication for long-term pain reduction and functional improvement. Medicare Part B covers physical therapy when medically necessary. Consistent engagement with a physical therapist produces the best outcomes.
Aquatic exercise and gentle yoga reduce pain from arthritis and back conditions with minimal injury risk. Cognitive behavioral therapy (CBT) for pain management has strong evidence, particularly for chronic pain with a significant psychological component. Acupuncture has moderate evidence for lower back and osteoarthritis pain. Heat therapy provides reliable short-term relief for muscle and joint pain.
