Successful opioid tapering using a non-pharmacological approach in chronic pain: a case report

Résumé fourni par la source

Chronic pain in older adults is a major clinical challenge due to its high prevalence, complex pathophysiology, and frequent impact on function and quality of life. Polypharmacy and prolonged analgesic use, particularly opioids, often complicate management, leading to dependence and adverse effects. We report the case of a 75-year-old woman with chronic low back pain associated with significant functional impairment and opioid dependence. A multimodal, patient-centered approach was implemented, including gradual morphine tapering, transcutaneous electrical nerve stimulation, functional rehabilitation, and structured psychological support. This integrated strategy aimed to control pain while improving mobility and autonomy and addressing psychological dimensions of chronic pain. The patient showed a favorable evolution, with reduced pain intensity, improved functional capacity, and decreased reliance on opioids. Functional autonomy improved the Instrumental Activities of Daily Living score from 4/8 to 6/8; transition from Groupes Iso-Ressources 2 to 4, along with social reintegration. She also reported a subjective improvement in quality of life and increased engagement in her care. This case emphasizes the value of multimodal, non-pharmacological strategies and individualized, function-oriented management in older adults with chronic pain.

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